The reference values of the cross-sectional area of umbilical cord increased according to gestational age until the 33rd week and are related to parameters of fetal growth.

No abstract

The placenta is fundamental for fetal development. It combines the functions of an endocrine organ, kidneys, lungs and intestines, purifying catabolites, oxygenating and nourishing the conceptus. Its fetal portion is the largest part develops from the chorionic sac. The maternal portion, which is smaller, is originated in the endometrium, more specifically in the decidua basalis. The placenta starts its function closer to the fourth week of gestation, when anatomical arrangements for the physiological exchanges are already established. The circulatory function of the placenta appears at an early stage of embryo-placental development and it is strongly related to fetal growth, to the placental size and to uterine and umbilical blood flows. Therefore, an adequate placental angiogenesis is critical for the establishment of a normal placental vascularization with consequent normal development of the fetus. In this review article, the authors discuss about placental ontogeny, focusing on the main aspects of its normal development, and about the recent advances in ultrasonography for the study of the vascular architecture of the placenta through three-dimensional power Doppler ultrasonography.

The HS had higher diagnostic accuracy in the detection of uterine cavity anomalies and it was better tolerated by the patients when compared to hysterosalpingography and hysteroscopy.

3DPD placental vascular indices obtained using the automatic sphere mode had a good intra and interobserver reproducibility for pregnancies between 26 and 35 weeks. The FI obtained the highest reproducibility scores.

The authors describe a new methodology for volumetric calculation through three-dimensional ultrasonography called eXtended Imaging VOCAL (XI VOCAL), which is part of the software Three-dimensional eXtended Imaging (3DXI). This software virtualizes real organs, by analyzing the volume through a diagram of slice sections (Multi-slice view) that simultaneously shows a sequence of images in parallel planes, and establishes the volume of the organ. Because of the importance of accurate volumetric measurements in obstetric ultrasonography, a new method allowing this measurement should be regarded as of great interest.

We present a case of interstitial gestation diagnosed in the sixth week in an asymptomatic woman, who had a previous diagnosis of primary infertility. The 2D-TVUS revealed the presence of a gestational sac outside of the uterine cavity; moreover the colored Doppler and the power Doppler indicated a thriving vascular ring. The 3D-TVUS in the surface and transparency mode demonstrated that the gestational sac was located in the interstitial region of the uterine tube, and the niche mode accurately evaluated the relationship between the gestational sac and the uterine cavity. The patient was successfully treated with a local injection of methotrexate guided by a transvaginal ultrasonography. The 3D-TVUS was of great importance to confirm the diagnosis, to allow appropriate therapeutic choices and to decrease the morbidity.

The results obtained here suggest that the uterine factor has high prevalence in patients with a RPL history, and for this reason it should be systematically assessed in patients with a RPL history.