Measurement of the Area and Circumference of the Leg

Abstract

Objective-To standardize a new technique to evaluate the fetal leg muscle trophism by measuring the area and circumference, and comparing this technique between normal and fetuses with open lumbosacral spina bifida (SB).Methods-Observational cross-sectional study was carried out on pregnant women with 26 weeks who were divided into two groups: Group I-fetuses with diagnosis of open lumbosacral SB; Group II-normal fetuses (control). In fetuses with SB, subjective evaluation of the lower limbs was performed (muscle echogenicity and leg movements). To estimate the leg muscle trophism, the measurement of the area and circumference of the leg were standardized, and the reproducibility of this method was performed.Results-Thirty-one fetuses with open lumbosacral SB and 51 normal fetuses were evaluated. The measurements of the area and circumference of the leg proved to be highly reproducible (intraclass correlation coefficient-ICC > 0.95). The leg area and circumference measurements were statistically lower in the SB group than in the control group (p < .001). When subjective ultrasound assessment demonstrated hypotrophy of the lower limbs, the measurements of the area and circumference of the leg were statistically lower when compared to normal fetuses (p < .001). Fetuses with open SB with abnormal lower limb movements had lower measurements of the area and circumference of the leg than fetuses with normal movements (p < .001). Conclusion-Anew technique for estimating fetal leg muscle trophism was standardized, which proved to be highly reproducible and was able to show the difference between normal and fetuses with SB.

Congenital Intracranial Teratoma: Management Challenges!

“…Precise determination of extent of tumor involvement of adjacent structures is vital to determine the prognosis, amenability for resection and possible sequelae of surgery. 9…”

“…Since it usually has a sporadic occurrence, karyotyping is not necessary 5 9 unless accompanied by other malformations.…”

“…Ultrasound and magnetic resonance imaging (MRI) appearance of intracranial teratoma is usually of an irregular heterogeneous mass with hyperechoic and hypoechoic features with both solid and cystic areas as well as calcified components with distorted brain anatomy. 2 9 10 11 MRI can help in determining the remaining brain structures, exact location of tumor, and differentiating from hemorrhages. 12 Both ultrasound and MRI are complementary 2 and together allow more precise diagnosis of these tumors prenatally.…”

“…Fetal medicine centers should be well equipped with multidisciplinary teams acting, in unison, to provide better perinatal management for the prospective parents and care for fetuses with congenital intracranial tumors. 6 9…”

Neue neurochirurgische Therapieverfahren in der Neonatologie – Möglichkeiten und Voraussetzungen

“…Obwohl Tumoren des zentralen Nervensystems die häufigsten soliden Tumorerkrankungen im Kindesalter darstellen, sind diese Erkrankungen in der Neugeborenenperiode sehr selten. Studien ergaben, dass nur 0,5–1,9 % der Hirntumore in diesem Zeitraum auftreten 41 . Biologisch unterscheiden sich diese Tumore deutlich von denen im Kindesalter, sie treten häufiger supra- als infratentoriell auf, die Prognose in der neonatalen Altersgruppe ist deutlich schlechter im Vergleich zum späteren Kindesalter 42 .…”