Three-Dimensional Sonographic Evaluation of the Position of the Fetal Conus Medullaris at First Trimester

2021 ◽  
pp. 1-8
Author(s):  
Ruben Ramirez Zegarra ◽  
Nicola Volpe ◽  
Evelina Bertelli ◽  
Greta Michela Amorelli ◽  
Luigi Ferraro ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Umbilical Cord ◽  
Interobserver Agreement ◽  
Interobserver Variability ◽  
First Trimester ◽  
3D Ultrasound ◽  
Conus Medullaris ◽  
Consecutive Series ◽  
Fetal Life ◽  
Umbilical Cord Insertion

<b><i>Objective:</i></b> The objective of this study was to assess the position of the conus medullaris (CM) at the first trimester 3D ultrasound in a cohort of structurally normal fetuses. <b><i>Methods:</i></b> This was a multicenter prospective study involving a consecutive series of structurally normal fetuses between 11 and 13 weeks of gestation (CRL between 45 and 84 mm). All fetuses were submitted to 3D transvaginal ultrasound using a sagittal view of the spine as the starting plane of acquisition. At offline analysis, the position of the CM was evaluated by 2 independent operators with a quantitative and a qualitative method: (1) the distance between the most caudal part of the CM and the distal end of the coccyx (CMCd) was measured; (2) a line perpendicular to the fetal spine joining the tip of the CM to the anterior abdominal wall was traced to determine the level of this line in relation to the umbilical cord insertion (conus to abdomen line, CAL). Interobserver agreement for the CCMd was evaluated. Linear regression analysis was used to determine the association between the CMCd and CRL, and a normal range was computed based on the best-fit model. The absence of congenital anomalies was confirmed in all cases after birth. <b><i>Results:</i></b> In the study period between December 2019 and March 2020, 143 fetuses were recruited. In 130 fetuses (90.9%), the visualization of the CM was feasible. The mean value of the CMCd was 1.09 ± 0.16 cm. The 95% limits of agreement for the interobserver variability in measurement of the CMCd were 0.24 and 0.26 cm. The interobserver variability based on the intra-class correlation coefficient (ICC) for the CCMd was good (ICC = 0.81). We found a positive linear relationship between the CCMd and CRL. In all these fetuses, the CAL encountered the abdominal wall at or above the level of the cord insertion. <b><i>Conclusion:</i></b> In normal fetuses, the assessment of the CM position is feasible at the first trimester 3D ultrasound with a good interobserver agreement. The CM level was never found below the fetal umbilical cord insertion, while the CMCd was noted to increase according to the gestational age, confirming the “ascension” of the CM during fetal life.

scholarly journals First trimester diagnosis of body stalk anomaly complicated by ectopia cordis

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052098021
Author(s):  
Yi Yang ◽  
Hong Wang ◽  
Zhenpeng Wang ◽  
Xuefeng Pan ◽  
Ying Chen
Keyword(s):  
Abdominal Wall ◽  
Umbilical Cord ◽  
Chromosomal Abnormalities ◽  
Abdominal Wall Defect ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Ectopia Cordis ◽  
Wall Defect ◽  
Abdominal Organs ◽  
Increased Risk

Body stalk anomaly is a rare abnormality characterized by an abdominal wall defect with evisceration of abdominal organs, severe kyphoscoliosis, and a very short or absent umbilical cord. Ectopia cordis (EC) is a rare, lethal anomaly characterized by complete or partial malpositioning of the heart outside of the thorax. A 28-year-old healthy primigravida was referred to our department to undergo a nuchal translucency thickness scan at 12 weeks’ gestation. The scan revealed typical features of body stalk anomaly and EC. Given the lethal condition of the fetus, the patient opted for termination of the pregnancy. Body stalk anomalies, especially those complicated by EC, are universally lethal for the affected fetus. Selective termination should be recommended to avoid possible complications that can arise during pregnancy. Additionally, the future parents should be informed that because the condition is not associated with chromosomal abnormalities, there is no increased risk of recurrence.

scholarly journals 6-(2,3-Dichlorodiphenyl)-1,2,4-Triazine-3,5-Diamine Use in Pregnancy and Body Stalk Anomaly- A Possible Association?

2019 ◽  
Vol 70 (7) ◽  
pp. 2656-2659
Author(s):  
Anca Huniadi ◽  
Andrea Sorian ◽  
Adrian Maghiar ◽  
Diana Mocuta ◽  
Liana Antal ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Umbilical Cord ◽  
Abdominal Wall Defect ◽  
Medical Abortion ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Caucasian Woman ◽  
Ultrasound Images ◽  
Large Defect ◽  
Acquired Epilepsy

Body Stalk Anomaly is a rare malformation syndrome characterized by anterior abdominal wall defect, kyphoscoliosis, limb reduction, rudimentary umbilical cord, craniofacial defects and anomalies of the chest wall. The association between antiepileptic drugs, such as Lamotrigine [6-(2,3-dichlorophenyl)- 1,2,4-triazine-3,5-diamine], and the development of such malformation have been studied for many years. Many studies can be found regarding the teratogenic potential of Lamotrigine, but they have contradictory results. We present the case of a 34-year old pregnant, caucasian woman, known with acquired epilepsy due to neurocysticercosis for which she is under treatment with Lamotrigine 400mg/day. The patient was examined at 12 weeks of gestational age, when the ultrasound images showed a large defect in the fetal abdominal wall: eviscerated liver and bowel outside the coelomic cavity, kyphoscoliosis, a short umbilical cord, nuchal translucency 2.8mm, mandibular retrognathism. Based upon the aforementioned ultrasound findings we considered the diagnosis to be Body Stalk Anomaly and recommended a medical abortion. Embryological remainings were sent to pathology and genetic department revealing Turner Syndrome. We consider important to detect typical features of the anomaly in the first trimester and distinguish it from other abdominal defects like omphalocele and gastroschisis, since the conditions imply different management. Another important issue is to be aware about the treatment with Lamotrigine.

Placental volume measurement by 3D-ultrasound in the first trimester and prediction of fetal growth

2008 ◽  
Vol 68 (S 01) ◽  
Author(s):  
B Meurer ◽  
B Meurer ◽  
N Dinkel ◽  
N Hart ◽  
J Siemer ◽  
...  
Keyword(s):  
Fetal Growth ◽  
First Trimester ◽  
3D Ultrasound ◽  
Volume Measurement ◽  
Placental Volume

scholarly journals Evaluation of the risk of umbilical cord prolapse in the second twin during vaginal delivery: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046616
Author(s):  
Rokuhiro Asahina ◽  
Hiroyuki Tsuda ◽  
Yuki Nishiko ◽  
Kazuya Fuma ◽  
Momoko Kuribayashi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Umbilical Cord ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Cord Prolapse ◽  
Umbilical Cord Insertion ◽  
Umbilical Cord Prolapse ◽  
Second Twin

ObjectiveThis study aimed to evaluate the success rate of vaginal delivery, the reasons for unplanned caesarean delivery, the rate of umbilical cord prolapse and the risk of umbilical cord prolapse in twin deliveries.DesignRetrospective cohort study.SettingSingle institution.ParticipantsThis study included 455 women pregnant with twins (307 dichorionic and 148 monochorionic) who attempted vaginal delivery from January 2009 to August 2018. The following criteria were considered for vaginal delivery: diamniotic twins, cephalic presentation of the first twin, no history of uterine scar, no other indications for caesarean delivery, no major structural abnormality in either twin and no fetal aneuploidy.ResultsThe rate of vaginal delivery of both twins was 89.5% (407 of 455), caesarean delivery of both twins was 7.7% (35 of 455) and caesarean delivery of only the second twin was 2.9% (13 of 455). The major reasons for unplanned caesarean delivery were arrest of labour and non-reassuring fetal heart rate pattern. The rate of umbilical cord prolapse in the second twin was 1.8% (8 of 455). Multivariate analysis revealed that abnormal umbilical cord insertion in the second twin (velamentous or marginal) was the only significant factor for umbilical cord prolapse in the second twin (OR, 5.05, 95% CI 1.139 to 22.472, p=0.033).ConclusionsAbnormal umbilical cord insertion in the second twin (velamentous or marginal) was a significant factor for umbilical cord prolapse during delivery. Antenatal assessment of the second twin’s umbilical cord insertion using ultrasonography would be beneficial.

Relation of site of umbilical cord insertion and birth weight

1988 ◽  
Vol 9 (1) ◽  
pp. 34-35 ◽  
Author(s):  
N. Bruyniks ◽  
T. Y. Khong ◽  
R Leong
Keyword(s):  
Birth Weight ◽  
Umbilical Cord ◽  
Umbilical Cord Insertion

The Development of the Embryo and Membranes of the Humpback Whale, Megaptera nodosa (Bonnaterre)

1960 ◽  
Vol 11 (3) ◽  
pp. 365 ◽  
Author(s):  
CW Stump ◽  
JP Robins ◽  
ML Garde
Keyword(s):  
Umbilical Cord ◽  
Uterine Cavity ◽  
Distal Region ◽  
Yolk Sac ◽  
Consecutive Series ◽  
Chorionic Villi ◽  
Suspensory Ligament ◽  
Foetal Membranes ◽  
Uterine Fluid ◽  
Tubular Form

The material consists of 20 embryos (5-30 mm) and two foetuses (63 mm and 90 mm) collected at whaling stations on Moreton and Norfolk Islands (latitude 27� 11'S. and 29� 5' S. respectively) during late August, September, and early October in 1952-53-54 and 1956. The consecutive series permitted the study of membrane formation and organogenesis. Younger embryos are found in grooves between the folds of endometrium in a constant site in that uterine horn associated with the ovary containing the recent corpus luteum. Older embryos and the early foetus are adapted to lie freely in the uterine fluid, and are devoid of any mechanism for apposition or attachment to the endometrium. Variation in the sequence of the association of the components of the umbilical cord provides suspensory structures for the amnion and yolk sac, and for the embryo a bifid ligament, retained in the early foetus for attachment of the foetal membranes. In the younger foetus the allantoic duct drains the nephric secretion into the uterine cavity. In the older foetus chorionic villi are present. The bifid suspensory ligament forms the major part of the distal region of the umbilical cord. The allantoic duct is reunited with the allantoic sac. Amniogenesis is by folding. During the embryonic period the chorio-amniotic connection forms a suspensory ligament. The yolk sac, attached by a novel ligament to the amnion, is large and functional in the embryo. In the foetus vascular splanchnopleure is present in a tubular form. A rete system develops in the embryo.

scholarly journals P25.09: First trimester umbilical cord cyst

2008 ◽  
Vol 32 (3) ◽  
pp. 400-400
Author(s):  
S. R. Kim ◽  
K. D. Ki ◽  
S. Y. Tong ◽  
J. M. Lee ◽  
E. H. Yoo ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
First Trimester ◽  
Umbilical Cord Cyst
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