First and early second-trimester diagnosis of fetal urinary tract anomalies using transvaginal sonography

Urinary tract anomalies are common. Prenatal diagnosis is important and enables either special obstetric management or termination of pregnancy and probably in the future, intrauterine intervention. Transvaginal sonography (TVS) allows visualization of the normal and anomalous fetal urinary tract at an early stage. One thousand nine hundred and forty women were examined via TVS at an early stage of pregnancy between 10 and 16 weeks from the last menstrual period (LMP) and 35 anomalies (1·8 per cent) were clearly identified: 29 cases of low urinary tract obstruction, 2 cases of multicystic dysplastic kidney, 2 cases of polycystic kidney (infantile type), 1 case of double collecting system, and 1 case of horseshoe kidney. Potter syndrome could be ruled out in three patients who had delivered fetuses suffering from this anomaly in previous pregnancies. The concise and early identification of anomalies makes TVS an important aid in the hands of the obstetrician, ultrasonographer, and neonatologist.     

CONFLICT AND COOPERATION OVER INTERNATIONAL FRESHWATER RESOURCES: INDICATORS OF BASINS AT RISR1

ABSTRACT: In this paper we seek to identify historical indicators of international freshwater conflict and cooperation and to create a framework to identify and evaluate international river basins at potential risk for future conflict. We derived biophysical, socioeco‐nomic, and geopolitical variables at multiple spatial and temporal scales from GIS datasets of international basins and associated countries, and we tested these variables against a database of historical incidents of international water related cooperation and conflict from 1948 to 1999. International relations over freshwater resources were overwhelmingly cooperative and covered a wide range of issues, including water quantity, water quality, joint management, and hydropower. Conflictive relations tended to center on quantity and infrastructure. No single indicator—including climate, water stress, government type, and dependence on water for agriculture or energy—explained conflict/cooperation over water. Even indicators showing a significant correlation with water conflict, such as high population density, low per capita GDP, and overall unfriendly international relations, explained only a small percentage of data variability. The most promising sets of indicators for water conflict were those associated with rapid or extreme physical or institutional change within a basin (e.g., large dams or internationalization of a basin) and the key role of institutional mechanisms, such as freshwater treaties, in mitigating such conflict.     

Prenatal diagnosis of ventricular septal defect and overriding aorta at 14 weeks' gestation,using trans vaginal sonography

Two fetuses with heart abnormalities were detected by transvaginal sonography at 14 weeks of gestation. In the first fetus, a ventricular septal defect and an overriding aorta were detected and a diagnosis of tetralogy of Fallot was suggested. In addition, cystic hygroma and omphalocoele were visualized and the cytogenetic study revealed trisomy 18. In the second fetus, ventricular septal defect, pericardial effusion, and omphalocoele were detected.