Prenatal diagnosis and outcome of lymphangiomas and its relationship with fetal chromosomal abnormalities

Objectives: Our aim was to evaluate ultrasound findings and perinatal outcome after prenatal diagnosis of lymphangioma.Methods: This was a retrospective case series study. We searched the archives of our ultrasound database at our center for cases with the prenatal diagnosis of the lymphangioma in the period between January 2008 and November 2014. We described maternal, fetal and perinatal variables for all cases.Results: Nine fetuses with lymphangioma were identified. All cases were diagnosed during the second and third trimesters with the average gestational age of 22.63.9 weeks. The average diameter of lymphangioma was 55.4 +/- 20.1mm at the time of diagnosis. Five fetuses (55.6%) had lymphangioma on the neck, and four fetuses (44.4%) had lymphangioma on other localizations. Normal fetal karyotype was detected in all cases. There were a total of six live births, one intrauterine death and two medical terminations of pregnancy following the diagnosis of lymphangioma. No abnormal Doppler finding or hydrops were detected in the antenatal follow-up of remaining six cases.Conclusion: The risk of chromosomal abnormalities is very low in pregnancies with isolated lymphangioma. The outcome of pregnancies with lymphangioma is generally favorable and prognosis depends on their locations and size

Increased Insulin Levels Independent of Gestational Overweight in Women with Preeclampsia

OBJECTIVE: To evaluate whether increased insulin levels are independent of gestational overweight in women with preeclampsia. STUDY DESIGN: The patients studied were selected at the Zeynep Kamil Woman and Children’s Hospital during their 29th and 40th week of pregnancy. The patients were evaluated in the four groups according to the diagnosis of preeclampsia (PE) and body mass index (BMI), group 1 overweight patients with mild preeclampsia (n=20), group 2 overweight patients without preeclampsia (n=20), group 3 nonoverweight patients with mild preeclampsia (n=20), and group 4 non-overweight patients without preeclamp sia (n=20). The serum fasting glucose and immunorective insulin levels were determined, and Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. RESULTS: The results show that there is no relation between high and normal BMI values and insulin resistance in patients with preeclampsia. Although, it was found that the HOMA-IR values of the patients with PE were higher than without PE. CONCLUSIONS: The results indicate that there was no relation between the increased insulin resistance and the weight gain. Increased insulin resistance should be developed as a result of the pathophysiology of the preeclampsia itself

Comparison of elasticity values in normal and gestational diabetic pregnancies in the third trimester

Placental elasticity was compared by using Shear wave elastography (SWE) in patients with gestational diabetes mellitus (GDM) with and without insulin to non-diabetic controls. Three groups were created as follows: Group 1 (n = 79, GDM with insulin therapy), Group 2 (n = 90, GDM with only diet) and Group 3 (n = 150, healthy controls) All patients were above 36 gestational weeks with anterior placenta. Clinical trial number was also received (NCT04455880). Group 1 had higher BMI while group 3 had lowest rate of C/S. Birthweight in GDM groups was statistically significantly higher than controls (p = .001). Although there was no significant difference between APGAR scores, Group 1 had higher rates of neonatal intensive care unit (NICU) admission. SWE values were significantly higher in GDM patients treated with insulin or diet than controls. SWE may be an alternatively supplementary management modality in GDM.IMPACT STATEMENT What is already known on this subject? Shear wave elastography (SWE), is one of the types of sono elastography methods that are used to measure the stiffness and elasticity of soft tissues. Recently, it became popular for screening the stiffness and elasticity of the placenta in high-risk pregnancies like preeclampsia, intrauterine growth restriction (IUGR), and placental dysfunction. What the results of this study add? All SWE velocities on the maternal side were statistically significantly different between groups. Regarding foetal side velocities, GDM groups had statistically significantly higher values (stiffer tissue) compared to controls. What the implications are of these findings for clinical practice and/or further research? SWE may be a Supplementary method in the diagnosis and management of GDM. Placental SWE should be measured at 24–28 weeks of gestation in patients with GDM and diagnosis confirmation and their responses to the treatment should be examined

Prenatal diagnosis and outcome of lymphangiomas and its relationship with fetal chromosomal abnormalities

Objectives: Our aim was to evaluate ultrasound findings and perinatal outcome after prenatal diagnosis of lymphangioma.Methods: This was a retrospective case series study. We searched the archives of our ultrasound database at our center for cases with the prenatal diagnosis of the lymphangioma in the period between January 2008 and November 2014. We described maternal, fetal and perinatal variables for all cases.Results: Nine fetuses with lymphangioma were identified. All cases were diagnosed during the second and third trimesters with the average gestational age of 22.63.9 weeks. The average diameter of lymphangioma was 55.4 +/- 20.1mm at the time of diagnosis. Five fetuses (55.6%) had lymphangioma on the neck, and four fetuses (44.4%) had lymphangioma on other localizations. Normal fetal karyotype was detected in all cases. There were a total of six live births, one intrauterine death and two medical terminations of pregnancy following the diagnosis of lymphangioma. No abnormal Doppler finding or hydrops were detected in the antenatal follow-up of remaining six cases.Conclusion: The risk of chromosomal abnormalities is very low in pregnancies with isolated lymphangioma. The outcome of pregnancies with lymphangioma is generally favorable and prognosis depends on their locations and size