Women's response to fetal choroid plexus cysts detected by prenatal ultrasound

OBJECTIVES

To determine maternal responses to detection of a minor structural variant, the choroid plexus cyst (CPC), in their fetus on prenatal ultrasound.

STUDY DESIGN

We interviewed 34 pregnant women with an isolated CPC detected on mid-pregnancy ultrasound about their objective experience at diagnosis, emotional response and subsequent reactions. Audiotaped, transcribed responses were evaluated by two independent raters and analyzed qualitatively and quantitatively.

RESULTS

All women reported negative emotional responses including shock, distress, fear and decreased attachment, despite counseling by 82% of providers that the CPC was probably benign. Three women underwent amniocentesis purely for reassurance after CPC detection. Most (79%) sought information beyond what their physician provided, frequently on the internet. One half of women reported that intense negative responses were temporary. However, weeks after diagnosis, 62% continued to believe that the CPC presented some danger to their baby.

CONCLUSIONS

Detection of CPC prenatally can evoke profound, negative maternal emotional responses despite accurate provider counseling. Practitioners should consider these responses when counseling parents about these and other structural variants of unclear functional significance.

Fetal growth in Peru: comparisons with international fetal size charts and implications for fetal growth assessment

OBJECTIVES

To compare fetal biometry measurements obtained in a Peruvian population with reference fetal size charts obtained in Peruvian and non-Peruvian populations.

METHODS

Fetal biometry measurements collected prospectively in 195 uncomplicated pregnancies were included in the presented analysis. At 20, 24, 28, 32, 36 and 38 weeks' gestation, fetal head circumference, abdominal circumference and femur diaphysis length were measured. Fetal biometry measurements were compared with fetal size charts obtained from another Peruvian and two non-Peruvian populations from North America and Europe.

RESULTS

When compared with ultrasound-based reference fetal size charts obtained from North American and European populations, fetuses from the studied population appeared to grow more slowly with advancing gestational age. This trend was not observed when a Peruvian population, similar to the one studied here, was used as a reference.

CONCLUSIONS

The results suggest that fetal growth in this Peruvian population may not be adequately assessed by using reference charts obtained from other populations and have implications for the use of growth standards in antenatal management.

Cross-correlation of fetal cardiac and somatic activity as an indicator of antenatal neural development

OBJECTIVE

In this study, we wanted to model the emergence of coupling between fetal cardiac and somatic activity in normal and at-risk fetuses.

STUDY DESIGN

One hundred six fetuses of uncomplicated pregnancies were longitudinally monitored at 20, 24, 28, 32, 36, and 38 weeks of gestation by using a fetal actocardiograph and computerized data collection. Twenty-six fetuses of complicated pregnancies were also included. Statistical time series analysis techniques were used to examine the relation between fetal movement and fetal heart rate.

RESULTS

A linear increase was found in the magnitude of the cross-correlation function between fetal movement and fetal heart rate as gestation advanced, with coalescence around a peak lag of 5 seconds by 32 weeks. Fetuses that delivered before term evidenced accelerated fetal movement and fetal heart rate coupling, whereas fetuses affected by deleterious conditions showed a decline in developmental trajectory.

CONCLUSIONS

The cross-correlation between fetal cardiac and somatic activity is an indicator of neuroregulation in human fetuses.

Complementary and non-coincident increases in heart rate variability and irregularity during fetal development

1. Two distinct notions of variability have been defined to assess heart rate: deviation from a constant output (SD) and irregularity. One statistical measure of irregularity is approximate entropy, with greater irregularity corresponding to larger approximate entropy values. The specific aims of this investigation were to determine the manner in which SD and irregularity evolve during fetal development and whether this evolution is coincident or distinct. 2. Fetal heart rate was computed in 14 males and 17 females for 15 min of undisturbed recording using a fetal actocardiograph at 4 week intervals from 20 to 36 weeks gestation. 3. Mean heart rate decreased significantly with gestational ages (P < 0.05). SD increased significantly from 4.4 +/- 0.3 ms (SEM) at 20 weeks to 7.7 +/- 0.4 ms at 36 weeks (P < 0.05) and was similar between male and female fetuses (P = 0.57). Fixed approximate entropy increased significantly from 0.47 +/- 0.04 to 0.78 +/- 0.03, paralleling the change in SD (P < 0.01). Notably, normalized approximate entropy, which decorrelates SD from regularity, increased significantly with gestational age (P < 0.01) for males, while it remained relatively constant for females (P = 0.68). Approximate entropy was significantly lower at 20 weeks in males than females (P < 0.05); however, the values were similar by 28 weeks gestation. 4. Our results demonstrate that variability increases, and that irregularity increases, independently in male fetuses but not female fetuses, consistent with an increase in the coupling of emerging networks with gestational age. The present study demonstrates the complementary information obtained by analyses of both measures of variability and regularity. This reinforces a difference in gender-based development as noted in the separate context of fetal lung maturation.

Pathological changes in mice infected with tetrathyridia of Mesocestoides corti

Long-term studies in mice experimentally infected with the tetrathyridia of Mesocestoides corti have revealed disseminated lesions in the liver, lung, kidney, epididymis, and testicle.