Antenatal diagnosis of bilateral fetal inguinal hernias

We report a case of prenatal ultrasound diagnosis of bilateral inguinal hernias. The two earlier ultrasound examinations at 17 and 22 weeks of gestations showed normal scrotal sac. An ultrasound examination at 41 weeks demonstrated non-cystic scrotal swelling that proved to be bilateral inguinal hernias containing loops of small intestines.     

Antenatal diagnosis of fetal renal calculus.

Pediatric urolithiasis is commonly associated with structural renal tract anomalies and metabolic disorders. Antenatal diagnosis of renal calculi is extremely rare, with only one report in the literature. We present a case of renal stone formation diagnosed at 34 weeks' gestation on ultrasound examination.     

Antenatal diagnosis of fetal intra-abdominal umbilical vein dilatation.

Dilatation of the intra-abdominal portion of the fetal umbilical vein is a rare abnormality. We describe here a new case diagnosed at 31 weeks of gestation and discuss the clinical features and management of this abnormality.     

Antenatal 3-dimensional sonographic diagnosis of fetal oropharyngeal teratoma

We report a case of a large fetal oropharyngeal teratoma in a 19-week fetus evaluated with 3-dimensional (3D) sonography. The 3D sonographic surface and maximum mode rendering of the tumor allowed detailed visualization of the mass lesion and thus enabled active patient participation in the management of the pregnancy.     

Antenatal diagnosis and treatment of fetal hydrops secondary to pulmonary extralobar sequestration.

Bronchopulmonary sequestration with associated non-immune hydrops has been previously reported with generally poor prognosis for the neonate. The vast majority of sequestrations are discovered postnatally, and less than half are correctly identified as sequestration before birth.Until recently, treatment for pulmonary sequestration was limited to postnatal respiratory support and resection of the sequestered lung. But aggressive respiratory support does not succeed in salvaging infants with underlying pulmonary hypoplasia. In our report, we describe the antenatal treatment of pleural effusions complicated by hydrops fetalis secondary to a bronchopulmonary sequestration, successfully managed with a transthoracic catheter placement. This therapy resulted in the resolution of pleural effusion, polyhydramnios and hydrops, with a good fetal outcome.     

Antenatal diagnosis and treatment of a case of fetal goitrous hypothyroidism associated with high-output cardiac failure.

A case of fetal goitrous hypothyroidism associated with high-output cardiac failure is presented. At 32 weeks of gestation, the antenatal diagnosis of goiter was made based on ultrasound examination, and the fetal thyroid function was examined by amniocentesis and cordocentesis. Color and pulsed Doppler examinations demonstrated a high vascular flow pattern in the goiter and marked elevation of the maximum velocity in the common carotid artery at the level of the neck. It was suspected that arteriovenous shunting through the large goiter resulted in high-output cardiac failure with cardiomegaly and pleural effusion. The fetus was treated by injection of levothyroxine sodium into the amniotic fluid at 33 weeks of gestation and the goiter thereafter decreased in size, with subsequent improvement of the high-output cardiac failure. The maximum velocity in the common carotid artery fell rapidly before the shrinkage of the fetal goiter and in parallel with the fetal level of thyroid stimulating hormone.     

产前超声鉴别诊断胎儿颈部肿块

目的 探讨产前超声鉴别诊断胎儿颈部肿块的价值。方法 回顾性分析50胎颈部肿块胎儿的影像资料及部分胎儿染色体结果,与产后新生儿特殊检查或病理结果相比较,总结其声像图特征、鉴别诊断要点与预后。结果 129 173胎胎儿（127 577例孕妇）产前超声共检出50胎颈部肿块。32胎经产后CDFI、MRI、CT或术后病理随访确诊,诊断淋巴管瘤20胎、血管瘤4胎、梨状窝囊肿8胎;18胎淋巴管瘤经引产后尸体解剖证实。超声对颈部肿块的诊断符合率为98.00%（49/50）。26胎淋巴管瘤超声表现为多房囊性,内见粗或细分隔带回声,肿块边界不清;12胎为单房囊性,囊壁薄,囊内透声好;CDFI示6胎肿块周边及分隔上星点状血流信号,32胎肿块无血流信号。颈部血管瘤超声表现为混合性或稍低实性,内部为厚壁囊性,呈蜂窝状,边界清晰;CDFI示肿块周边及内部丰富血流信号,其中1胎示动静脉瘘血流信号。6胎梨状窝囊肿超声显示为单房薄壁囊性,2胎合并感染囊壁增厚,囊内显示液平面;CDFI示6胎囊肿周边无血流信号,2胎囊肿周边星点状血流信号。结论 产前超声可应用于胎儿颈部肿块的鉴别诊断。