The objective of this paper was to determine the rate of prenatal detection of ultrasonographic abnormalities in fetuses with trisomy 18 during the early second trimester. Our prenatal diagnosis database (encompassing January 1987 to June 1996) was searched for all patients referred for prenatal genetic evaluation between 14 and 22 weeks of gestation and who were found to have a fetus with a trisomy 18 karyotype. The sonographic reports and films were evaluated for the presence or absence of fetal anatomic abnormalities. Thirty-five fetuses were identified with a mean age of 17.3+/-2.0 (standard deviation) weeks. Thirty of the 35 (86%) had at least one detected abnormality. Most fetuses had more than one abnormality, with the mean number of abnormalities per fetus being three (range, 0 to 6). The most common abnormalities noted were persistent abnormal position of fetal fingers (89%); choroid plexus cysts (43%); abnormally shaped fetal head (strawberry or lemon) (43%); two-vessel umbilical cord (40%); cardiac defects (37%); intrauterine growth restriction (29%); omphalocele (20%); neural tube defects (9%); and cystic hygroma or lymphangiectasia (14%). Abnormalities of amniotic fluid volume (12%) and renal defects (9%) were seen less frequently. These data suggest that in the early second trimester, the time of most routine screening ultrasonographic examinations, most but not all fetuses with trisomy 18 have sonographically detectable anatomic abnormalities. The fetal hand appears to be abnormal in most early second trimester fetuses with trisomy 18, but the abnormality may be subtle and or unilateral.

Transvaginal and translabial techniques should not be used interchangeably for clinical assessment of cervical length because agreement between the methods is not within an acceptable range.

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In a prospective study, 15 pregnant patients with a total of 7 leiomyomas and 10 focal myometrial contractions were evaluated with color flow imaging. Images were graded based on vascularity. Leiomyomas were grade III (hypervascular) in 85.7% and grade II (peripheral flow only) in 14.3% of cases. Contractions were grade I (hypovascular) in 80% and grade II in 20% of cases. Contractions involving the placenta demonstrated vascularity adjacent to the myometrium at the placentation site. Color flow imaging is useful when used in conjunction with two-dimensional findings to differentiate between leiomyomas and focal myometrial contractions during pregnancy.Leiomyomas are the most common solid uterine mass found during pregnancy, occurring in 0.3% to 2.6% of all pregnancies. I Only 40% of leiomyomas diagnosed sonographically during pregnancy, however, are clinically detected. 2 On ultrasound, leiomyomas may be mistaken for ovarian tumors, the cornua of a bicornuate uterus, or focal myometrial contractions.3 It is especially difficult to differentiate between leiomyomas of less than 3 cm and focal myometrial contractions. The ultrasound differentiation of leiomyomas from focal myometrial contractions is usually based on two-dimensional characteristics. To date, a comparison of color flow characteristics of leiomyomas and focal myometrial contractions has not been discussed. This study compares and contrasts the color flow characteristics of leiomyomas and focal myometrial contractions and discusses the diagnostic implications of the findings. Materials and MethodsColor flow imaging was used to examine 15 patients with a total of 7 leiomyomas and 10 contractions (two patients had both a leiomyoma and a contraction). Of the 15 patients, 3 were in the first trimester of pregnancy (20%), 9 were in the second