Differences in Origin and Outcome of Intra-Abdominal Cysts in Male and Female Fetuses

Objective: To investigate the origin and outcome in a cohort of male and female fetuses with intra-abdominal cysts, in order to provide recommendations on management and to improve prenatal counselling. Methods: From 2002 to 2016, intra-abdominal cysts were detected by ultrasound in 158 fetuses. Cases with an umbilical vein varix were excluded. Fetal, neonatal, and maternal characteristics were retrieved from electronic patient files. Results: In female fetuses (n = 114), intra-abdominal cysts were diagnosed at a later gestational age compared with male fetuses (n = 44) (median 32.0 vs. 21.5 weeks, p < 0.001). The maximum prenatal cyst diameter was larger in female fetuses (median 35 vs. 17 mm, p < 0.001). Associated anomalies were less frequent in females (n = 15, 13.2%) compared with males (n = 15, 34.1%). In females (n = 114), most cysts were of ovarian origin (n = 81, 71.1%). Surgery was performed in 30 (26.3%) female and 15 (34.1%) male neonates (p = 0.33). Anorectal malformations were present in 6 cases and often not recognized prenatally. Conclusions: The differences in the origin of intra-abdominal cysts between male and female fetuses, resulting

First-trimester detection of surface abnormalities: A comparison of 2- and 3-dimensional ultrasound and 3-dimensional virtual reality ultrasound

The aim was to determine the diagnostic performance of 3-dimensional virtual reality ultrasound (3D-VR-US) and conventional 2- and 3-dimensional ultrasound (2D/3D-US) for first-trimester detection of structural abnormalities. Forty-eight first trimester cases (gold standard available, 22 normal, 26 abnormal) were evaluated offline using both techniques by 5 experienced, blinded sonographers. In each case, we analyzed whether each organ category was correctly indicated as normal or abnormal and whether the specific diagnosis was correctly made. Sensitivity in terms of normal or abnormal was comparable for both techniques (P =.24). The general sensitivity for specific diagnoses was 62.6% using 3D-VR-US and 52.2% using 2D/3D-US (P =.075). The 3D-VR-US more often correctly diagnosed skeleton/limb malformations (36.7% vs 10%; P =.013). Mean evaluation time in 3D-VR-US was 4:24 minutes and in 2D/3D-US 2:53 minutes (P <.001). General diagnostic performance of 3D-VR-US and 2D/3D-US apparently is comparable. Malformations of skeleton and limbs are more often detected using 3D-VR-US. Evaluation time is longer in 3D-VR-US