Sonographic imaging and differential diagnosis of fetal perineal masses

This case series describes our experience with a prenatal diagnosis of fetal perineal masses. We propose a clinical-sonographic approach for prenatal workup in cases presenting perineal findings based on imaging the target sign at the posterior perineal triangle, the fetal genitalia, and sacrum. Targeted, structured prenatal anatomical scan in fetuses presenting with perineal masses may aid in the prenatal differential diagnosis and enable appropriate genetic analysis, prenatal counseling, and postnatal treatment

Assessment of fetal thymus size and BMI in pregnant women with diabetes

Materials and methods: The study group consisted of 63 pregnant women admitted to the Department of Perinatology, Obstetrics and Gynaecology. Inclusion criteria included patients with PGDM – 11 pregnancies, GDM1– 23 pregnancies, and GDM2 – 29 pregnancies. Exclusion criteria included pregnant women with gestational diabetes and history of other comorbidities as well as multiple pregnancies, fetal developmental abnormalities and genetic disorders. Each patient received a detailed fetal ultrasound performed by the team of ultrasound experts specialising in obstetric ultrasonography. Fetal thymus measurements were obtained between 14+5 and 40+0 weeks of gestational age. After the three-vessel view was clearly displayed we assessed longitudinal dimensions of the thymus. The obtained measurements were juxtaposed with nomograms for thymus size in healthy foetuses whose mothers had no history of diabetes. Prior to ultrasound examination the participants were asked to complete a questionnaire regarding their body weight status before 10 weeks of gestational age. Results: The Mann–Whitney U test was used for comparison of two groups, i.e. diabetic pregnancies and non-diabetic pregnancies, whereas Kruskal–Wallis H test was used to compare multiple groups. A linear regression model was used to determine the correlation between the type of diabetes and fetal thymus size as well as between maternal BMI and fetal thymus size. The significance level α was set at 0.05. Thymus size is statistically smaller in foetuses of diabetic mothers when compared to healthy controls. Overweighted and obese pregnancy is not a factor affecting fetal thymus size

Metformin administration during pregnancy — current insight

The main mechanism of gestational diabetes mellitus (GDM) is insulin resistance, therefore using metformin as a medicinereducing insulin resistance appears to be promising.Currently, the majority of medical associations do not recommend using metformin during pregnancy as the first-line oftherapy when the diet regimen is insufficient for glycaemic control. However, they do allow its administration if there isno possibility of insulin treatment.There is some evidence which suggests that using metformin during pregnancy is not related to an increased risk of obstetriccomplications during delivery and that its influence on the foetus can be beneficial.Since metformin crosses the placenta, the major argument for cautious use of this drug are the potential long-term effectsof the treatment for the child and its development in later life.In this article, the authors attempt to discuss the use of metformin during pregnancy and the safety of the treatment inthe light of current studies and recommendations