• We found a proband carried RHD*01W.100 as well as RHD*weak partial 15, which inherited from her father and mother respectively.

近年来,高龄孕妇增加伴随辅助生殖技术在临床工作中广泛应用,使双胎妊娠比例上升.据北京协和医院统计,1990年至2014年双胎妊娠胎儿总数占围产儿总数的比例由2.0％上升至5.0％[1].美国统计资料显示,近10年双胎妊娠约占活产婴儿的3.2％～3.3％,较1980年增加76％.

Objective:To explore the diagnostic value of ultrasound in posterior fossa anomalies (PFA) at 11-13 + 6 gestational weeks by measuring brainstem (BS), brainstem-to-occipital bone (BSOB) diameter and BS/BSOB ratio. Methods:A total of 209 normal fetuses (control group) were randomly selected from Beijing Obstetrics and Gynecology Hospital, Capital Medical University, between March 2018 and November 2021. Reference ranges for BS, BSOB diameter and BS/BSOB ratio were obtained on the mid-sagittal view of the fetal profile and the relationship of three parameters and crown-rump length (CRL) was investigated. The intra- and inter-observer reliabilities were determined by intraclass correlation coefficient (ICC) in 30 normal fetuses. Fourteen fetuses diagnosed with PFA in the same period including 10 cases of cystic posterior fossa malformations (cPFM) and 4 cases of open spine bifida (OSB) were retrospectively selected to compare BS, BSOB diameter and the BS/BSOB ratio with control group.Results:BS and BSOB diameters were successfully obtained in all control fetuses (100%), and the intra- and inter-observer reliabilities for BS and BSOB diameters were good (ICC=0.877, 0.846 and 0.939, 0.895). In the control group, BS and BSOB diameter linearly correlated with CRL ( r=0.867, 0.794; all P<0.001), while the BS/BSOB ratio was 0.75 (0.71, 0.79). There were significant differences of BSOB diameter and BS/BSOB ratio between control group and PFA group (all P<0.05). Except for one isolated vermian hypoplasia (VH), the BSOB diameters in 9 (90%) cases of cPFM were above the 95th percentile of the calculated normal range and were below the 5th percentile in 4(100%) cases of OSB.Except for one isolated VH, the BS/BSOB ratio in 9 (90%) cases of cPFM was below the 5th percentile of the calculated normal range. The BS/BSOB ratio in 4 (100%) cases of OSB was above the 95th percentile of the calculated normal range. Conclusions:The measurements of BS and BSOB diameter are feasible with good repeatability. Abnormal BSOB diameter and BS/BSOB ratio are suggestive for PFA. The posterior fossa of isolated VH can be normal in the first trimester.

OBJECTIVE:To evaluate the efficacy of the first-trimester ultrasound scan in the detection of fetal structural anomalies in twin pregnancies. To examine the association between increased nuchal translucency (NT) thickness, crown-rump length (CRL) or NT discordance, and detection of structural anomalies in a large twin series in China.METHODS:We performed retrospective analysis of twin pregnancies who underwent 11-13+6 -week and second-trimester anomaly scan and booked at Beijing Obstetrics and Gynecology Hospital between January 2012 and December 2016. Measurement of fetal CRL/NT and assessment of fetal anatomic structures were based on standard (not detailed) protocols. Conjoined twins and twin-reversed arterial perfusion sequence (TRAPS) were excluded from structural anomalies. The diagnostic performance of first-trimester ultrasound in detection of fetal structural anomalies in twins was determined and compared with that of second trimester. The accuracy of independent variates associated with structural anomaly detection was calculated.RESULTS:A total of 1442 women with twin pregnancies were included. In 40 women and 45 fetuses, structural anomalies were found. Fetal structural anomalies verified at delivery were detected in 42.5% (17/40) of affected pregnancies in the first trimester and 92.5% (37/40) of affected pregnancies when added second trimester (P = .13). The survival rate of pregnancies detected in second trimester was higher than that of pregnancies detected in first trimester (11.8% vs 65.2%). The mean value of intertwin CRL/NT discordance in cases with fetal structural anomalies was larger in monochorionic twins than dichorionic twins, but monochorionicity was not associated with structural anomalies. CRL discordance ≥10% (OR 3.1, 95%CI 1.5-6.3) and NT ≥95th centile (OR 20.0, 95%CI 9.0-44.2) were associated with fetal structural anomalies. In both dichorionic (DC) and monochorionic (MC) twins, the percentages of CRL discordance ≥10% was larger in twins with structural anomalies than those without structural anomalies (37.5% vs 13.4% in DC twins and 50.0% vs 12.5% in MC twins), and this was also true for NT ≥95th centile (31.3% vs 1.7% in DC twins and 37.5% vs 2.2% in MC twins). In the setting of CRL discordance ≥10%, 40.0% (16/40) of twins with structural anomalies were found, in which the predominant fetal structural anomalies were cardiovascular defects, abdominal wall defects, and central nervous system defects. The AUC for detecting structural anomalies by CRL discordance ≥10% was 0.63. In the setting of NT ≥95th centile, 32.5% (13/40) of twins with structural anomalies were found, in which the predominant fetal structural anomalies were cardiovascular defects, cystic hygroma, and abdominal wall defects. The AUC for detecting structural anomalies by NT ≥95th centile was 0.65.CONCLUSIONS:The detection rate of twins with fetal structural anomalies was 42.5% per pregnancy in the first trimester. CRL discordance ≥10% and NT ≥95th centile may indicate higher risk of fetal structural anomalies in twins, but their efficacy was limited.

目的 探讨超声在诊断孕中期完全性子宫破裂中的价值.方法 选取2010年至2019年在首都医科大学附属北京妇产医院收治的经手术证实的8例孕中期完全性子宫破裂患者,对8例患者的术前超声声像图特点及临床资料进行回顾性分析.结果 8例病例均存在异常超声表现,且复杂多样.结合高危因素及临床表现,超声明确诊断子宫破裂2例、先兆子宫破裂1例,可疑子宫破裂4例,误诊胎盘早剥1例.结论 超声是诊断孕中期完全性子宫破裂的重要方法,可为临床诊断提供依据和参考.

Objective:To evaluate the placental villus blood flow in different pregnancy using superb microvascular imaging(SMI).Methods:Fifty single pregnant women were randomly selected from early pregnancy pregnant women with outpatient examinations from January 2019 to June 2019. The SMI technique was used to monitor the villus blood flow of the placenta during routine ultrasound examination in early, middle and late pregnancy. The blood flow of the placental villus at the insertion point of the placenta umbilical cord and the edge of the placenta was explored, and the corresponding arterial blood flow spectrum was collected, and the values of systolic/diastolic velocity ratio(S/D), pulsatility index(PI), resistance index(RI) and peak systolic velocity(PSV) were recorded. The correlation between the measurement rate of villus blood flow spectrum and the placenta position, fetal position, and pregnancy period were analyzed by Spearman correlation. Chi-square test was used compare the difference of the display rates of placental villus blood flow and the measurement rates of blood flow spectrum during different pregnancy periods. The consistency analysis of the results between the two inspectors was performed using Kappa test.Results:Finally, 30 pregnant women were enrolled. SMI showed 98.9% (89/90) of placental villus blood flow. The consistency of the examination results between the two examiners was good. The measurement rate of villus artery blood flow spectrum was not correlated with the placenta and fetal position ( P>0.05), but correlated with defferent trimesters ( r s=0.478, P<0.05). There was no difference in the display rate of villus blood flow at the insertion point of the placenta umbilical cord and at the edge of the placenta in each trimester( P>0.05). The measurement rate of blood flow spectrum was statistically different ( P<0.05). And the measurement rate of early pregnancy (33.3%/3.3%) was lower than the middle (70.0%/50.0%) and late pregnancy (56.6%/60.0%). The consistency of the examiners results between the two examiner is good (Kappa=0.55-0.92, P<0.05). Conclusions:SMI can display the blood flow of placental villus in different stages of pregnancy and can measured blood flow accordingly. The different pregnancy stages affect the measurement results. Placental villus blood flow measurement in the middle and late pregnancy is easier to measure than in the early pregnancy. The fetal position and placental position do not affect blood flow measurement.

目的 应用超声心动图评估双胎妊娠并发症孕妇左心结构和功能随孕周增长的变化规律.方法 选取经我院定期产前检查诊断的双胎妊娠并发症孕妇20例(病例组)和正常双胎妊娠孕妇50例(对照组),均于妊娠早中期(孕11～14周)、妊娠中期(孕21～26周)及妊娠晚期(孕28～34周)行常规产前超声检查和成人超声心动图检查,对病例组孕妇的左心结构和功能进行纵向研究,并与对照组各相关参数进行比较.结果 两组孕妇左房舒张末期内径均随孕周增加而增大,其中病例组左房收缩末期内径在妊娠中晚期显著增加,两组比较差异有统计学意义(P<0.05);两组二尖瓣舒张早期血流峰值速度与二尖瓣环舒张早期运动峰值速度比值(E/e')均随孕周增长而升高,但病例组心输出量、心脏指数、心率及左室射血分数(LVEF)随孕周增加无明显变化;与对照组比较,病例组妊娠早中期LVEF低,妊娠中期Tei指数高,差异均有统计学意义(均P<0.05).结论 双胎妊娠并发症孕妇左房舒张、收缩末期内径随孕周增大而增加,心输出量、心脏指数、心率随孕周增大未出现正常适应性改变,妊娠早中期即表现为左室收缩末期内径增高、LVEF降低,妊娠中期心脏整体功能较差.

Purpose To analyze copy number variants (CNVs) in subjects with small for gestational age (SGA) in China. Methods A total of 85 cases with estimated fetal weight (EFW) or birth weight below the 10th percentile for gestational age were recruited, including SGA associated with structural anomalies (Group A, n = 20) and isolated SGA (Group B, n = 65). In all cases, cytogenetic karyotyping and infection screening were normal. We examined DNA from fetuses (amniocentesis or cordocentesis) and newborns (cord blood) to detect CNVs using a single nucleotide polymorphism (SNP, n = 75) array or low-pass whole-genome sequencing (WGS, n = 10). Results Of 85 total cases, 3 (4%) carried pathogenic chromosomal abnormalities, including 2 cases with pathological CNVs and 1 case with upd(22)pat. In Group A, the mean gestational age at the time of diagnosis was 26.8 (SD 4.1) weeks and mean EFW/birth weight was 907.2 (SD 567.8) g. In Group B, the mean gestational age at the time of diagnosis was 34.1 (SD 5.8) weeks. Mean EFW/birth weight was 1879.2 (SD 714.5) g. The pathologic detection rate was 10% (2/20) in Group A and 2% (1/65) in Group B. It was inclined that the lower the EFW percentile, the more frequent the occurrence of CNVs. Conclusions Pathological subchromosomal anomalies were detected by CMA or low-pass WGS in 10% and 2% of SGA subjects with and without malformation, respectively. SGA fetuses with structural anomalies presented with higher pathological subchromosomal anomalies. The molecular genetic analysis is not recommended for isolated SGA pregnancies without other abnormal findings.

目的 探讨单核苷酸多态性微阵列(single nucleotide polymorphism array,SNP-array)技术在早期胎停育遗传学病因诊断中的应用价值.方法 收集2018年1月至2019年2月妊娠12周以前在首都医科大学附属北京妇产医院明确诊断胎停育并行人工流产术的患者28例为胎停育组,同时收集正常妊娠要求人工流产终止妊娠的患者10例作为对照组.两组患者术后留取绒毛组织标本进行SNP-array检测.结果 胎停育组中23例(82.1％)SNP-array检测结果显示染色体异常,其中21例(91.3％)为染色体数目异常.高龄孕妇与非高龄孕妇的染色体异常发生率比较差异无显著性(P>0.05).重复胎停育组与首次胎停育组的染色体异常发生率和年龄比较差异无显著性(P>0.05).胎停育组与对照组患者年龄比较差异有显著性(P=0.035).结论 ①胚胎染色体异常是导致早期胎停育的主要原因之一;②胚胎染色体异常最常见的类型是染色体数目异常;③早期胎停育染色体异常与孕妇年龄无直接相关性;④早期胎停育染色体异常与胎停育次数无直接相关性.

先天性心脏病(congenital heart disease,CHD)为最常见的出生缺陷,根据中国出生缺陷防治报告(2012)数据,2011年我国CHD围生期发生率为4.095‰,居出生缺陷之首,至少50％为严重CHD需要接受外科治疗[1].对严重CHD定义并不统一,大多数学者认为严重CHD是指生后(一年内)需要手术或介入治疗干预的CHD,活产儿发病率为4‰～5‰[2].严重CHD导致围生期死亡率增加,活产儿治疗难度高.超声检查是孕期重要的检查手段,对严重CHD的超声早期识别有助于临床早期诊断决策,提高围生期生存率.因此,本文对孕11～13+6周胎儿超声心动图识别严重先天性心脏病的研究进展进行综述.

目的 探讨血生化指标联合超声标记预测胎儿21-三体综合征、18-三体综合征的价值. 方法 收集在首都医科大学附属北京妇产医院接受孕中期(20 ～24+6周)产前超声检查且染色体结果为21-三体(28例)、18-三体(17例)或染色体判定为正常(5 572例)的共计5 617例病例的超声影像学信息及唐氏筛查(血清学三联产前筛查)结果,通过计算灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比、约登指数、受试者工作特征曲线(ROC曲线)下面积(AUC)等指标,分析比较唐氏筛查结果单独预测染色体异常与唐氏筛查结合超声信息联合预测染色体异常两种筛查方法的效果. 结果 接受唐氏筛查共计4 122例,检查率为73.4％.唐氏筛查结合超声信息联合预测染色体异常的特异度(83.4％)低于唐氏筛查结果单独预测染色体异常的特异度(93.1％),但灵敏度及综合性指标(约登指数、AUC)高于唐氏筛查结果单独预测染色体异常的对应指标(联合判定效果:灵敏度84.2％、约登指数67.6％,AUC 0.838;唐氏筛查效果:灵敏度42.1％,约登指数35.2％,AUC 0.535). 结论 血清学三联产前筛查(唐氏筛查)诊断胎儿染色体异常存在一定的局限,联合应用孕中期产前超声检查指标可以在一定程度上改善诊断效果.

Objective To explore the value of ultrasonic markers of first trimester in prediction of trisomy 21, trisomy 18 and trisomy 13 syndrome. Methods Totally 1564 pregnant women were collected from Beijing Obstetrics and Gynecology Hospital, Capital Medical University from September 2014 to May 2016. All the cases underwent the ultrasound screening during 11 to 13+ 6 weeks and the chromosome results were Trisomy 21, Trisomy 18, Trisomy 13 or normal. The effects of using different kinds of ultrasonic markers combination to predict chromosomal abnormalities were evaluated by the area under the receiver operating characteristic curve (AUC), sensitivity, specificity and Youden index. Results The results of multivariate Logistic regression model suggested that maternal age (OR=1.05, 95%CI: 1.01-1.10), nasal bone hypoplasia (OR=14.54, 95%CI: 2.28-92.75), nuchal translucency (NT) thickening (OR=12.46, 95%CI: 8.27-18.78), the crown-rump length (GRL) decrease (OR=12.79, 95%CI: 1.45-113.14), fetal edema (OR=9.69, 95%CI: 3.55-26.48) were the risk factors of common trisomy syndromes. Using these factors to establish Model A, the the AUC, sensitivity, specificity and Youden index of were 0.770, 0.630, 0.904 and 0.534. While the results of using NT thickening and age to establish the multiple Logistic regression model (Model B) were 0.756, 0.618, 0.907 and 0.525. NT thickening and age were used as single variable, and the other 8 ultrasonic markers were combined into a new variable (other abnormality), and the results of establishing a multiple Logistic regression model (Model C) were 0.775, 0.642, 0.902 and 0.543. Conclusion NT thickening in early pregnancy ultrasonic markers is of great significance in predicting the common trisomy syndromes in fetuses, and the combination of other ultrasonic indicators can optimize the prediction effect to some extent. Key words: First trimester; Ultrasonic markers; Trisomy 21 syndrome; Trisomy 18 syndrome; Trisomy 13 syndrome

目的 探讨双胎妊娠并发症孕妇血管阻力及子宫动脉血流参数的变化规律.资料与方法 选择2013年1月-2015年1月在首都医科大学附属北京妇产医院建档的20例双胎妊娠并发症孕妇作为研究组,并选择同期50例正常双胎孕妇作为对照组,于妊娠各期行超声心动图、子宫动脉检查及测量血压,对其总血管阻力、血压及子宫动脉血流行纵向研究.结果 对照组妊娠早中期总血管阻力降低(P<0.01),研究组无明显变化(P>0.05);研究组双侧子宫动脉血流参数值及舒张早期切迹随妊娠进展减少(P<0.01),妊娠早中期舒张早期切迹存在率较对照组高(P<0.05),妊娠中期舒张期血压升高(P<0.05),妊娠晚期收缩期血压升高(P<0.05).结论 双胎妊娠并发症孕妇总血管阻力未出现适应性降低,影响胎盘功能导致并发症发生,妊娠中晚期血压及早中期子宫动脉舒张早期切迹存在率较正常双胎孕妇高,可作为预测并发症的候选指标.

目的 探讨不同种类非整倍体染色体异常妊娠中期超声表现,制定妊娠中期预测21-三体综合征、18-三体综合征的超声量化评分表.方法 选择207例非整倍体染色体异常患者作为研究组,21 310例染色体正常者作为对照组,分析妊娠20～25周不同非整倍体染色体异常的超声表现.将与非整倍体染色体异常相关的轻微结构异常及畸形作为超声指标,通过logistic回归筛选指标,根据阳性似然比赋予指标单项分值,制定妊娠中期预测21-三体综合征、18-三体综合征的相关超声量化评分表,并进行诊断试验评价.结果 ①超声图像中,65.7％(65/99)21-三体综合征,98.3％ (59/60) 18-三体综合征,73.3％(11/15) Turner综合征,14.8％(4/27) XXX/XXY/XYY综合征,5例13-三体综合征,1例9-三体综合征可发现轻微结构异常和(或)畸形;②21-三体综合征患者脑室扩张、颈后皮褶厚度增厚、心室内点状强回声、肾盂扩张、肢体短小发生率均超过10％,35.4％(35/99)患者存在畸形,最常见为心脏畸形,其次为消化道畸形.预测21-三体综合征的量化评分表的敏感度和特异度分别为56.6％和97.2％;18-三体综合征患者脉络丛囊肿、胎儿生长受限发生率均超过10％,颈后皮褶厚度增厚发生率为3.3％,95.0％患者存在畸形,最常见为心脏畸形,其次为消化道畸形、肢体畸形及面部畸形.预测18-三体综合征的量化评分表的敏感度、特异度分别为93.5％和98.1％.结论 妊娠中期不同种类非整倍体染色体异常者可有多种超声轻微结构异常及畸形.超声量化评分表对21-三体综合征、18-三体综合征具有较好的预测价值,便于临床综合应用.

Objective To assess the application value of trans-vaginal ultrasound and real-time sono-elastography in assessing the risk of preterm birth in pregnant women. Methods A total of 108 pregnant women who received prenatal examination at Beijing Obstetrics and Gynecology Hospital from January to November 2017 were included. Based on the presence of threatened premature or preterm labor or not, they were divided into a study group (n=29, with threatened premature or preterm labor) and a control group (n=79, with no threatened premature or preterm labor). Cervical length (CL) was measured by trans-vaginal ultrasound, and the following three cervical elasticity indexes were obtained by sono-elastography: the entire cervical strain rate (CS), the internal cervical os strain rate (IS), and external cervical os strain rate (ES). Independent samples t-test was used to analyze the difference in the above indexes between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to assess the value of the above indexes in predicting the risk of preterm birth.Results CL was significantly lower[(2.94±0.66)cm vs(3.91±0.71)cm]and IS was significantly higher [(0.53±0.28)% vs (0.47±0.20)%] in the study group than in the control group (t=6.436, 3.406,both P<0.05).CS and ES in the study group were higher than those in the control group[(0.40±0.30)% vs (0.24±0.19)%,(0.74±0.39)% vs(0.73±0.37)%],but the differences were not statistically significant(t=1.365, 0.207, both P>0.05). ROC curve analysis indicated that CL, CS, IS, and ES performed differently in assessing the risk of preterm birth in pregnant women [area under the ROC curve (AUC): 0.156, 0.558, 0.689, 0.499]. The AUCs of CS and IS were greater than 0.50, and the AUC of IS was larger than those of other indexes. Using 0.30% as a cut-off for IS, its sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 66.7%, 79.3%, 71.1%, 55.4%, and 80.2%, respectively. Conclusions Cervical tissue elasticity indexes obtained by sono-elastography can be used to assess pregnant women at different gestational ages and predict the risk of preterm birth feasibly. IS is more useful than other indexes in predicting early or asymptomatic preterm birth.

Objective To investigate the diagnosis value of the three-dimensional transvaginal ultrasound volume technology in polycystic ovary syndrome (PCOS).Methods Totally 75 patients with PCOS and 50 normal subjects as controls from Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University were chosed. The volume of the endometrium and ovaries were measured with virtual organ computer-aided analysis techniques (VOCAL). While the follicular numbers and the volumes were measured by sono follicle technique. The ovarian volumes, the follicular volumes and the endometrial volumes were compared between the two groups. Independent samplest test was used to compare PCOS group patients and healthy subjects with endometrial volumes, ovarian volumes, follicle volumes and the average numbers of follicle. Pearson correlation analysis was used to analyze the correlation between the number of total follicles and the volume of ovary, follicle volume and serum sex hormone concentration in PCOS group.Results With the endometrial volume of PCOS patients about (1.6±0.9) cm3 was less than that of the control group [(3.1±1.7) cm3]. The ovarian volume, follicular volume and the average number of follicles were (13.6±4.6) cm3, (1.9±0.7) cm3 and (27.7±7.4). All of them were higher than those in healthy subjects [(7.4±2.9) cm3, (1.1±0.7) cm3, (8.4±3.4)], and the differences were statistically significant (t=6.013, P<0.001;t=8.087,P=0.015;t=7.222,P<0.001;t=15.637,P<0.001). The total number of follicles in PCOS patients were positively correlated with ovarian volume, follicle volume and serum testosterone concentrations (r=0.467,P=0.000;r=0.446,P=0.000;r=0.383,P=0.001). There was no correlation with luteinizing hormone (LH)/thyroid stimulating hormone (TSH) (r=0.048,P=0.702).Conclusion The sono follicle and VOCAL technology provide a new and objective measurement method for PCOS diagnosis.

Rationale:Uniparental disomy (UPD) gives a description of the inheritance of both homologues of a chromosome pair from the same parent. The consequences of UPD depend on the specific chromosome/segment involved and its parental origin.Patient concerns:We report prenatal phenotypes of 2 rare cases of UPD.Diagnoses:The prenatal phenotype of case 1 included sonographic markers such as enlarged nuchal translucency (NT), absent nasal bone, short femur and humerus length, and several structural malformations involving Dandy-Walker malformation and congenital heart defects. The prenatal phenotype of Case 2 are sonographic markers, including enlarged NT, thickened nuchal fold, ascites, and polyhydramnios without apparent structural malformations.Interventions:Conventional G-band karyotype appears normal in case 1, while it shows normal chromosomes with a small supernumerary marker chromosome (sSMC) in case 2. Genetic etiology was left unknown until single-nucleotide polymorphism-based array (SNP-array) was performed, and segmental paternal UPD 22 was identified in case 1 and segmental paternal UPD 14 was found in case 2.Outcomes:The parents of case 1 chose termination of pregnancy. The neonate of case 2 was born prematurely with a bellshaped small thorax and died within a day.Lessons:UPD cases are rare and the phenotypes are different, which depend on the origin and affected chromosomal part. If a fetus shows multiple anomalies that cannot be attributed to a common aneuploidy or a genetic syndrome, or manifests some features possibly related to an UPD syndrome, such as detection of sSMC, SNP-array should be considered.

Objectives To investigate the significance of antenatal ultrasonography on the diagnosis of suprarenal masses and the effect on the postnatal strategy. Methods Analyzed the antenatal ultrasonographic manifestations and followed up the outcomes of 17 cases with suprarenal masses diagnosed in Beijing Obstetrics and Gynecology Hospital from January 2014 to June 2016. Results Among 17 cases of fetal suprarenal masses, 19 lesions were located on the left side in 8 cases, on the right side in 7 cases, bilaterally in 2 cases; the initial sizes of lesions were 1.2-6.5 cm, with the mean of 2.8±1.4 cm; the original ultrasonographic manifestations were cystic in 4 lesions, cystic-solid in 11 lesions, solid in 4 lesions; internal blood flow was detected in 7 lesions; antenatal follow-up results were available in 3 cases, which showed slightly increased lesion size in 2 cases and remarkably increased size in 1 case, and the internal echoes of lesions was persistently cystic-solid or solid in 2 cases, while in 1 case, the cystic echo turned into cystic-solid. Among 17 cases, 4 cases terminated the pregnancy selectively. In 13 cases which continued the pregnancy, 8 cases were diagnosed as adrenal hemorrhage and the lesions disappeared on the postnatal ultrasound examinations, while 5 cases were neuroblastoma, 3 received surgery postnatally and 2 were followed up conservatively and the lesions decreased in size or completely disappeared. Conclusions Adrenal bleeding and neuroblastoma have certain characteristics on antenatal ultrasound.Antenatal ultrasound has important role in the definite diagnosis and the establishment of treatment strategy of the suprarenal masses. Key words: Ultrasonography, prenatal; Fetus; Adrenal glands; Hemorrhage; Neuroblastoma

Objective: To explore the application value of assisted laparoscopic ultrasound in myomectomy. Methods: One hundred and fifty six patients who underwent myomectomy in Beijing Obstetrics and Gynecology Hospital from 2011 to 2013 were enrolled.The patients were randomly divided into laparoscopic ultrasound guided group (n=57), laparoscopic group (n=54) and open resection group (n=45). The patients were followed up to calculate the residue and recurrence rates of uterine fibroids by vaginal ultrasound at 6th month and 12th-18th month after the operation. The residual and recurrence rates of the three methods were calculated and compared. Results: The recurrence rate of laparoscopic ultrasound guided group wassignificantly lower than that of laparoscopic group and open resection group (P<0.01) and (P<0.01). The residual rate of laparoscopic ultrasound guided group was also lower than that of laparoscopic group(P<0.05). However, there was no difference between the residual rates of laparoscopic ultrasound guided group and open resection group (P>0.05). When compared with open resection group, no difference was found in the residual and recurrence rates of laparoscopic group. The number of myoma was proportional to the residual rate and the recurrence rate. When the number of the myoma was more than 10, most of the cases existed residue. Conclusion: The application of assisted laparoscopic ultrasound in myomectomy couldreduce the residual and recurrence rate of uterine fibroids.