Congenital anomalies are the second leading cause of perinatal mortality in the United States after premature birth. Advances in imaging techniques have allowed the detection of many anatomical defects with ultrasound before birth. The goal of this project is to improve the diagnosis and treatment of fetal disease and congenital anomalies. The Perinatology Research Branch has initiated a project to use tri-dimensional ultrasound to delineate normal fetal anatomy, improve the detection of congenital anomalies and the estimation of fetal weight and growth. The Branch has acquired the skills and equipment to initiate the project. The diagnostic power of this technology is illustrated by the improved detection of a vassa previa, a rare but potentially lethal condition. This condition is characterized by the presence of aberrant fetal vessels within the fetal membranes in close proximity to the uterine cervix. At the time of rupture of membranes (spontaneous or artificial), patients with a vassa previa may sustain laceration of the fetal vessels resulting in fetal exsanguination and fetal death or severe anemia and neurologic handicap. Therefore, prenatal diagnosis is critical. The Branch has been able to use grey scale multi-planar and the flight path techniques to make the diagnosis in two cases. We expect that tri-dimensional ultrasound would enhance the precision of prenatal diagnosis of many other congenital anomalies. - congenital anomalies, prenatal diagnosis, ultrasound - Human Subjects

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Intramural Research (Z01)
Project #
1Z01HD002401-07
Application #
6290248
Study Section
Special Emphasis Panel (PRB)
Project Start
Project End
Budget Start
Budget End
Support Year
7
Fiscal Year
1999
Total Cost
Indirect Cost
City
State
Country
United States
Zip Code
Korzeniewski, Steven J; Grigorescu, Violanda; Kleyn, Mary et al. (2013) Transient hypothyroidism at 3-year follow-up among cases of congenital hypothyroidism detected by newborn screening. J Pediatr 162:177-82
Gotsch, Francesca; Romero, Roberto; Espinoza, Jimmy et al. (2010) Prenatal diagnosis of truncus arteriosus using multiplanar display in 4D ultrasonography. J Matern Fetal Neonatal Med 23:297-307
Kusanovic, Juan Pedro; Romero, Roberto; Gotsch, Francesca et al. (2009) Discordant placental echogenicity: a novel sign of impaired placental perfusion in twin-twin transfusion syndrome? J Matern Fetal Neonatal Med :1-4
Lampl, Michelle; Kusanovic, Juan Pedro; Erez, Offer et al. (2009) Growth perturbations in a phenotype with rapid fetal growth preceding preterm labor and term birth. Am J Hum Biol 21:782-92
Chaiworapongsa, Tinnakorn; Espinoza, Jimmy; Gotsch, Francesca et al. (2008) The maternal plasma soluble vascular endothelial growth factor receptor-1 concentration is elevated in SGA and the magnitude of the increase relates to Doppler abnormalities in the maternal and fetal circulation. J Matern Fetal Neonatal Med 21:25-40
Espinoza, J; Romero, R; Kusanovic, J P et al. (2008) Standardized views of the fetal heart using four-dimensional sonographic and tomographic imaging. Ultrasound Obstet Gynecol 31:233-42
Kusanovic, J P; Nien, J K; Goncalves, L F et al. (2008) The use of inversion mode and 3D manual segmentation in volume measurement of fetal fluid-filled structures: comparison with Virtual Organ Computer-aided AnaLysis (VOCAL). Ultrasound Obstet Gynecol 31:177-86
Romero, Roberto; Nien, Jyh Kae; Espinoza, Jimmy et al. (2008) A longitudinal study of angiogenic (placental growth factor) and anti-angiogenic (soluble endoglin and soluble vascular endothelial growth factor receptor-1) factors in normal pregnancy and patients destined to develop preeclampsia and deliver a small for J Matern Fetal Neonatal Med 21:9-23
Mittal, P; Hassan, S S; Espinoza, J et al. (2008) The effect of gestational age and labor on placental growth hormone in amniotic fluid. Growth Horm IGF Res 18:174-9
Than, Nandor Gabor; Abdul Rahman, Omar; Magenheim, Rita et al. (2008) Placental protein 13 (galectin-13) has decreased placental expression but increased shedding and maternal serum concentrations in patients presenting with preterm pre-eclampsia and HELLP syndrome. Virchows Arch 453:387-400

Showing the most recent 10 out of 60 publications