Doppler colour flow mapping of fetal intracerebral arteries in the presence of central nervous system anomalies

The adjunctive role of Doppler colour flow mapping in the evaluation of intracerebral morphology and arterial blood flow in the presence of normal and abnormal central nervous system morphology was determined. A total of 59 fetuses with suspected central nervous system pathology between 14 and 37 weeks of gestation was studied (median 31 weeks). One hundred and one fetuses with normal central nervous system anatomy between 14 and 37 weeks (median 19 weeks) served as controls. Visualisation of blood flow in one or more intracerebral arterial vessels was successful in more than 80% of normal fetuses. For the anterior, middle and posterior cerebral artery, the percentages were 63%, 89% and 45%, respectively, at 14–25 weeks and 74%, 100% and 55%, respectively, at 26–37 weeks of gestation. Intracerebral arterial flow identification was attempted in 52/59 (88%) affected fetuses. Identification of blood flow in one or more intracerebral arterial vessels was successful in (77%) fetuses. End-diastolic flow velocities were present in at least one of the intracerebral arteries in fetuses, absent in one case of hydrocephaly and raised in the presence of an intracerebral vascular tumour. Doppler colour flow mapping seems to provide only limited additional information on intracranial structural pathology

Prenatal diagnosis of Klippel—Trenaunay—Weber syndrome: a case report

At 20 weeks of gestation, a typical combination of a massive enlargement of the right fetal leg and multiple cystic lesions was detected at ultrasound examination. Color‐coded Doppler examination revealed no arteriovenous fistulae. These findings allowed an in utero diagnosis of the Klippel‐Trenaunay‐Weber syndrome, which was confirmed after subsequent termination of the pregnancy. The severe malformation involved the upper and lower right leg. No arteriovenous fistulae were found. Copyrigh

Shared constitutional risks for maternal vascular-related pregnancy complications and future cardiovascular disease

Maternal predisposition to vascular and metabolic disease may underlie both vascular-related pregnancy complications, such as preeclampsia and intrauterine growth restriction, as well as future maternal cardiovascular disease. We aimed to substantiate this hypothesis with biochemical and anthropometric evidence by conducting an intergenerational case-control study in a Dutch isolated population including 106 women after preeclampsia or intrauterine growth restriction (median follow-up: 7.1 years) and their fathers (n=43) and mothers (n=64), as well as 106 control subjects after uncomplicated pregnancies with their fathers (n=51) and mothers (n=68). Cardiovascular risk profiles were assessed, including fasting glucose, lipids, anthropometrics, blood pressure, intima-media thickness, and metabolic syndrome. We found significantly higher fasting glucose levels, larger waist circumferences, and a 5-fold increased prevalence of hypertension in women with a history of preeclampsia as compared with control subjects (P<0.001). Likewise, their parents had higher glucose levels than control parents (P<0.05). Their mothers had larger waist circumferences and higher blood pressures (P<0.05). Also, women after pregnancies complicated by intrauterine growth restriction had higher glucose levels and increased prevalence of hypertension (P<0.01). Their fathers showed higher glucose levels as well (P<0.05). Mean carotid intima-media thickness was increased in a subset of women after preeclampsia diagnosed with chronic hypertension as compared with those without hypertension (P<0.01). Metabolic syndrome was more prevalent both in women with a history of preeclampsia and their mothers (P<0.05). We demonstrated intergenerational similarities in cardiovascular risk profiles between women after preeclampsia or intrauterine growth restriction and their parents. These findings suggest shared constitutional risks for vascular-related pregnancy complications and future cardiovascular disease