The aim of this study was to establish a method for determination of fetal lung volume by three-dimensional ultrasound. The thoraces of a total of 113 fetuses (singleton pregnancies, 11-41 weeks of gestation without any signs of malformation or oligohydramnios) were examined by three-dimensional ultrasound. Volumetric evaluation of each lung was performed in each of three perpendicular planes (six measurements in total). There were significant differences in all three measurements between the left and right lungs. Especially in the second and third trimesters, measurement of the frontal and the sagittal planes was sometimes prevented by poor imaging conditions. The scan volume was always too small for fetuses above 34 weeks. With these problems considered, nomograms of fetal lung volume for the left and the right lung were calculated. Lung volumes in the present study showed good correlation with published autopsy findings. Three-dimensional ultrasonographic volumetry is a useful method for determining fetal lung volume and may have a role to play in the detection of pulmonary hypoplasia.

Background State-of-the art therapy for recurrent ovarian cancer (ROC) suitable for platinum-based re-treatment includes bevacizumab-containing combinations (eg, carboplatin/paclitaxel, carboplatin/gemcitabine) or the most active non-bevacizumab regimen: carboplatin/pegylated liposomal doxorubicin (PLD). This head-to-head trial compared a standard bevacizumab-containing regimen versus carboplatin/PLD combined with bevacizumab. Methods In this multicentre, open-label, randomised, phase 3 trial, eligible patients had histologically confirmed epithelial ovarian, primary peritoneal, or fallopian tube carcinoma with first disease recurrence >6 months after first-line platinum-based chemotherapy, and were aged ≥18 years with Eastern Cooperative Oncology Group performance status 0-2. Patients were stratified by platinum-free interval, residual tumour, prior anti-angiogenic therapy, and study group language, and centrally randomised 1:1 using randomly permuted blocks of size two, four, or six to six intravenous cycles of carboplatin (AUC 4, day 1) plus gemcitabine (1000 mg/m 2 , days 1 and 8) every 3 weeks or six cycles of carboplatin (AUC 5, day 1) plus PLD (30 mg/m 2 , day 1) every 4 weeks, both given with bevacizumab (15 mg/kg every 3 weeks or 10 mg/kg every 2 weeks) until disease progression or toxicity. The primary endpoint was investigator-assessed progression-free survival (PFS). Efficacy data were analysed in the intention-to-treat population (all randomised patients). Safety was analysed in all patients who received at least one dose of study drug. This completed study is registered with ClinicalTrials.gov number NCT01837251.

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In standard measuring planes, lemon sign, banana sign and an inability to image the cistern magna are very reliable indirect ultrasound markers of spina bifida. © 2014 John Wiley & Sons, Ltd.

The early fetal ultrasound assessment at 11 - 13(+6) weeks of gestation remains the cornerstone of care despite the progress in diagnosing fetal chromosomal defects using cell-free fetal DNA (cffDNA) from the maternal circulation. The measurement of nuchal translucency (NT) allows the risk calculation for the fetal trisomies 21, 18 and 13 but also gives information on those fetal chromosomal defects which are at present unable to be detected using cffDNA. Nuchal translucency is the only auditable parameter at 11 - 13(+6) weeks and gives thus information on the quality of the first trimester anomaly scan. In addition it gives indirect information on the risks for fetal defects and for cardiac anomalies. Also the chances for a healthy live baby can be estimated. As experience with first trimester anomaly scanning increases, and the resolution of the ultrasound equipment has increased substantially, more and more details of the fetal anatomy become accessible at the first trimester scan. Therefore fetal anatomical defects and complex anomalies have become amenable to examination in the first trimester. This guideline describes compulsory and optional parameters for investigation at the first trimester scan and outlines a structured method of examining a first trimester fetus at 11 - 13(+6) weeks of gestation.