From what week do the lateral ventricles of the fetus become smaller? Samsung medical equipment
Why is it important to assess the condition of the baby’s internal organs? The fact is that some deviations in their development are markers of chromosomal abnormalities. Such pregnant women are then recommended to undergo genetic counseling.
The timing of the screening study (16-22 weeks) was chosen so that if severe intrauterine developmental anomalies incompatible with life are detected, the pregnancy can be terminated.
All fetuses with ultrasound diagnosis of ventriculomegaly had a significantly larger volume of the lateral ventricles than controls. One 37-week fetal control case had a normal atrial diameter of 3 mm but a lateral ventricular volume of 8 cm 3 , within the lower range of ventriculomegaly as defined in this study. With the exception of this control case, there was no overlap in any volume of the lateral ventricle. Atrial diameter and lateral ventricular volume correlated well in the ventriculomegaly cohort.
Causes of abnormalities in the fetal stomach
There was no significant difference in basal ganglia, thalamus, and white matter volumes between cohorts. For volumetric comparisons of the lateral ventricles, ventriculomegaly data show the largest ventricle in unilateral cases and the largest ventricle only in bilateral cases. Continuous line: normal control cohort and dotted line: Ventriculomegaly cohort.
Norms for the size of the fetal stomach on ultrasound and possible deviations
The fetal stomach at 16-20 weeks can have variable sizes. They are defined in millimeters. The normal sizes of the fetal stomach by week are presented in the table.
The examination may reveal the following deviations:
- large or small stomach in the fetus on ultrasound;
- absence of an organ;
- presence of pseudo-content;
- slit-like stomach;
- gastric atresia in the fetus.
Causes of abnormalities in the fetal stomach
The stomach on ultrasound is defined as a round or oval anechoic formation located in the upper left parts of the abdominal cavity. Changes on its part may be signs of gastrointestinal pathology or indirect signs of other unfavorable conditions.
Norms for the size of the fetal stomach on ultrasound and possible deviations
Relationship between ventricular atrial diameter and volume in controls and ventriculomegaly. Atrial diameter and volume correlated well in controls and ventriculomegaly. There was a slight increase in third ventricle volume with a relative growth rate of 088% per week, increasing from 092 cm 3 at 22 weeks to 446 cm 3 per week. Due to the large scatter of measurements, data are presented as the mean measurement for each week of gestation against gestational age. Due to the limited number of cases, there was a large deviation between 34 and 36 weeks.
If The fetal stomach is not visible on ultrasound, then suggest esophageal atresia. In this case, the organ is there, but it is not filled with amniotic fluid. The absence of echoshadow may indicate oligohydramnios, and this indirectly indicates kidney pathology, chronic infections of the mother, pathology of the placenta, and gestosis. Sometimes the fetal stomach is not visualized if it is displaced from its usual place. This condition occurs with a diaphragmatic hernia.
In unilateral cases, the hemisphere with a dilated ventricle was 1% larger compared with the right and left hemispheres in the control cohort. The hemisphere containing the normal-sized ventricle was also significantly larger than the right and left hemispheres in the normal control cohort. There was no significant difference between the two hemispheres in fetuses with unilateral ventriculomegaly. The significance did not change when repeat scan data were excluded and when controlling for sex.
Total cortical gray matter, basal ganglia and thalamic white matter contents were measured in 19 cases of ventriculomegaly. As expected, when compared between subgroups, brain volume was significantly greater in fetuses with ventriculomegaly compared with controls. The ventriculomegaly cohort had significantly larger cortices than controls, even when correcting for brain volume. There was no significant difference in cortical gray matter volume between the two hemispheres in fetuses with unilateral ventriculomegaly.
Fluid in the stomach sometimes absent due to defects of the central nervous system, cleft lip, neuromuscular diseases.
"Pseudo-contents" of the stomach- these are various hyperechoic inclusions. They are formed when clumps of cells are ingested. Sometimes an intrauterine tumor manifests itself this way, but it is rarely diagnosed in isolation; it is accompanied by other anomalies. Swallowed blood also gives the picture of a full stomach. In this case, you need to look for the cause of the bleeding and carefully examine the placenta for abruption. Blood may appear after amniocentesis is performed.
Basal ganglia volume increased from 46 cm 3 at 22 weeks to 92 cm 3 per week. Thalamic volume increased from 99 cm 3 at 22 weeks to 79 cm 3 at 38 weeks, and white matter volume increased from 41 cm 3 at 22 weeks to 53 cm 3 per week There was no significant difference in the volume of the basal ganglia, thalamus and white matter , between cohorts.
Correlations with Ventricular Size
In contrast, in the ventriculomegaly cohort, total ventricular volume correlated significantly and positively with all measurements. The results are shown in the table. Fetuses with ventriculomegaly had significantly increased brain tissue volume compared to controls with expansion limited to gray skin. The volume of the white matter, thalamus, and basal ganglia was not significantly different among cohorts.
If no pathology of the placenta or other defects is detected, then the isolated presence of “pseudo-content” is taken as a variant of the norm.
Reason enlarged stomach in the fetus There may be intestinal obstruction and obstruction. But it should be remembered that the stomach can expand to significant sizes and this is the norm. Therefore, if the size of an organ deviates from the norm, you need to look for additional symptoms:
In addition, cortical volume increased at a greater rate than supratentorial brain volume in our control cohort, as previously shown in fetal and preterm brains. Ultrasound studies have shown that atrial diameter remains relatively stable in the second and third trimesters, although an increase in absolute values is observed. Our results showed a small but significant increase in absolute values of ventricular volume from 22 to 38 weeks of gestation.
As expected, fetuses with ventriculomegaly diagnosed by two-dimensional atrial diameter measurements had significantly larger lateral ventricular volumes compared with controls. Fetuses with isolated ventriculomegaly had significantly greater brain tissue volume than controls, supporting the hypothesis that ventriculomegaly may be associated with brain overgrowth that is evident from mid-gestation. Interestingly, in unilateral cases, both hemispheres were enlarged and brain expansion was not localized to the hemisphere containing the larger ventricle.
- polyhydramnios;
- thickening of the walls of the organ;
- the vestibule is narrowed and funnel-shaped;
- no slight curvature.
Microgastria of the fetal stomach does not occur as a separate congenital disease. It is usually part of the pathology of the entire gastrointestinal tract. It can be combined with:
- violation of rotation of abdominal organs;
- absence of a gallbladder;
- abnormal position of the liver.
With microgastria, the stomach looks small, significantly smaller in size than normal, and may be cylindrical in shape.
In contrast, in the ventriculomegaly cohort, total ventricular volume correlated well with all measured intracranial structures, indicating altered communication between the ventricles and developing structures in this cohort. In addition, a homogeneous ventriculomegaly “development” cohort was selected for analysis, excluding cases with chromosomal abnormalities, infection, brain parenchymal damage, or additional abnormalities. The structures were automatically segmented.
They found no significant difference in brain tissue or cortical volume between the groups. We repeated our analysis in a subset of our cohorts using the same age range and found that fetuses with isolated ventriculomegaly had significantly increased brain tissue volumes in a similar age range. Unilateral congenital hydrocephalus is an extremely rare malformation and is rarely detected in the prenatal period. It is considered a distinct entity from bilateral hydrocephalus in terms of morbidity, mortality, and perinatal prognosis.
Slit-like stomach in the fetus means its underdevelopment during onotogenesis.
Microgastria and slit-like stomach are subject to observation after detection. After the baby is born, perform plastic surgery to create a stomach from part of the small intestine. It will not be able to perform its main functions, but will keep food from directly entering the intestines. This will increase the digestion time, and the child will be able to absorb more nutrients.
In unilateral hydrocephalus, there is a high survival rate and favorable neurological outcome when the degree of dilatation is mild, stable over time, and not associated with other malformations. Prenatal diagnosis is carried out by ultrasound and magnetic resonance and confirmed at birth by ultrasound, computed tomography or magnetic resonance imaging. There are currently no standardized guidelines for long-term management and control.
Congenital unilateral hydrocephalus is an extremely rare form, rarely occurring in the prenatal period. It is considered a different organization than bilateral hydrocephalus in terms of morbidity, mortality, and perinatal outcome. Unilateral hydrocephalus has a high survival rate and favorable neurological outcome when the dilatation is mild, stable over time, and not associated with other malformations. There are currently no standard guidelines for management and long-term monitoring.
Gastric atresia- a rare anomaly. This is the presence of a membrane in the pyloric or antrum. Sometimes the fusion is incomplete, there is a small hole. Like most developmental defects, there is a combination of atresia with anomalies of the larynx, esophagus, pulmonary dysplasia, ascites, and hydrothorax. Sometimes it is a sign of autosomal recessive hereditary diseases, combined with epidermolysis bullosa. Isolated pyloric atresia can be treated surgically, with a survival rate reaching 90%.
We present a report on the antenatal diagnosis of congenital unilateral hydrocephalus and the literature. Congenital hydrocephalus is defined as abnormal dilatation of the lateral ventricles with an atrium greater than 10 mm. It is usually bilateral and symmetrical hydrocephalus and is associated with high morbidity and perinatal mortality of up to 85%.
Unilateral hydrocephalus corresponds to dilatation of one of the lateral ventricles greater than or equal to 10 millimeters at the level of the atrium. The largest published series reported an incidence of unilateral hydrocephalus of 0.07%. It is considered a distinct entity from bilateral hydrocephalus in terms of perinatal mortality and prognosis.
The fetus may not have a stomach. This condition is called agastria or agenesis. In the first case, the pathology is the absence of the upper part of the abdominal wall and the organs of half of the abdominal cavity. Agenesis is the absence of an organ. An extremely rare pathology, combined with multiple defects of other organs. These developmental anomalies are incompatible with life.
Of the 44 articles, 17 were selected that assessed the diagnosis, management or prognosis of unilateral fetal hydrocephalus. They correspond to the main links. In addition, due to their importance, two articles related to prenatal diagnosis of hydrocephalus were added, which are consistent with our secondary recommendations. A 27-year-old patient with no significant medical history with a child born from a previous normal pregnancy. The current pregnancy was well controlled, with normal examinations on admission to antenatal care.
What to do if a fetal stomach pathology is detected by ultrasound?
Any pathologies identified during screening require repeated ultrasound diagnostics over time. It is carried out at 22 weeks. If the anomalies detected in the previous study were transient in nature, then they will disappear with repeated diagnostics. Persistent changes speak in favor of serious congenital diseases.
Routine ultrasound at 24 weeks shows right unilateral hydrocephalus with posterior fossa and normal thalamus. The rest of the anatomy is described as normal. The thalamus on the right side is smaller than the contralateral thalamus. The left hemisphere of the brain has no focal damage. No damage is observed in the brainstem or cerebellum. The aqueduct of Silvio has a normal aspect, like the fourth ventricle. There is a slightly larger bulge of the skull on the right. There is no evidence of spinal distraction or meningocele.
In case of severe concomitant malformations, the woman is offered termination of pregnancy for medical reasons. The birth of such a child is impossible; it will end in death in the first few days.
Yulia Shevchenko, obstetrician-gynecologist, especially for the site
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There are no malformations at the level of the chest or abdomen. The patient was managed expectantly, giving birth at 38 weeks by caesarean section. Physical examination reveals a diagnosis of macrocephaly and suture with hypertelorism. The peritoneal derivative valve was installed on the day of life without complications. Cytochemical examination of the cerebrospinal fluid was normal. Normal chest x-ray, abdominal ultrasound and echocardiogram. Assessed by a genomic physician, a karyogram is proposed, and evaluation by an ophthalmologist shows intermittent exotropia associated with hypertelorism.
