Cardiac tumors constitute a rare condition, affecting 0.17-28/10,000 of the general population. Rhabdomyomas represent the most frequently found type of tumor in the prenatal period. The present report describes the case of a 31-week fetus presenting with a large intracardiac tumor with severe clinical repercussions.

Keywords: Prenatal diagnosis, Ultrasonography, Fetal masses, Fetal tumors

OBJECTIVE: To evaluate the uterine cervix length with magnetic resonance imaging in comparison with findings at transvaginal ultrasonography. MATERIALS AND METHODS: Twenty pregnant women between the 19th and 30th gestational weeks underwent magnetic resonance imaging and transvaginal ultrasonography for evaluation of their uterine cervix. Measurements by means of magnetic resonance imaging were performed by two specialists in imaging diagnosis for calculating the interobserver variability of the method. RESULTS: Calculation of the Pearson's correlation coefficient between measurements of the cervical length demonstrated a significant correlation between the results of both methods (r=0.628; p<0.01). The paired t test demonstrated no statistically significant difference between measurements obtained by transvaginal ultrasonography and magnetic resonance imaging (p=0.068). Interobserver agreement in cervical measurements by magnetic resonance imaging was high (a=0.96), demonstrating the reliability of the method. CONCLUSION: The comparison between both imaging methods in the evaluation of cervical biometry showed no statistically significant difference thus reinforcing the utilization of ultrasonography. However, in some cases where transvaginal ultrasonography is contraindicated, magnetic resonance imaging can be alternatively utilized for measurement of the cervical length.

Keywords: Uterine cervix, Pregnancy, Magnetic resonance imaging

For the last years three-dimensional ultrasonography has become an imaging diagnosis method of great importance in obstetrics. One of its advantages would be the higher sensitivity compared with two-dimensional ultrasound in the diagnosis of some fetal malformations. The potential applications of this new method would be an improved accuracy in the measurement of fetal organs, the possibility of reviewing volumes in the absence of the patient, and using different planes to assess specific anatomical structures, as well as the capacity to transfer data files to remote reference centers. Ultrasonographic evaluation of fetal cerebellum is particularly important, since developmental alterations are correlated with the fetal growth alterations and congenital anomalies. The objective of this updating is to demonstrate the VOCAL™ and 3D XI™ methods in the evaluation of the fetal cerebellum, their potential benefits, and the latest information in the literature about this subject.

Keywords: Fetus, Cerebellum, Volume of organs, Prenatal diagnosis, Three-dimensional ultrasound

The fetal limb volume reflects the nutritional status and intra-uterine growth of the fetus. The arrival of the three-dimensional ultrasound has allowed a more accurate volumetric evaluation of irregularly shaped structures such as fetal organs. The three-dimensional multiplanar mode is the most efficient technique to evaluate fetal limb volume as a parameter for a more accurate birth weight prediction. Currently, this method is useful for monitoring the development of soft tissue and for early detection of fetal growth deviations. In our country, where fetal growth restriction is frequent, with poor access to a skilled neonatal assistance, the dissemination of this technique could definitely contribute to reduce the rates of perinatal morbidity and mortality.

Keywords: Three-dimensional ultrasound, Fetal limbs, Volume

The measurement of cervical length utilizing transvaginal ultrasound is of help for pregnant women screening for premature labor, the shortening of the cervix being a predictor of higher risk of preterm delivery. Traditional methods for evaluating the uterine cervix during pregnancy are limited and unsatisfactory. Digital examination of cervix, considered as the standard method, demonstrates large variation among different examiners; on the other hand, transvaginal sonography is an effective method of examination during pregnancy. Recently, three-dimensional ultrasound has been used in the clinical practice including the study of uterine cervix. The three-dimensional technology allows acquisition and storage of a large volume of data. Such stored information can be reformatted and analyzed through an unlimited number of planes. The three-dimensional transvaginal ultrasound is the unique imaging method capable of obtaining a true coronal plane by direct correlation of the views in a multiplanar display. This method seems to offer a diagnostic potential because of the cervical ultrasonography increased accuracy.

Keywords: Uterine cervix, Pregnancy, Three-dimensional ultrasonography

Although congenital heart defect is the most frequent anomaly in newborns, its antenatal detection rate through conventional ultrasound remains low. 3D and 4D ultrasound technology was developed early in the nineties, bringing great benefits in obstetrics, especially in cases of dubious diagnosis at 2D ultrasound. The spatio-temporal image correlation (STIC) is a significant development in the field of 4D ultrasound. A software coupled with a Voluson 730 Expert equipment allows a volumetric acquisition of the fetal heart and its vascular connections. Volumetric analyses are performed in multiplanar and surface rendering modes or, alternatively in association with color Doppler. Major advantages are fast images acquisition and the possibility of a later analysis by fetal echocardiography specialists. Differently from 2D ultrasound, this technique may be applied for evaluating any congenital cardiopathy because of the increased number of frames acquired from a specific anatomical region. Main disadvantage is related to the necessity of fetal immobility. The higher diffusion of this method may improve prenatal detection of heart malformations since volumes data captured by a sonographer may be sent through the Internet for analysis by fetal echocardiography specialists.

Keywords: Congenital heart defect, Prenatal diagnosis, STIC

OBJECTIVE: To verify if different morphological ultrasonographic markers such as the funneling sign and the cervical gland area can be predictors of spontaneous premature delivery in pregnant women between 21 and 24 weeks of gestation. MATERIALS AND METHODS: This was a prospective cross-sectional study in which 361 women with 21 to 24 weeks of gestation were examined by transvaginal ultrasonography. The gestational age at delivery was later checked by telephone or mail. RESULTS: Spontaneous preterm delivery (SPD) occurred in 5% of the patients. Cervical funneling occurred in 4.2% of the women and in 22.2% of those who had SPD. This finding was correlated to preterm delivery (p < 0.001; relative risk of 6.68). Absence of a hypoechoic area peripheral to the cervical canal consistent with endocervical epithelium glands, namely endocervical glandular echo (EGE) feature, was detected in 2.8% of all patients and in 44.4% of those who developed spontaneous preterm labor. There was a statistically significant association of this feature to SPD (p < 0.001; relative risk of 28.57). Multivariance logistic regression analysis showed that this was the feature with strongest correlation with SPD, when compared to cervical funneling. CONCLUSION: Prediction of SPD through ultrasound features should observe biometrical and morphological signs such as absence of EGE. This is a new and important ultrasound finding that can be considered a predictor of risk for SPD, and should be confirmed in future multicentric trials.

Keywords: Cervical gland area, Pregnancy, Preterm delivery, Transvaginal ultrasonography