All newborns (n=8,896) sequentially delivered in the Maternal and Child Health Hospital of Milan underwent US examination in the first week of life and, when findings were within normal limits, in the third month of life. Subjects categorised at birth as Graf type 2a with alpha angle between 50 degrees and 52 degrees, underwent a further US examination at the end of the first month of life. Subjects with ambiguous findings at the 3-month examination were re-examined at the end of the fourth month of life. All infants with abnormal hips abandoned the screening process and underwent treatment. RESULTS. Overall, 56 cases of DDH were identified: 34 in the first week of life examination, 10 at 1 month; 10 at 3 months and 2 at 4 months. CONCLUSIONS. A two-step US screening of newborns is recommended: at the end of the first month and within the fourth month of life.
At present it is possible to detect prenatally many abnormalities of the central nervous system with ultrasound. This report presents a case of glioblastoma detected in the 33rd week of pregnancy.
CASE REPORTA 21-year-old woman, gravida 1 with a normally progressing pregnancy, came for an ultrasound examination at the Provincial Maternal Hospital of Milan because of clinical signs of hydramnios. She had had an ultrasound examination at another hospital during her 18th week and the results were within the limits of normal. Our examination, during the 33rd week, indicated that hydramnios was present. There was a single fetus having a hydropic appearance in longitudinal lie, with a vertex presentation. Heart activity and movements, and fluid in the thoracic and abdominal cavities were noted. The biparietal diameter was 11.0 cm (above the 95th percentile). Study of the head of the fetus revealed that the falx cerebri was shifted toward the left by a strongly echogenic mass that occupied the posterior two thirds of the right cerebral hemisphere. The anterior third and the contralateral hemisphere were anechogenic (Fig. 1). This ultrasound picture was compatible with a large lesion associated with contralateral hydrocephalus. The day after the ultrasound examination labor began and a cesarian section was performed. The neonate died 20 minutes after delivery.The male fetus was premature, weighed 3390 g, was 42 cm long, and had a cranial circumference of 32.5 cm. The skin was extremely pallid, subcutaneous tissue and muscles highly edematous, pleural and ascitic fluid abundant, and very anemic viscera. The right cerebral hemisphere consisted of hemorrhagic tissue that looked like placenta and the contralateral ventricle was dilatated. The histological sections of the mass showed highly vascularized tissue consisting of a rich population of moderately polymorphic cells,
We report a case in which a discrepancy emerged between the prenatal diagnosis of female chromosomal sex and male sex at ultrasound examination. The FSH dosage performed on an amniotic fluid sample previously stored confirmed the male phenotype of the fetus. The effectiveness of the AF-FSH level dosage in prenatal diagnosis was taken into consideration.
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