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The relationship of fetal renal pelvis dilatation in mid-secondtrimester and postnatal uropathySuzuki M, Kameda Medical Center, Japan

Objectives: The purpose of this study was to determine the incidenceof minor degree of renal pelvis dilatation in an unselected Japanesepopulation at mid second trimester (18 to 20 weeks of gestation) byantenatal ultrasonography and to evaluate the relationship of postnataluropathies.Methods: The fetuses were evaluated renal pelvis dilatation as part ofroutine fetal structural screening ultrasonography at mid second trimes-ter between 6/01/2004 and 6/31/2005. Fetus with more than 3 mm of ananterior-posterior pelvis diameter (APPD) was enrolled. The fetus withprenatal pyelectasis was checked up after birth and re-evaluated thesize of pelvis.Results: On 504 fetuses were performed a routine fetal structuralscreening ultrasonography at mid-second trimester. Twenty-five fe-tuses and 36 kidneys had pyelectasis (17 in the right, 19 in the left and11 in both sides). The male/female ratio was 14/11 fetuses. Threefetuses with more than 5.0 mm of APPD at mid-second trimester hadpyeloectasis in neonate. No one with below 5.0 mm of APPD hadpyelectasis postnatally.Conclusions: Pyelectasis was found 5.0% of fetuses at mid-secondtrimester in an unselected Japanese population. More than 5.0 mm ofAPPD at 18 to 20 weeks of gestation was cut off value of neonataluropathies.

3409

Patterns of normal change in fetal cerebral artery pulsatilityindex during pregnancy: A prospective longitudinal studyChoi SJ, Chung I-B, Wonju College of Medicine, Yonsei University,Korea

Objectives: Recent studies have attempted to document the relation-ship between the Doppler variables of the fetal cerebral artery and fetalhypoxia. For clinical applications, the normal range at each gestationalperiod needs to be known. The aim of this study was to establish thenormal range of the fetal cerebral artery pulsatility index (PI) through-out pregnancy.Methods: A prospective observational study was undertaken. Dopplerultrasonographic examination was performed in 26 normal pregnanciesbetween 28 and 40 weeks gestation.Results: The gestational weeks were grouped into 4-week sections.Group I ranged from 28 to 32 gestational weeks. Groups II and IIIranged from 33 to 36 and from 37 to 40 weeks, respectively. Theanterior cerebral artery PI decreased with increasing gestational time(group I: 1.805 � 0.415, group II: 1.542 � 0.309, group III: 1.461 �0.303; p � 0.01). The middle cerebral artery PI also decreased (groupI: 2.064 � 0.478, group II: 1.789 � 0.366, group III: 1.519 � 0.334;p � 0.01).Conclusions: We showed the pattern of normal change in fetal cerebralartery throughout pregnancy.

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A case of fetal multicystic renal dysplasia complicated by severeoligohydramnios in the second trimesterKil K, Yoon J-H, Park D-C, Kwon D-J, Yoo Y-O, Kim D-H, ShinJC, Lee GSR, St. Vincent’s Hospital, The Catholic University ofKorea, Korea; Kang Nam St. Mary’s Hospital, The CatholicUniversity of Korea, Korea

The multicystic renal dysplasia is the most common form for renalcystic disease in childhood and represents one of the most common

abdominal masses in the neonate. We present a case of unilateralmulticystic renal dysplasia complicated by severe oligohydramnios inthe second trimester diagnosed by ultrasound examinations and MRI,and successfully managed conservatively by serial amnioinfusion.

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Congenital diaphragmatic hernia into pericardial space withouthypoplasia of lungWu P-J, Hsieh C-C, Huang Y-H, Ko B-J, Hsieh TT, Chang GungMemorial Hospital, Taipei, Taiwan

This report was to demonstrate antenatal diagnosis of a case of con-genital diaphragmatic hernia with liver herniation into pericardial spacewithout hypoplasia of lung. Case: A 26-year old woman G1P0, under-went level II sonography at 22 weeks gestation, which revealed rightdiaphragmatic hernia with liver herniation, pericardial effusion anddeviation of the heart without polyhydramnios. PROM happened at 37weeks gestation and the patient requested Cesarean section. A malebaby was delivered and weighing 2950 gm with immediate endotra-cheal tube intubation in OR and transferred to NICU for furthermanagement. Surgery performed 2 days later revealed a huge retro-sternal defect of diaphragm (7 � 5 cm) with left lobe of liver herniationinto pericardial space. Reposition of the liver with closure of defect wasperformed with well expansion of bilateral lung. Two days after oper-ation, the baby received weaning the ventilator successfully and expe-riences a very good clinical course up to date.

3412

The clinical usefulness of the dynamic magnetic resolution image(DMR) in catheter insertion proceduresKim A, Cho HJ, Shim J-Y, Won H-S, Lee PR, University of UlsanCollege of Medicine, Asan Medical Center, Korea

The purpose of this study is to introduce the clinical usefulness of theDMR in obstetrics especially various catheter insertion procedures. TheDMR is a technology for examining more fine images. The specklenoise is eliminated and the images of edges are enhanced by specialfiltering in DMR. We performed conventional 2D ultrasonogram sup-plemented by DMR using Accuvix XQ convex probe (Medison Co.Korea). We checked DMR in cordocentesis for fetal karyotyping,transfusion and basket insertion technique for posterior urethral valves(PUVS) with oligohydramnios. We demonstrated tips of the catheterand edges of the fetal vessel were identified more easily and clearly inDMR. Most of all, DMR was useful in judgment whether site of theinserted catheter was correct or not in cases of PUVS with oligohy-dramnios after procedure and needle position during fetal transfusion.In our study, we present DMR may be useful additional method invarious catheter insertion procedures.

3413

Fetal strokeWang C-N, Chao A-S, Chiu T-H, Yang T-Y, Hsieh TT, Hsieh C-C,Wu P-J, Chang Gung Memorial Hospital, Taipei, Taiwan

The objective of this report was to demonstrate evolving changes offetal intraventricular hemorrhage. Two cases were presented with themanifestation of ventriculomegaly and hydrocephalus noted duringsonographic examinations. Case 1: A 36-year old woman, G2P1, un-derwent level II sonography at 25 weeks gestation, which revealedunilateral ventriculomegaly of fetus. Further MRI study presentedhemorrhage of right germinal matrix with rupture into the right lateralventricle and enlargement of lateral ventricle with the maximal widthof 15 mm. The patient requested termination of this pregnancy. Case 2:A 32-year old woman, G2P1, had received regular antenatal examina-

P260 Ultrasound in Medicine and Biology Volume 32, Number 5S, 2006