Rescue cerclage when foetal membranes prolapse into the vagina

A cross-sectional study was conducted to evaluate the efficacy of rescue cerclage in patients with a dilated cervix and prolapsed foetal membranes. Thirty-five patients presenting with cervical dilatation and prolapsed foetal membranes were included in the study. A McDonald cerclage was placed in 27 patients. The duration of pregnancy prolongation and the number of deliveries after 28 weeks were evaluated. The median prolongation of pregnancy after cerclage placement differed significantly between the cerclage and bed-rest groups (64 days versus 13.5 days). Of the 27 patients who had cerclage, 17 (63%) delivered after 28 weeks of gestation, whereas all patients in the bed-rest group delivered before 28 weeks of gestation. The take-home baby rate was 63% in the cerclage group. When pregnancies were complicated by cervical dilatation with membrane prolapse into the vagina, placement of a McDonald cerclage in appropriately selected patients can be a beneficial therapeutic option.Impact statement Although the effectiveness and safety of rescue cerclage is controversial, our study provides strong support for the notion that cervical cerclage accompanied by long-term broad-spectrum antibiotics improves the perinatal outcomes in singleton gestations with membrane prolapsed into the vagina. Further prospective randomised trial is required to prove these findings

Recognition of Normal Fetal Cardiac Structures

Fetal heart examination requires in depth knowledge of fetal cardiac physiology and fetal cardiac anatomy. Therefore, the cardiac sonographer must possess considerable skills to acquire optimum images on cardiac anatomy on predefined standard views. An appropriate interpretation of acquired fetal cardiac images is also a basic requirement that is expected from a cardiac sonographer. Any cardiac ultrasound operator who performs the fetal heart scan is expected to recognize normal cardiac structures, to assess myocardial function and heart rhythm but also should be able to pick up any deviation from well-defined normality

The criterion value of fetal cerebral lateral ventricular atrium width for diagnosis of ventriculomegaly

Aim: To determine the distribution of cerebral lateral ventricular atrium width (LVAW) as established according to gestational weeks, and calculate the criterion value of LVAW that differentiates normal fetuses from abnormal fetuses. Materials and Methods: A total of 832 patients meeting the study's criteria were included in the control group. An additional 43 fetuses with LVAW > ten mm formed the case group. Results: The criterion value of LVAW was 9.7 mm. It did not change significantly throughout gestation. In the case group, 23 fetuses were terminated for fetal abnormalities, two fetuses died in utero, and 18 infants were born alive. Most of the abnormal development coincided with LVAW values greater than 12 mm. Conclusion: The authors suggest 9.7 mm as the criterion value, based on receiver operating characteristic (ROC) curve analysis. When the LVAW is between 9.8 and 12 mm without other fetal abnormalities, it may be regarded as a variation of the normal