The split hand split foot malformation is a rare disorder inherited in an autosomal dominant pattern with variable expression. In our case it was detected early by ultrasound in the twelfth week of gestation. To our knowledge, this is the earliest finding by ultrasound of this malformation. The sonographic findings were bilateral split hands and split foot. No other associated malformation was observed. The pathological findings were consistent with the diagnosis of split hand split foot malformation. Prenatal diagnosis, the genetic background, and the differential diagnosis are discussed. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology

Seit der Einführung der Dopplersonographie ist die nichtinvasive Überwachung des fetomaternalen Kreislaufes möglich [7, 8, 9]. Durch die qualitative Analyse der Flußgeschwindigkeitskurven mittels winkelunabhängiger Indizes werden Parame ter wie die kardiale Funktion, die Gefäßwand-Compliance und der periphere Widerstand indirekt erfaßt [22, 31]. Durch pathologisch veränderte Flußmuster sowohl in der Aorta fetalis wie auch in der A. umbilicalis (A. umb.) kann eine drohende fetale Gefährdung erfaßt werden [12, 14, 25].DerenddiastolischeFlußverlust(EDFV) und der Reverse flow sind als hochpathologische Veränderungen des Flußmusters in hohem Maße mit intrauteriner Asphyxie, intrauterinem Fruchttod (IUFT) und perinataler Mortalität assoziiert [2, 6, 11, 18, 20, 29, 34]. Über das geeignete geburtshilfliche Management bei EDFV bestehen noch Unsicherheiten bzw. Kontroversen. Während einerseits bei EDFV die vorzeitige Entbindung empfohlen wird [27, 35], stellen z.B. Weiß und Berle (1991) [34] bei EDFV die Indikation für eine stationäre Intensivüberwachung. Nachgewiesene gute Korrelationen zwischen Blutgasanalyse und Dopplerbefunden [4, 21 ] lassen eine bessere Beurteilung des fetalen Zustandes erwarten. Ziel dieser Arbeit ist, anhand der Analyse von 41 Fällen mit EDFV unsere Erfahrungen darzustellen.

From 1987 until 1992, 16 triplets and 2 quadruplets were studied by pulsed Doppler ultrasound between 17 and 36 weeks of gestation. A resistance index (RI) of the foetal aorta and umbilical artery above the 95th percentile was considered pathological. Elevated RI-values of the umbilical artery as compared to the A. cerebri media were indicative of circulatory centralisation. Intrauterine growth retardation (IUGR) was found in 9 (16%) foetuses, discordant growth occurred in 7 (39%) pregnancies. 41 (73%) of 56 foetuses survived in good health. Four of 7 foetuses with pathological Doppler findings died. The three survivors were markedly retarded. Four of 6 cases of intrauterine endangered foetuses were detected by Doppler sonography. The diagnosis of IUGR or discordant growth was based more frequently on pathological Doppler findings than on biometry and improved upon by combinations of both methods. Doppler sonography proved to be an important complementary method in the monitoring of high-grade multiple pregnancies.

From 1987 until 1992, 16 triplets and 2 quadruplets were studied by pulsed Doppler ultrasound between 17 and 36 weeks of gestation. A resistance index (RI) of the foetal aorta and umbilical artery above the 95th percentile was considered pathological. Elevated RI-values of the umbilical artery as compared to the A. cerebri media were indicative of circulatory centralisation. Intrauterine growth retardation (IUGR) was found in 9 (16%) foetuses, discordant growth occurred in 7 (39%) pregnancies. 41 (73%) of 56 foetuses survived in good health. Four of 7 foetuses with pathological Doppler findings died. The three survivors were markedly retarded. Four of 6 cases of intrauterine endangered foetuses were detected by Doppler sonography. The diagnosis of IUGR or discordant growth was based more frequently on pathological Doppler findings than on biometry and improved upon by combinations of both methods. Doppler sonography proved to be an important complementary method in the monitoring of high-grade multiple pregnancies.

From 1987 until 1992, 16 triplets and 2 quadruplets were studied by pulsed Doppler ultrasound between 17 and 36 weeks of gestation. A resistance index (RI) of the foetal aorta and umbilical artery above the 95th percentile was considered pathological. Elevated RI-values of the umbilical artery as compared to the A. cerebri media were indicative of circulatory centralisation. Intrauterine growth retardation (IUGR) was found in 9 (16 %) foetuses, discordant growth occurred in 7 (39 %) pregnancies. 41 (73 %) of 56 foetuses survived in good health. Four of 7 foetuses with pathological Doppler findings died. The three survivors were markedly retarded. Four of 6 cases of intrauterine endangered foetuses were detected by Doppler sonography. The diagnosis of IUGR or discordant growth was based more frequently on pathological Doppler findings than on biometry and improved upon by combinations of both methods. Doppler sonography proved to be an important complementary method in the monitoring of high-grade multiple pregnancies.

The horns of the mufflon ram are ideal study objects for hunting biological and population genetic purposes.Subsequent measuring of the horns of 81 gold medal and 16 non-medal rams from East Germany permitted the calculation of the average values and distribution of age dependent growth. A great amount of overlap was observed in the evaluations of the juvenile classes, which makes the certain differentiation according to the real growth achieved practically impossible. This statement is supported by values predicted by the degree of certainty. Changes in the present hunting strategies should be considered.

Die Widderschnecke stellt ein ideales jagdbiologisches und populationsgenetisches Studienobjekt dar.