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Preoperative Imaging of Costal Cartilage to Aid Reconstructive Head and Neck Surgery. Ann Plast Surg 2022; 89:e69-e80. [DOI: 10.1097/sap.0000000000003325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Clinical and neurodevelopmental outcome of prenatally diagnosed Wormian bones. Am J Obstet Gynecol 2022; 226:420-428. [PMID: 34537159 DOI: 10.1016/j.ajog.2021.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 09/09/2021] [Indexed: 11/24/2022]
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Schut PC, Brosens E, Van Dooren TJM, Galis F, Ten Broek CMA, Baijens IMM, Dremmen MHG, Tibboel D, Schol MP, de Klein A, Eggink AJ, Cohen-Overbeek TE. Exploring copy number variants in deceased fetuses and neonates with abnormal vertebral patterns and cervical ribs. Birth Defects Res 2020; 112:1513-1525. [PMID: 32755042 PMCID: PMC7689732 DOI: 10.1002/bdr2.1786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 07/03/2020] [Accepted: 07/21/2020] [Indexed: 12/13/2022]
Abstract
Background Cervical patterning abnormalities are rare in the general population, but one variant, cervical ribs, is particularly common in deceased fetuses and neonates. The discrepancy between the incidence in the general population and early mortality is likely due to indirect selection against cervical ribs. The cause for the co‐occurrence of cervical ribs and adverse outcome remains unidentified. Copy number variations resulting in gain or loss of specific genes involved in development and patterning could play a causative role. Methods Radiographs of 374 deceased fetuses and infants, including terminations of pregnancies, stillbirths and neonatal deaths, were assessed. Copy number profiles of 265 patients were determined using single nucleotide polymorphism array. Results 274/374 patients (73.3%) had an abnormal vertebral pattern, which was associated with congenital abnormalities. Cervical ribs were present in 188/374 (50.3%) and were more common in stillbirths (69/128 [53.9%]) and terminations of pregnancies (101/188 [53.7%]), compared to live births (18/58, 31.0%). Large (likely) deleterious copy number variants and aneuploidies were prevalent in these patients. None of the rare copy number variants were recurrent or overlapped with candidate genes for vertebral patterning. Conclusions The large variety of copy number variants in deceased fetuses and neonates with similar abnormalities of the vertebral pattern probably reflects the etiological heterogeneity of vertebral patterning abnormalities. This genetic heterogeneity corresponds with the hypothesis that cervical ribs can be regarded as a sign of disruption of critical, highly interactive stages of embryogenesis. The vertebral pattern can probably provide valuable information regarding fetal and neonatal outcome.
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Affiliation(s)
- Pauline C Schut
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Erwin Brosens
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Tom J M Van Dooren
- Naturalis Biodiversity Center, Leiden, The Netherlands.,CNRS, Institute of Ecology and Environmental Sciences iEES Paris, Sorbonne University, Paris, France
| | | | | | - Inge M M Baijens
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marjolein H G Dremmen
- Department of Radiology, Division of Paediatric Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dick Tibboel
- Department of Paediatric Surgery, Erasmus MC, Erasmus University Medical Center Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Martin P Schol
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Alex J Eggink
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Titia E Cohen-Overbeek
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Kalelioglu IH, Gursoy Erzincan S, Erturk E, Has R. Prenatal Incidence and Clinical Value of the Absence of 12th Ribs in a Population in a Setting of Detailed Second-Trimester Sonography. Fetal Diagn Ther 2019; 46:368-375. [PMID: 30970358 DOI: 10.1159/000497159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/21/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVES We aimed to determine the incidence of the absence of the (last) 12th ribs in a population in a setting of detailed 2nd-trimester sonography using three-dimensional (3D) ultrasound and to assess whether or not this may be related to chromosomal aneuploidies. METHODS Prospectively, we counted fetal ribs for the absence of the (last) 12th ribs in singleton pregnancies of women who presented to our clinic for detailed 2nd-trimester sonography. The assessment was carried out using 3D ultrasound. Volume data sets were acquired with the 3D skeleton mode using the maximum intensity with X-ray-weighted rendering. If the 3D skeleton mode was not sufficient, volume contrast imaging with the OmniView bone mode was used. RESULTS The fetal ribs could be visualized in 97.01% of the 1,943 fetuses examined between 20 and 23 weeks' gestation. Timing the examination at 21, 22, or 23 weeks was found to be more successful than conducting it at 20 weeks. Twelfth ribs were found to be absent in 33 fetuses; 16 fetuses had 11 ribs unilaterally and 17 had so bilaterally. None of them had chromosomal abnormalities. Associated anomalies were present in 6 fetuses (18.2%); 2 of the anomalies were major and 4 minor. CONCLUSION The incidence of absent 12th ribs in this mixed population was 1.75%. In the absence of additional anomalies, the prognosis is favorable.
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Affiliation(s)
- Ibrahim Halil Kalelioglu
- Department of Obstetrics and Gynecology, Istanbul University Faculty of Medicine, Istanbul, Turkey,
| | - Selen Gursoy Erzincan
- Department of Obstetrics and Gynecology, Trabzon Kanuni Research and Teaching Hospital, Trabzon, Turkey
| | - Emircan Erturk
- Department of Obstetrics and Gynecology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Recep Has
- Department of Obstetrics and Gynecology, Istanbul University Faculty of Medicine, Istanbul, Turkey
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Schut PC, Ten Broek CMA, Cohen-Overbeek TE, Bugiani M, Steegers EAP, Eggink AJ, Galis F. Increased prevalence of abnormal vertebral patterning in fetuses and neonates with trisomy 21. J Matern Fetal Neonatal Med 2018; 32:2280-2286. [PMID: 29353507 DOI: 10.1080/14767058.2018.1431622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To assess the prevalence of an abnormal number of ribs in a cohort of fetuses and neonates with trisomy 21 and compare this with a subgroup of fetuses without anomalies. MATERIALS AND METHODS Radiographs of 67 deceased fetuses, neonates, and infants that were diagnosed with trisomy 21 were reviewed. Terminations of pregnancy were included. The control group was composed of 107 deceased fetuses, neonates, and infants without known chromosomal abnormalities, structural malformations, infections or placental pathology. Cases in which the number of thoracic ribs or presence of cervical ribs could not be reliably assessed were excluded. The literature concerning vertebral patterning in trisomy 21 cases and healthy subjects was reviewed. RESULTS Absent or rudimentary 12th thoracic ribs were found in 26/54 (48.1%) cases with trisomy 21 and cervical ribs were present in 27/47 (57.4%) cases. This prevalence was significantly higher compared to controls (28/100, 28.0%, Χ2(1) = 6.252, p = .012 and 28/97, 28.9%, Χ2(1) = 10.955, p < .001, respectively). CONCLUSIONS Rudimentary or absent 12th thoracic ribs and cervical ribs are significantly more prevalent in deceased fetuses and infants with trisomy 21.
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Affiliation(s)
- Pauline C Schut
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | | | - Titia E Cohen-Overbeek
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | - Marianna Bugiani
- c Department of Pathology , VU University Medical Centre , Amsterdam , The Netherlands
| | - Eric A P Steegers
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | - Alex J Eggink
- a Department of Obstetrics and Gynecology , Erasmus MC University Medical Center , Division of Obstetrics and Prenatal Medicine , Rotterdam , The Netherlands
| | - Frietson Galis
- b Naturalis Biodiversity Center , Leiden , The Netherlands
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Durell J, Dagash H, Eradi B, Rajimwale A, Nour S, Patwardhan N. 13 ribs as a predictor of long gap esophageal atresia: myth or reality? Analysis of associated findings of esophageal atresia and abnormal rib count. J Pediatr Surg 2017; 52:1252-1254. [PMID: 28545763 DOI: 10.1016/j.jpedsurg.2017.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 04/17/2017] [Accepted: 04/27/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The presence of 13 pairs of ribs on pre-operative chest x-ray has been postulated to be an indicator for long gap esophageal atresia (EA). This study sought to determine the validity of this theory and identify associated pathological conditions in patients with EA and abnormal rib count. METHODS Babies with EA from January 2005 - December 2012 were retrospectively analyzed. Information was gathered from neonatal health records and operation notes. Chest x-rays were reviewed to determine rib count. Long gap EA was defined as failure to achieve primary esophageal anastomosis. Statistical analysis performed with Fisher's exact test. RESULTS Seventy-six patients were identified. Eight patients had long gap EA, with none of these patients having 13 pairs of ribs. Paradoxically, 10 patients with esophageal atresia +/- trachea-esophageal atresia (EA +/- TEF) and supernumerary ribs underwent primary repair. Nine patients had 11 pairs of ribs, of which 2 had pure EA and a long gap. Using Fisher's exact test to compare the groups of supernumary ribs and non-supernumary ribs there is a p value of 0.587. VACTERL association was identified in 40% of those with supernumerary ribs. Various associated syndromes and concomitant abnormalities were identified. CONCLUSION We found no association between 13 pairs of ribs and long gap in esophageal atresia. Those with 13 pairs of ribs were more likely to have associated anomalies, although this was not statistically significant. Our cohort of patients was found to have a range of pathology related to genetic syndromes, further atresias, and malformations, which is well known to be associated with children born with EA +/- TEF. LEVEL OF EVIDENCE Prognosis study - level IV.
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Affiliation(s)
- Jonathan Durell
- Department of Paediatric Surgery, Leicester Royal Infirmary, Leicester, United Kingdom LE1 5WW
| | - Haitham Dagash
- Department of Paediatric Surgery, Leicester Royal Infirmary, Leicester, United Kingdom LE1 5WW.
| | - Bala Eradi
- Department of Paediatric Surgery, Leicester Royal Infirmary, Leicester, United Kingdom LE1 5WW
| | - Ashok Rajimwale
- Department of Paediatric Surgery, Leicester Royal Infirmary, Leicester, United Kingdom LE1 5WW
| | - Shawqui Nour
- Department of Paediatric Surgery, Leicester Royal Infirmary, Leicester, United Kingdom LE1 5WW
| | - Nitin Patwardhan
- Department of Paediatric Surgery, Leicester Royal Infirmary, Leicester, United Kingdom LE1 5WW
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Adverse Fetal and Neonatal Outcome and an Abnormal Vertebral Pattern: A Systematic Review. Obstet Gynecol Surv 2016; 71:741-750. [DOI: 10.1097/ogx.0000000000000388] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Khodair SA, Hassanen OA. Abnormalities of fetal rib number and associated fetal anomalies using three dimensional ultrasonography. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2014.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Martinez LH, Araujo Júnior E, Simioni C, Nardozza LMM, Moron AF. Reference ranges for vertebral body areas of the fetal lumbosacral spine on 3-dimensional sonography using volume contrast imaging with OmniView. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:1743-1752. [PMID: 23091244 DOI: 10.7863/jum.2012.31.11.1743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES; The purpose of this study was to establish reference ranges for vertebral body areas of the fetal lumbosacral spine in the coronal plane on 3-dimensional sonography using volume contrast imaging with OmniView (GE Healthcare, Zipf, Austria). METHODS; An observational cross-sectional study was conducted on 576 healthy pregnant women at gestational ages of 20 weeks to 34 weeks 6 days. Volume contrast imaging with OmniView was used to measure the vertebral body areas (L1-L5, S1, and S2) by positioning a curved line along the fetal lumbosacral spine. To create reference ranges, first- and second-degree linear regression models adjusted using residual analysis and the coefficient of determination (R(2)) were created. To assess reproducibility, two examiners evaluated 40 random volumes using the intraclass correlation coefficient. RESULTS; The mean areas of the vertebral bodies were 102.72 (range, 25-254), 107.29 (range, 30-245), 105.10 (range, 31-231), 99.09 (range, 31-211), 87.74 (range, 11-178), 65.80 (range, 18-161), and 46.54 (range, 12-129) mm(2) for L1, L2, L3, L4, L5, S1, and S2, respectively. In the intraobserver and interobserver reproducibility assessments, intraclass correlation coefficients of greater than 0.80 were found for all fetal vertebral body areas. CONCLUSIONS; Reference values for fetal lumbosacral spine vertebral body areas were determined by 3-dimensional sonography using volume contrast imaging with OmniView, and they were shown to be reproducible.
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Affiliation(s)
- Luis Henrique Martinez
- Department of Obstetrics, Federal University of São Paulo, 05303-000 São Paulo-SP, Brazil
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Sepulveda W. Poland syndrome: a rare cause of cardiac dextroposition in the fetus. Prenat Diagn 2009; 29:903-5. [DOI: 10.1002/pd.2310] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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