Prenatal diagnosis of congenital ranula: Case Report

Congenital ranula is a mucous retention cyst which originates from the base of the oral cavity and is caused by sublingual or submandibular canal atresia or canalization defect. As with the other tumors in the oral cavity it may cause upper airway obstruction and hypoxia immediately after delivery. In the following stages of life, apart from the respiratory problems it may cause speach, chewing and swallowing disorders. The prenatal diagnosis of congenital sublingual ranula is very rare, and it presents as an avascular and anechoic cystic mass displacing the tongue upwards on fetal ultrasonography. Polyhydramnios can develop due to the obstruction and stomach may not be visualized. The differential diagnosis includes lymphatic malformations, epulis, epignatus, tyroglossal canal cyst and hemangioma. In this paper, we present a case of ranula which was diagnosed during prenatal ultrasonographic examination. The detailed fetal ultrasound scan performed at the 31th week of gestation revealed a non-septated anechoic cyst in the oral cavity measuring 20 x 17 x 15 mm. The cyst had well-defined regular borders with no solid component. Doppler ultrasonograhy did not show any vascularization within the cyst. After the delivery at the 38th week of gestation, a sublingual cystic mass with regular borders measuring 1.5 x1.5 cm was detected in the mouth of the neonate. Entubation was not required due to the absence of respiratory distress. In order to prevent difficutlies in feeding, the cystic mass was aspirated just after the delivery. A diagnosis of sublingual ranula was made based on the localization and the mucoid consistency of the cyst

Uterusun diffüz kavernöz hemanjiyomunun antenatal sonografik tanısı

Uterusun kavernöz hemanjiyomu, endometriyal polip veya myoma benzeyen bir kitle şeklinde ortaya çıkabileceği gibi (lokalize tip), uterus duvarında normal myometriumun yerini alan geniş vaskuler boşluklar şeklinde de (diffüz tip) görülebilir. Genellikle asemptomatiktir, ancak jinekolojik pratikte menometroraji ve infertilite şeklinde, obstetrik hastalarda ise intrapartum veya postpartum kanama ya da tromboembolizm şeklinde ortaya çıkabilir. Diffüz kavernöz hemanjiyom, türbülan akım içeren kavernöz boşluklarla dolu kalınlaşmış uterus duvarı görüntüsüyle, rutin antenatal ultrasonografi incelemesi sırasında nadiren saptanabilir. Fetusta ağır gelişme geriliği olan, sezaryen sırasında ve sonrasında hemorajik komplikasyon gelişmeyen ve antenatal dönemde tanısı koyulan bir diffüz kavernöz hemanjiyom olgusu sunmaktayız.Cavernous hemangioma of the uterus may be either localized presenting as an endometrial polyp or a uterine mass mimicking myoma, or as a diffuse mass in which most of the uterine wall is composed of enlarged vascular spaces replacing the normal myometrium. It is usually asymptomatic, but can present with menometrorrhagia and infertility in gynecological practice, and intra or postpartum bleeding or thromboembolism in obstetric patients. Diffuse cavernous hemangioma can be seldom, identified during routine antenatal ultrasonographic examination as the thickened uterine wall composed of cavernous fluid-filled spaces with turbulent flow. We present an antenatally diagnosed case of diffuse cavernous hemangioma in which the fetus was severely growth-restricted. Caesarean section was performed successfully without any intra or postpartum hemorrhage

Prenatal Diagnosis of Persistent Left Superior Vena Cava and its Clinical Significance

Background: Persistent left superior vena cava (PLSVC) is a variant of systemic venous return which is observed in 0.3% of autopsies in the general population and in 4-8% of patients with congenital heart disease. Aims: To evaluate associated cardiac, extracardiac and chromosomal anomalies in prenatally diagnosed cases of PLSVC and to review their outcome. Study Design: Retrospective comparative study. Methods: The data of patients with a prenatal diagnosis of PLSVC between May 2008 and January 2013 were reviewed retrospectively. Results: Data of 31 cases were reviewed. Fifteen (48.4%) cases were associated with cardiac defects and 17 (54.8%) cases had associated extracardiac sonographic or postpartum findings. Two fetuses had karyotype anomalies. Outcome was significantly more favorable in cases not associated with cardiac defects in comparison to those associated with cardiac anomalies (84.6% vs. 33.3%, p=0.009). All cases with isolated PLSVC survived, while among the cases associated with extracardiac anomalies, with cardiac anomalies and with both extracardiac and cardiac anomalies, the survival rate was 75%, 50% and 22.2%, respectively. The most frequent group of cardiac anomalies associated with PLSVC was septal defects and VSD was the most common heart defect individually, being observed in nine fetuses. Conclusion: Prenatally diagnosed PLSVC is associated with cardiac and extracardiac anomalies in the majority of cases. Outcome is significantly worse if PLSVC is associated with a cardiac defect, and the prognosis is excellent in isolated cases

Guideline on Pregnancy and Diabetes by the Society of Specialists in Perinatology (PUDER), Turkey

ABS TRACT Diabetes mellitus (DM) is the most common endocrinologic problem in pregnancy. In Turkey, the reported prevalance is between 1.9-27.9%, with an average of 7.7%. While some of these cases are pregestational diabetes (PGDM), about 90% are detected during the pregnancy for the first time and diagnosed as gestational diabetes (GDM). Diabetes in pregnancy confers serious risks regarding the fetus, newborn and the mother. Therefore, we offer GDM screening for all pregnant women preferantially between 24-28 weeks of gestation. Either one-step 75-g oral glucose tolerance test (OGTT) or two-step 50-g glucose challenge test and 100-g OGTT may be used for the screening and diagnosis. In pregnancies with high-risk for DM, screening should be performed earlier, if possible, in the first antenatal visit. When GDM is diagnosed, maternal glycemic control is tried to be achieved by diet and exercise program, and if necessary, by using insulin. The use of metformin or glyburide in pregnancy is also possible. In women with the diagnosis of DM before pregnancy, preconceptional control of plasma glucose levels is of utmost importance in order to prevent adverse pregnancy outcomes. In pregnancies with GDM regulated by diet and exercise, pregnancy follow-up may be performed as in the low risk group without any pregnancy complications. If maternal or fetal distress is not observed, delivery is planned between 39+0 -40+6 weeks. Although caesarean section is recommended when estimated fetal weight is 4500 g or more, the mode of delivery may be decided more appropriately on a case-by-case basis