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Assessment of Fetal Swallowing with Gray-Scale and Color Doppler Sonography

¹ Institute of Radiology, Second University of Naples, Naples, Italy.
² Department of Diagnostic Imaging, "A. Cardarelli" Hospital, Viale Cardarelli, 9, Naples 80131, Italy.
³ Dipartimento di Oncologia, Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy.

View larger version (3K): [in a new window]   Fig. 1A —Graphs show Kaplan-Meier curves for trend over time. Mandibular and/or labial movements (2 = 56.4, p < 0.0001).

View larger version (3K): [in a new window]   Fig. 1B —Graphs show Kaplan-Meier curves for trend over time. Rhythmic mandibular and/or labial movements (2 = 41.4, p < 0.0001).

View larger version (3K): [in a new window]   Fig. 1C —Graphs show Kaplan-Meier curves for trend over time. Nose–mouth flow signals (2 = 57.6, p < 0.0001).

View larger version (3K): [in a new window]   Fig. 1D —Graphs show Kaplan-Meier curves for trend over time. Larynx–esophagus flow signals (2 = 13.2, p = 0.0003).

View larger version (3K): [in a new window]   Fig. 1E —Graphs show Kaplan-Meier curves for trend over time. Effective swallowing (2 = 36.0, p < 0.0001). Oronasal flow signal presented quadratic trend, so it is impossible to visualize as cumulative incidence.

View larger version (150K): [in a new window]   Fig. 2 —Sagittal sonogram of fetus at gestational age of 24 weeks shows evidence of fluid flow signals in nasal cavity (arrow) with moderate reflux back from oral cavity (asterisk).

View larger version (156K): [in a new window]   Fig. 3 —Sagittal color Doppler sonogram of fetus at gestational age of 26 weeks shows evidence of fluid flow signals in oral cavity (arrow) and distention of hypopharynx without visualization of flow (arrowheads). Other flow areas in image correspond to umbilical artery (white asterisk) and aortic arch (black asterisk).

View larger version (96K): [in a new window]   Fig. 4A —Sagittal oblique sonograms of fetus at gestational age of 25 weeks. Oropharynx region is on left and heart is on right. Fluid distention of larynx (asterisk, B) is probably due to immaturity.

View larger version (129K): [in a new window]   Fig. 4B —Sagittal oblique sonograms of fetus at gestational age of 25 weeks. Oropharynx region is on left and heart is on right. Fluid distention of larynx (asterisk, B) is probably due to immaturity.

View larger version (103K): [in a new window]   Fig. 5A —Sagittal sonograms of fetus at gestational age of 22 weeks. Distention of hypopharynx (diamond) without visualization of flow.

View larger version (100K): [in a new window]   Fig. 5B —Sagittal sonograms of fetus at gestational age of 22 weeks. Visualization of fluid flow in hypopharyngeal triangle (diamond) and in esophagus not accompanied by oronasal regurgitation, defined as "effective" swallowing.

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