Objectives To construct a nomogram of fetal stomach, and to prospectively determine the clinical value of stomach measurement in pathological cases. Methods A cross‐sectional prospective study was conducted between 14 and 40 weeks in well‐dated, low‐risk, singleton pregnancies. Stomach dimensions were acquired in longitudinal plane in which maximal stomach length was measured, and in axial plane in which were measured: antero‐posterior and latero‐lateral. Stomach maximal and axial 1st to 99th centiles were calculated for each gestational‐week. Results Five hundred fifty‐four measurements were performed. A cubic polynomial regression model best described the correlation between stomach size and gestational age. The correlation coefficient (r2) was 0.627 and 0.754 (p < 0.001) for the stomach axial and maximal diameters, respectively. Intra‐ and interobserver variability had high interclass correlation coefficients (>0.9). Nomograms were created for predicted stomach axial and maximal 1st, 3rd, 10th, 25th, 50th,75th, 90th, 95th, 97th, and 99th centiles. The nomogram correctly detected 92.3% (12/13) of pathological cases including three bowel obstruction, eight esophageal atresia, and two hypotonic syndromes. Conclusions The present study provides updated nomograms of the fetal stomach. Clinical application of these nomograms may assist in preventing unnecessary investigation in falsely perceived small or large stomachs and may improve the in utero detection of true pathologies.

Objectives Abnormal fetal tongue size is a phenotypic feature of various syndromes including Beckwith‐Wiedemann, Pierre‐Robin, oromandibular limb hypoplasia, chromosomal aberrations, etc. Current data regarding normal fetal tongue size are limited. Hence, micro/macroglossia are subjectively determined. The aim of the study was to construct a contemporary fetal tongue nomogram and to assess its clinical contribution. Methods A prospective cross‐sectional study was performed in well dated, low risk, singleton pregnancies. Fetal tongues were measured by 5 trained sonographers. Highest quality images were selected. Intra‐ and interobserver variability was assessed. Tongue length, width, area, and circumference 1st to 99th centiles were calculated for each gestational week. Based on the normal tongue size charts, we created a Tongue Centile Calculator. Results Over 18 months, 664 tongue measurements were performed. A cubic polynomial regression model best described the correlation between tongue size and gestational age. The correlation coefficient (r2) was 0.934, 0.932, 0.925, and 0.953 for tongue length, width, area, and circumference, respectively (P < .001). Intra‐ and interobserver variability had high interclass correlation coefficients (>0.9). Using the new charts, we were able to identify 2 cases of macroglossia, subsequently diagnosed with Beckwith‐Wiedemann, and 4 cases of microglossia, 3 associated with Pierre‐Robin sequence, and 1 associated with persistent buccopharyngeal membrane. Conclusions We present novel fetal tongue size charts from 13 to 40 weeks of gestation. Clinical application of these nomograms may be beneficial in the prenatal diagnosis of syndromes or malformations associated with abnormal fetal tongue size.

Objective: To describe the sonographic appearance of the fetal esophagus during early pregnancy and evaluate the feasibility of imaging the entire esophageal length.In addition, we present a case of disrupted esophageal continuity, subsequently diagnosed with esophageal atresia (EA).Methods: A prospective observational study of 145 patients. During the early second trimester anomaly scan performed at 12-17 weeks' gestation the entire esophagus was captured in a single sonographic image at the midsagittal plane (one shot technique). Postnatal follow-up of esophageal patency included review of medical records and telephone interviews.Results: Complete visualization of the esophagus (neck to diaphragm) was possible in 144 cases. In 88% of cases the esophagus was demonstrated by transvaginal approach. The time required to obtain the desired view of the esophagus, once the fetus was in an optimal position, was on average 13 s (range: 5-30 s). In one case at 15 weeks' gestation, the cervical segment of the esophagus was demonstrated while the lower thoracic segment was not identified. Subsequently EA was diagnosed. Conclusions:It is feasible to demonstrate the entire esophagus during early second trimester anomaly scan. An early second trimester anomaly scan may serve as a window of opportunity for EA screening.

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Objectives: Abnormal fetal tongue size is a phenotypic feature of various congenital syndromes including Beckwith-Wiedemann, Pierre-Robin, oromandibular limb hypoplasia, chromosomal aberrations and more. Currently, data regarding fetal tongue size are limited (Achiron et al in 1997). Therefore, micro and macroglossia are subjectively determined. The aim of the study was to construct a contemporary fetal tongue nomogram between 13-40 weeks of gestation. Methods: A prospective cross-sectional study was performed in low risk, well dated, singleton pregnancies. Fetal tongue measurements were taken and recorded by four trained sonographers. The highest quality images in the axial plane were selected. Intra-and interobserver variability was assessed. Tongue length, width, area and circumference percentiles were calculated for each gestational week. Results: Over a period of 18 months, 664 tongue measurements were performed. A cubic polynomial regression model best described the correlation of tongue size with gestational age. The correlation coefficient (r2) was 0.934, 0.932, 0.925 and 0.953 for tongue length, width, area and circumference, respectively (p < 0.001). Intra-and interobserver variability had high interclass correlation coefficients (> 0.9). During the study period, using the new charts we were able to identify two cases of macroglossia, subsequently diagnosed with Beckwith-Wiedemann, and three cases of microglossia, two associated with Pierre-Robin sequence and one associated with persistent buccopharyngeal membrane. Conclusions: We present contemporary, comprehensive fetal tongue size charts from 13 to 40 weeks of gestation. Using these nomograms assisted the detection of genetic abnormalities associated with abnormal fetal tongue size. Clinical application of these novel nomograms may be beneficial in the prenatal diagnosis of syndromes associated with micro/macroglossia. VP10.02 A new sign to be sure of soft palate integrity: the uvulaepiglottis distance

Cancer is the second most common cause of death in the United States, accounting for 602,350 deaths in 2020. Cancer-related death rates have declined by 27% over the past two decades, partially due to the identification of novel anti-cancer drugs. Despite improvements in cancer treatment, newly approved oncology drugs are associated with increased toxicity risk. These toxicities may be mitigated by pharmacokinetic optimization and reductions in off-target interactions. As such, there is a need for early-stage implementation of pharmacokinetic (PK) prediction tools. Several PK prediction platforms exist, including pkCSM, SuperCypsPred, Pred-hERG, Similarity Ensemble Approach (SEA), and SwissADME. These tools can be used in screening hits, allowing for the selection of compounds were reduced toxicity and/or risk of attrition. In this short commentary, we used PK prediction tools in the optimization of mitogen activated extracellular signal-related kinase kinase 1 (MEK1) inhibitors. In doing so, we identified MEK1 inhibitors with retained activity and optimized predictive PK properties, devoid of hERG inhibition. These data support the use of publicly available PK prediction platforms in early-stage drug discovery to design safer drugs.

The optimal risk cutoff value was 0.003 with sensitivity 80.0% (28.4-99.5), specificity 91.7% (89.5-93.5), positive likelihood ratio 9.6 (5.8-15.8), and negative likelihood ratio 0.2 (0.04-1.3). The risk cutoff value of which the sensitivity was 100% was 0.00065. Conclusions: A simple and traditional method of calculating the risk of DS using maternal age and NT thickness may be acceptable to screen DS in triplet pregnancy.