Development of the meniscus of the knee joint in human fetuses

Discoid meniscus of the knee joint occurs at a higher incidence in the lateral than in the medial menisci. Although its developmental origin has been suggested, it remains unclear. To verify the developmental etiology, we examined the meniscus of the knee joint in 41 human fetuses (from 14 to 30 weeks of gestation) and 14 adults (from 56 to 91 years of age) comparatively. The articular surfaces of the tibia and meniscus of the left knees in 40 fetuses and 14 adults were photographed and each area was measured by Scion Image (Scion; http://www.scioncorp.com ). Morphometric analyses revealed that the proportion of the area of meniscus to that of the plateau was continuously higher in the lateral side than in the medial side. The right knee joints of seven fetuses were histologically observed, and the layered structure of fibers developed earlier in the lateral meniscus than in the medial in fetuses. The observed differential development of lateral and medial sides of the meniscus may be involved in the etiology of discoid meniscus.     

Systematic multidisciplinary approach to reporting perinatal mortality: Lessons from a five-year regional review

Background:  Because of differences in reporting criteria throughout the world, comparing perinatal mortality rates and identifying areas of concern can be complicated and imprecise.
Aims:  To detail the systematic approach to reporting perinatal deaths and to identify any significant differences in outcomes in the Australian Capital Territory (ACT).
Methods:  Review of perinatal deaths from 2001 to 2005 in the ACT using the Australian and New Zealand Antecedent Classification of Perinatal Mortality (ANZACPM) and the Australian and New Zealand Neonatal Death Classification (ANZNDC) systems.
Results:  ACT residents' perinatal mortality rate was 10.6 per 1000 total births, fetal death rate 7.5 per 1000 total births and neonatal death rate 3.2 per 1000 live births. The three leading antecedent causes of perinatal death were congenital anomalies, spontaneous preterm birth and unexplained antepartum death. The three leading causes of neonatal death were extreme prematurity, cardiorespiratory disorders and congenital anomalies. Multiple births attributed to 20% (65 of 321) of perinatal deaths. Perinatal autopsy was performed in 50% of cases, but in only 64% of unexplained antepartum deaths.
Conclusions:  Causes of perinatal death for the ACT and surrounding New South Wales region are similar to other states using this classification system. The following are considered important lessons to promote accurate perinatal mortality reporting: (i) a universal reporting system for Australia utilising a multidisciplinary team; (ii) a high perinatal autopsy rate, especially in the critical area of antepartum death with no identifiable cause; and (iii) standardised definitions for avoidability. Attention to these areas may prompt further research and changes in practice to further reduce perinatal mortality.     

妊娠期糖尿病与妊娠结局的关系

Objective To evaluate the influence of gestational diabetes mellitus(GDM) on the pregnancy outcome. Methods 84 cases with GDM by the clinical data of patients with GDM were analyzed retrospectively;84 cases were divided into untreated group(A group)42 cases and diet plus insulin treatment group(B group)45 cases, compared 2 groups of pregnancy outcome. Results In B group of pregnancy - induced hypertension, placental abrup-tion, polyhydranmios,when the middle class bleeding, puerperal infection (19.6%, 0%, 0%, 2.0%, 3.9%) were lower than A group (42.9%, 7.1% ,4.8% ,7.1%, 9.5%) (t=2.123,t =2.241,t =2.135,t =2. 312,t =2.309,P <0.05) ;In B group of gestational age(33.3%) was significantly lower than A group(23.8%) (χ2 = 3.95, P <0.05) ; In A group of cesarean section rate (69.0%) was significantly higher than the B group (22.2%) (χ2=4.01, P <0.05) ;in B group of stillbirth group (0%) was significantly lower than A group (9.5 %) (χ2= 7.89, P <0.01) ;In B group of birth weight was higher than A group(t = 2.209, P < 0.05), neonatal complications was lower than A group(χ2 =6.89,χ2 =7.09,χ2 =7.49,χ2=6.99,χ2 =7.29,χ2=7.39,P <0.01). Conclusion Pregnan-cy with diabetes is harmful to mother and infant. Diagnosing and treating the eases earlier can decrease the complica-tions of mother and infant as well as the death rate of perinatal fetus.     

Rapidly involuting congenital hemangioma: A case of complete prenatal involution

We report a case of rapidly involuting congenital hemangioma of the flank, which was diagnosed in the 2^nd trimester of gestation and showed complete involution before term. In our case sonography revealed a highly vascular soft tissue mass with smooth contours, which was isointense with the placenta on T2‐weighted MR images. The fetus was born with scar tissue at the site of the lesion. To our knowledge this is the 1^st reported case of rapidly involuting congenital hemangioma showing complete involution before term. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2010     

产前超声筛查诊断胎儿肢体畸形的价值

目的:探讨超声筛查诊断胎儿肢体畸形的价值.材料和方法:超声筛查13 919例孕15～34周的孕妇,主要运用二维超声,采用连续顺序追踪超声检测法重点检测胎儿四肢.结果:引产后胎儿肢体畸形33例,产前超声检出32例,14例双足内翻、7例四肢短小畸形、3例肢体姿势异常、3例双侧桡骨缺失、1例双上肢前臂缺如、1例右小腿缺如、1例人体鱼序列征、3例多指(趾).其中22例合并其他畸形,1例漏诊及4例部分漏诊.结论:二维超声连续顺序追踪检测法是产前胎儿肢体畸形筛查的有效方法,能及早发现胎儿肢体畸形.