Fetal aortopulmonary window: case series and review of the literature

Aortopulmonary window is a rare congenital cardiac anomaly characterized by communication between the aorta and the pulmonary artery above the semilunar valves. Prenatal diagnosis is rare. We report four fetuses with aortopulmonary window and review the relevant literature. Approximately half of the reported cases had additional cardiac defects. None had chromosomal abnormalities. In cases with normal cardiac connections, the diagnosis can be made prenatally on the standard three-vessel view, as seen in two of our cases. In one fetus with complete transposition of the great arteries, the diagnosis was made retrospectively on sagittal views. In the remaining case, the window was seen postnatally but could not be identified retrospectively due to the abnormal superoinferior relationship of the ventricles and vessels. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Premature rupture of membranes before 28 weeks managed expectantly: maternal and perinatal outcomes in a developing country

This study aimed to assess outcomes of expectant management for early preterm premature rupture of membranes (PPROM). This retrospective cohort involved 66 women with PPROM <28 weeks managed in a single hospital (1999-2006). Main outcomes were chorioamnionitis, severe maternal morbidity (maternal sepsis, haemorrhage/blood transfusion, hysterectomy or admission to intensive care unit), maternal mortality, low birth weight, preterm birth, neonatal infection and perinatal mortality. Mean gestational ages at PPROM and delivery were 21.7 ± 4.2 and 28.4 ± 5.9 weeks, respectively. Chorioamnionitis was diagnosed in 47%; no cases of severe maternal morbidity or mortality occurred. Stillbirth rate was 25.7% and >80% of infants were delivered before 34 weeks. Neonatal infection was diagnosed in 42.9% of the 49 live-births. Overall survival rate was 57.6%. Expectant management of PPROM <28 weeks resulted in high rates of chorioamnionitis and preterm deliveries but in over half of the cases, a live infant was discharged home.