Prenatal ultrasound detection of congenital cataract in trisomy 21

A 45-year-old woman underwent serial ultrasound screening procedures during late first and second trimesters of pregnancy for advanced maternal age. Cultured amniocytes karyotype indicated full trisomy 21. Subsequently, the fetus developed congenital cataract diagnosed at 24 weeks. This is the first antenatal diagnosis of this complication of Down syndrome.

[Odontogenesis in the human fetus: an echographic study]

During real-time ultrasound observation of swallowing movements in the human fetus, changes in the echostructure of the jaws were detected. Dense linear echoes (2-6 mm) arose symmetrically in the superior and inferior jaws from the median to the distal level with increasing gestational age. Their localisation and onset suggested they might represent tooth germs. The comparison between radiography after birth and pre- and postnatal echography confirmed that these particular echoes were indeed calcified tooth germs. The implications of this observation will be discussed in terms of fetal growth maturation and gestational age.

New aspects of fetal dynamics with a special emphasis on eye movements

During the last few years, special attention has turned to the recording of human fetal dynamic phenomena. These are movements of the whole body as well as breathing, cardiac and ocular movements. All of them can be observed and recorded simultaneously through real-time echography and Doppler systems. The analysis of the recording may be considered separately as well as simultaneously and are one of the grounds for fetal physiology studies. What is known about fetal dynamics and physiopathology is summarized. Fetal biorhythms were discovered and described in that manner. Progressive integration in behavioural patterns was observed suggesting that movements are under a general and central control early in fetal life. Particular attention is given to personal work on fetal eye movement. Based on eye movements patterns, the fetal behaviour patterns might be compared to the three sleep stages (paradoxal--quiet--transitional) as described in the full-term and premature newborns. Some contradictions have been noticed in the conclusions drawn from the analysis of the fetal activities considered separately. They might only be apparent in the light of these integrated patterns.

Neurological maturation of the human fetus

The study of body movements (gross, eye, breathing movements) by realtime echography and their computerized analysis the assessment of the maturation of the behavioural patterns in the human fetus in utero. From the 28 weeks of gestation, 3 patterns can be defined; they are comparable to the sleep stages described in the premature and fullterm newborn. Pathological cases are discussed separately.