Asymptomatic persons with lymphatic filariasis may harbor microfiliariae in the circulation, and despite the lack of symptoms, these patients may have occult pathologic lesions and renal abnormalities. Earlier investigators have shown that it is possible to detect live adult filarial worms and dilation of lymphatic channels with ultrasonography. It is also possible to assess response to therapy. Using sonography, we detected twirling motions in dilated lymph channels and characteristic sonographic findings associated with presence of adult filariae. On follow-up examination we also found evidence of loss of worm activity after chemotherapy.

Objective Compare the performance of first trimester ultrasound biparietal diameter (BPD) screening for open spina bifida (OSB) when BPD is adjusted for crown‐rump length (CRL) or abdominal circumference (AC). Methods For 63 OSB and 24 265 unaffected pregnancies, BPD was expressed as multiple of the normal median (MoM) based on CRL and on AC, and as the ratio BPD/AC. Screening performance was assessed by the Mahalanobis distance, the observed detection rate with normal fifth and 10th percentile cut‐offs and the area under the receiver‐operator characteristic curve (AUC). Results Mahalanobis distance for BPD MoM was considerably higher when based on AC than on CRL: 1.69 versus 1.14. Screening performance was also higher: using a fifth percentile cut‐off, the detection rate was 59% compared with 41%; using a 10th percentile cut‐off, the rates were 63% and 51%. Whilst the false‐positives rates were slightly higher too—5.3% versus 5.1% and 10.8% versus 9.9%—the AUC was statistically significantly higher: 0.872 (95% CI, 0.816‐0.928) compared with 0.735 (95% CI, 0.664‐0.806). BPD/AC had intermediate performance. Conclusion The best results are obtained when AC, rather than CRL, is used to express BPD values in MoMs. First trimester OSB screening can detect half to two‐thirds of cases.

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Blomstrand osteochondrodysplasia (BOCD) is a rare autosomal recessive sclerosing skeletal dysplasia characterized by accelerated chondrocyte differentiation. In this article, we discuss three cases where lethal skeletal dysplasia was suspected and Blomstrand dysplasia was diagnosed by autopsy. Antenatal ultrasound findings include increased nuchal translucency, tetramicromelia and polyhydramnios. Radiological hallmark is advanced skeletal maturation and bone sclerosis. Histology of long bones revealed narrow cartilagenous cap and changes in the physeal growth zone which showed severe hypoplasia and disorganization of proliferative phase and hypertrophic phase. Homozygous and compound heterozygous mutations in PTHR1 gene have been implicated in the pathogenesis of this chondrodysplasia.

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