Isolated Aberrant Right Subclavian Artery and Trisomy 21 Case

Abnormal right subclavian artery (ARSA) is the most common anomaly of the aortic arch with a rate of 0.5-1.4%. Normally, three vessels arises from the aortic arch, while four vessels arise in ARSA. ARSA leaves the distal of the aortic arch and passes behind the esophagus and trachea. It is also called the abnormal retroesophageal right subclavian artery. It is generally an asymptomatic benign finding, but it can cause esophageal compression causing dysphagia. In this article, an isolated ARSA and trisomy 21 case referred to our clinic in the second trimester of pregnancy and detected ultrasonographically is presented

Assessment of renal volume by 3D VOCAL Ultrasonography method in late-onset growth-restricted fetuses with normal amniotic fluid index

Objectives: The aim of this study was to study renal volumetric alterations and renal artery doppler changes in late-onsetfetal growth restricted (FGR) fetuses with normal amniotic fluid compared to healthy pregnancies.Material and methods: This prospective study was composed of pregnant women with late-onset FGR and a control groupof uncomplicated pregnancies within 32–37 weeks of gestation. Following the assessment of umbilical, bilateral uterine,middle cerebral using Doppler Ultrasonography (US), three dimensional (3D) US Virtual Organ Computer-aided Analysis(VOCAL) was executed to calculate bilateral renal volumes.Results: A total of 76 fetuses with FGR and 51 healthy fetuses (control group) were evaluated. Umbilical artery Dopplersystole/diastole and Pulsatility index values were found to be significantly different between the two groups (p = 0.001 andp = 0.001, respectively). Middle cerebral, bilateral uterine, and bilateral renal arteries’ Doppler indices revealed no differencebetween the two groups. Right, left, and mean renal volume of the fetuses with FGR were smaller than the controlgroup, and the differences were statistically significant (p = 0.025, p = 0.004, p = 0.004, respectively). Left renal volume wassignificantly greater than the right renal volume in the control group (p = 0.009).Conclusion: Although not accompanied by oligohydramnios, and having similar renal vascular resistance as the controlgroup, renal volumes of fetuses with late-onset FGR were still observed lower than the control group. This difference wasexplained by not decreased blood flow via redistribution but other mechanisms like glomeruli reduction and glomerularapoptosis

Ischemia modified albumin levels in intrauterine growth restriction: levels are increased in fetal cord blood but not in maternal blood

Objectives: In this study, our aim was to determine the differences between intrauterine growth restriction (IUGR) and normal birth weight fetuses in terms of ischemia modified albumin (IMA) levels. For this purpose, we measured ischemia modified albumin levels in the cord blood of fetuses and the mothers. Material and methods: This study is a prospective study conducted at University of Health Sciences Tepecik Training and Research Hospital between January 2018 and December 2019. According to the inclusion/exclusion criteria, 227 patients were included in the study. Participants were divided into two groups according to the presence (patient group) or absence (control group) of intrauterine growth restriction (IUGR). In addition to routine parameters recorded during pregnancy, the IMA levels and Doppler USG findings of all participants were recorded. Results: The mean cord blood serum IMA levels of the patient group were significantly elevated compared to controls (p = 0.038). Whereas mean maternal blood serum IMA levels were similar among groups (p = 0.453). The cord blood and mother blood serum IMA levels were not significantly different with regard to the presence or absence of perinatal asphyxia. Conclusions: In the literature, studies evaluating IMA levels in the cord and maternal blood of IUGR fetuses are limited. In IUGR patients, IMA level is expected to increase and in our study, IMA levels were significantly increased but the presence of oxidative stress has not been found to affect IMA levels

Diagnostic accuracy of pre-induction cervical elastography, volume, length, and uterocervical angle for the prediction of successful induction of labor with dinoprostone

Purpose: The study’s aim is to define among a group of ultrasonographic cervical measurements a candidate parameter predictive of successful of induction of labor in term pregnancies with unfavorable cervix. Methods: This prospective observational study included 141 pregnant women at term with an unfavorable cervix (Bishop score ≤ 6). All patients underwent clinical and ultrasonographic cervical evaluation before dinoprostone induction. Pre-induction cervical assessments included the Bishop score, cervical length, cervical volume, uterocervical angle, and cervical elastographic parameters. Vaginal delivery (VD) was accepted as successful dinoprostone induction. Multivariate logistic regression was conducted to identify the potential risk factors significantly associated with CS while controlling for possible confounding variables. Results: The vaginal delivery rate was 74% (n = 93) and the cesarean section (CS) rate was 26% (n = 32). Sixteen patients who had a cesarean section due to fetal distress before the active phase of labor were excluded from the study. The mean induction-to-delivery interval was 1176.1 ± 352 (540–2150) for VD and 1359.4 ± 318.4 (780–2020) for CS (p = 0.01). Bishop score was lower in women with cesarean section (p = 0.002). When both groups were compared in terms of delivery type, no difference was found between cervical elastography values, cervical volume, cervical length, and uterocervical angle measurements. Multivariable logistic regression model failed to show significant differences between cervical elastography values, cervical volume, cervical length, and uterocervical angle measurements. Conclusion: Cervical length, cervical elastography, cervical volume, and uterocervical angle measurements did not provide a clinically useful prediction of outcomes following labor induction in our study group with unfavorable cervix. Cervical length measurements significantly predicted the time interval from induction to delivery