Fetal esophageal imaging: Early pregnancy as a window of opportunity

Abstract

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.

Early Fetal Corpus Callosum: Demonstrating Normal Growth and Detecting Pathologies in Early Pregnancy

“…The advent of high-frequency transducers offers the opportunity to bring forward anomaly screening to the first trimester. [15][16][17][18][19][20] A recent publication depicted the early development of the CC on sonography, between 14 and 17 weeks; 21 however, whether at 13 weeks of gestation the commissural fibers of the CC have developed and can be demonstrated is still debated. 3,21,22 The aims of the study were the following: 1) to construct a normal modeled reference chart of the length of the fetal CC on 2D ultrasound between 13 and 19 weeks of gestation, 2) to propose imaging criteria to support identification of the early CC, and 3) to prospectively examine the growth of the CC in suspected or confirmed pathologic cases.…”