Model: amin/medical_embedding_1
Author: amin
Pipeline: sentence-similarity
Library: sentence-transformers
Tags: sentence-transformers, safetensors, bert, sentence-similarity, feature-extraction, generated_from_trainer, dataset_size:16156, loss:ContrastiveLoss, arxiv:1908.10084, base_model:abhinand/MedEmbed-small-v0.1, base_model:finetune:abhinand/MedEmbed-small-v0.1, model-index, text-embeddings-inference, endpoints_compatible, region:us
Base models (finetune): id: abhinand/MedEmbed-small-v0.1
Card metadata: tags: sentence-transformers, sentence-similarity, feature-extraction, generated_from_trainer, dataset_size:16156, loss:ContrastiveLoss
base_model: abhinand/MedEmbed-small-v0.1
widget: source_sentence: What are the symptoms of Anomalies?
sentences: 13 weeks menstrual age, there are three ossification centers in vertebrae C1 through L314 (Fig. 35.2). Neural arch ossification begins as a small focus at the base of the transverse process and extends simultaneously into the pedicle anteriorly and into the lamina posteriorly (Fig. 35.3). Ultrasound evaluation for spina bifida usually occurs between 16 and 22 weeks gestation. By 16 weeks, there is enough ossifica- tion in the neural arches to assess for spina bifida to level L5,15 by 19 weeks to level S1, and by 22 weeks to level S2 (Figs. 35.4 and 35.5). In some fetuses, there may be enough neural arch ossification to assess for spina bifida before these gestational ages. Braithwaite et al.16 assessed the fetal anatomy at 12 to 13 weeks gestation by a combination of transabdominal and transvaginal sonography and reported successful examination of the vertebrae and overlying skin in both the transverse and the coronal plane in all cases. Others have reported successful prenatal diagnosis of spina bifida at 12 to 14 weeks gestation on the basis of abnormal cranial findings.17-19 They caution that although the characteristic cranial findings may be present at 11 to 14 weeks, the prevalence of these findings in the first trimester remains to be determined (Table 35.2). Furthermore, closed NTDs are less likely to be associated with abnormal cranial findings and therefore are more difficult to detect in the first trimester. Normal Position of the Spinal Cord For fetuses at 19 to 33 weeks gestation, the conus medullaris is normally situated at level L2-L3 or higher (Fig. 35.6). Level L3 is taken to be indeterminate and L3-L4 or lower as abnormal.20 For those fetuses with tethered cord, the position of the conus CHAPTER 35 The Fetal Spine 1219 FIG. 35.2 Spine Ossification at 11 Weeks + 4 Days, Dorsiflexion of foot at ankle joint; inversion of foot; dynamic support of medial arch of foot Extensor hallucis longus Middle one-half of medial surface of fibula and adjacent surface of interosseous membrane Dorsal surface of base of distal phalanx of great toe Deep fibular nerve (L5, S1) Extension of great toe and dorsiflexion of foot Extensor digitorum longus Proximal one-half of medial surface of fibula and related surface of lateral tibial condyle Bases of distal and middle phalanges of lateral four toes Deep fibular nerve (L5, S1) Extension of lateral four toes and dorsiflexion of foot Fibularis tertius Distal part of medial surface of fibula Dorsomedial surface of base of metatarsal 5 Deep fibular nerve (L5, S1) Dorsiflexion and eversion of foot Modified from Drake, RL, Grays Anatomy for Students, 3rd ed, 2015, Churchill Livingstone, Elsevier. 7 137 Surface anatomy the soleus and the plantaris muscles (Fig. 7.14 and Table 7.6). These superficial muscles plantarflex the foot at the ankle joint. The gastrocnemius muscle is the most superficial muscle of the posterior calf and has two heads, the medial and lateral. Standing on tip toes makes the two heads of gastrocnemius more prominent and palpable. Distally, they converge to form the calcaneal tendon, or Achilles tendon, which can be observed toward its attachment on the calcaneus. The soleus muscle lies deep to the gas- trocnemius and also inserts into the calcaneal tendon. The soleus muscle can be palpated either side of the calcaneal tendon. The plantaris muscle is a small vestigial muscle with a long tendinous portion that passes between the soleus muscle and the gastrocnemius muscle. It cannot be palpated. The deep group of posterior compartment consists of the popliteus, flexor hallucis longus, flexor digitorum longus and tibialis posterior muscles (Table 7.6). Although these muscles are not palpable, their, recessive polycystic kidneys, autosomal dominant polycystic kidneys, Jeune asphyxiating thoracic dystrophy, Ellis-van Creveld syndrome, and others.115 Joubert Syndrome Joubert syndrome and related disorders (JSRD) have the key feature of molar tooth sign visible on MRI. The molar tooth appearance results from hypoplasia of the cerebellar vermis, horizontal thick elongated cerebral peduncles, and deep inter- peduncular fossa at upper pons; on axial MRI of the brainstem, these features look like a molar tooth. This sign is used as the diagnostic test in children. JSRD is clinically characterized by hypotonia, ataxia, psychomotor delay, irregular breathing, and abnormal eye movements and has an incidence of about 1 per 80,000 pregnancies. Different combinations of ciliary gene muta- tions can result in primary Joubert syndrome, and related disorders have variable abnormalities of the neurons, eye, renal tubules, and bile ducts and polydactyly.116 On ultrasound the molar tooth sign findings of vermian hypoplasia, thickened cerebral peduncles, and interpeduncular notch may be visible by 20 weeks and confirmed by MRI if needed.117 Additional cerebral imaging findings can include abnormalities of the corpus callosum and neuronal migrational abnormalities, Dandy-Walker malformation (DWM), and encephalocele as well as abnormalities in somatic structures. If the mutation is known (about 50%), early diagnosis is possible with chorionic villus sampling (CVS). Prognosis is generally poor and related to extent of breathing and feeding problems in the short term and renal and hepatic complications in the long term. Meckel-Gruber Syndrome Meckel-Gruber syndrome is likely the most common syndromic abnormality of the CNS and is characterized by occipital encephalocele, enlarged dysplastic kidneys, hepatic duct prolifera- tion, polydactyly, posterior fossa abnormalities, and craniofacial and heart defects and has features that overlap with JSRS. Incidence is 1 per 13,000 to 140,000 live births. It is a lethal autosomal recessive disorder associated with mutations in several ciliary genes., source_sentence: What is the prognosis for Hydrops?
sentences: cystic C- shaped structure typical of hydrosalpinx. Shama Puri 108 f f f component of the rare fallopian tube carcinoma is usually larger and less numerous than multiple small nodules seen in hydrosalpinx due to thickened endosalpingeal folds. Clinical signiﬁcance. Usually asymptomatic. Can present with pelvic pain or infertility. It can be treated by lysis of adhesions and tuboplasty. Peritoneal Inclusion Cyst Also referred to as peritoneal pseudocyst, this is a benign non-neoplastic cystic pelvic mass typically seen in premenopausal women with functioning ovaries and pelvic adhesions impairing the absorp- tion of ovarian ﬂuid secreted during ovulation. Almost always, there is a history of pelvic surgery, PID or endometriosis. Figure 8.21 Beads on a string sign of hydrosalpinx (or cog-wheel appearance) hyperechoic, short, round projections within the tube (arrows). Figure 8.22 Waist sign of hydrosalpinx. Indentations on the opposite of the tubular cystic structure forming a waist (arrows) are typical of hydrosalpinx. 8 Assessment of Ovarian Cysts and Masses 109 f f f Ultrasound features. Unilocular or multilocular cys- tic mass conforming to the contours of the peritoneal cavity with a normal-appearing ovary suspended within the mass, either centrally spider in web appearance or at the periphery [25] (Figure 8.24). Septations, when present, are usually thin and smooth but may be thick and show colour ﬂow. No solid elements are present. The ovarian contour may be distorted by adhesions. In contrast to septae within true ovarian cysts, the septae in pseudocysts generally move and ﬂap when the cystic area is prodded by the transvaginal ultrasound probe. This has been described as the ﬂapping sail sign. Tips and Tricks Key to the recognition of a peritoneal cyst is the demonstration of a normal ovary within or along the periphery of a cystic mass. Figure 8.24 Peritoneal inclusion cyst in a 45-year-old, born in military hospitals to Gulf War veterans. Teratology 56:244251, 1997. 907. Herwig MC, Gembruch U, Born M, et al: Preterm diagnosis of choristoma and choroidal coloboma in Goldenhars syndrome. Pediatr Dev Pathol 14:322326, 2011. 908. Ghi T, Contro E, Carletti A, et al: Prenatal sonographic imaging of Goldenhar syndrome associated with cystic eye. Prenat Diagn 28:362 363, 2008. Ob/Gyne Books Full CHAPTER 11 Fetal Musculoskeletal System 345 941. Christianson C, Huff D, McPherson E: Limb deformations in oligohydramnios sequence: effects of gestational age and duration of oligohydramnios. Am J Med Genet 86:430433, 1999. 942. Yamamoto H: A clinical, genetic and epidemiologic study of congenital club foot. Jinrui Idengaku Zasshi 24:3744, 1979. 943. Nemec U, Nemec SF, Kasprian G, et al: Clubfeet and associated abnormalities on fetal magnetic resonance imaging. Prenat Diagn 32(9):822828, 2012. 944. Shipp TD, Benacerraf BR: The significance of prenatally identified isolated clubfoot: is amniocentesis indicated Am J Obstet Gynecol 178:600602, 1998. 945. Malone FD, Marino T, Bianchi DW, et al: Isolated clubfoot diagnosed prenatally: is karyotyping indicated Obstet Gynecol 95:437440, 2000. 935. Zelop C, Benacerraf B: Sonographic diagnosis of fetal upper extremity dysmorphology: significance and outcome. Ultrasound Obstet Gynecol 8:391396, 1996. 936. Dicke JM, Piper SL, Goldfarb CA: The utility of ultrasound for the detection of fetal limb abnormalitiesa 20-year single-center experience. Prenat Diagn 35:348353, 2015. 937. Fahy MJ, Hall JG: A retrospective study of pregnancy complications among 828 cases of arthrogryposis. Genet Couns 1(1):311, 1990. 938. Bacino CA, Hecht JT: Etiopathogenesis of equinovarus foot malformations. Eur J Med Genet 57:473479, 2014. 939. Mammen L, Benson CB: Outcome of fetuses with clubfeet diagnosed by prenatal sonography. J Ultrasound Med 23:497500, 2004. 940. Bar-On E, Mashiach R, Inbar O, et al: Prenatal ultrasound diagnosis of club foot: outcome and recommendations for counselling and follow-up. J Bone Joint, to rise, the major limitation for expanding transplant programs is the shortage of suitable donor kidneys. This organ shortage has resulted in an increasing number of renal transplantations from living related donors. These donors may include family members or close friends with a long-standing relationship with the recipient. The average life expectancy for a cadaveric allograft is 7 to 10 years, whereas that for a live donor allograft is 15 to 20 years.44 Regardless of whether a cadaveric or live donor allograft is used, the cost-benefit ratio of a functioning successful transplant far outweighs that of a patient with persistent CRF, so multiple health care resources are targeted to ensure high rates of success. Ultrasound is the most valuable noninvasive imaging modality in monitoring the renal transplant. Surgical Technique Detailed sonography of the renal transplant requires knowledge of the surgical procedure used in most institutions as well as the postsurgical anatomic relationships. The right or left lower quadrant is selected for the incision, based on the patients prior surgical history and the surgeons preference. Usually, the right lower quadrant is selected because the right iliac vein is more superficial and horizontal on this side of the pelvis, facilitating creation of a vascular anastomosis.45,46 The type of arterial anastomosis used depends on whether the allograft is cadaveric or living related and on the number essential to facilitate early resection, ablation, or chemotherapy26,43 (Fig. 18.27). As in the general population, transplant recipients can develop any type of primary or secondary neoplasm within the liver. RENAL TRANSPLANTATION Transplantation is the treatment of choice for many patients with chronic renal failure (CRF) severe enough to warrant FIG. 18.18 Inferior Vena Cava (IVC) Infrahepatic Anastomosis: Normal and Abnormal in Two Patients. Sagittal sonograms of IVC show (A) a normal caliber at the anastomosis (arrows) and, source_sentence: What are the risk factors for Alternatively?
sentences: to 2% of cesarean deliveries.216 The right gonadal vein is more commonly involved, likely because of increased pressure on the right gonadal vein. The left ovarian vein is felt to be protected owing to retrograde flow from the left renal vein.13 Ovarian vein thrombosis will appear on ultrasound images as a tubular or serpentine avascular structure, often anechoic to hypoechoic, in the region of the right adnexa and psoas muscle corresponding to the thrombosed vein. Extension into the inferior vena cava may occur. However, these structures may be difficult to visualize at sonography, FIG 29-39 Spectrum of ultrasound findings of adenomyosis. A, Transabdominal sagittal ultrasound image demonstrates enlarged, heterogeneous, globular uterus with asymmetric thickening of the posterior myo- metrium. B, Transvaginal sagittal scan from a second patient demonstrates asymmetric thickening of the anterior myometrium, with markedly heterogeneous echotexture, hypoechoic linear striations, and shadow- ing. Endometrial thickness is measured (calipers). The uterus is retroverted. C, Transvaginal scan from a third patient demonstrates heterogeneity of the posterior myometrium with small myometrial cysts (white arrows) and linear striations. Note linear rays of shadowing in a comb-like or Venetian blind pattern. The region of abnormal myometrial echotexture is posterior to the endometrium (black arrow). D, Larger myometrial cyst (arrow and calipers), with asymmetric thickening, heterogeneity of the myometrium, and comb-like shadowing. E, Color Doppler sonogram demonstrates diffuse hypervascularity of the asymmetrically thick- ened posterior myometrium. F, Sagittal T2-weighted magnetic resonance image of a different patient with diffuse adenomyosis demonstrating marked diffuse thickening of the junctional zone (arrow) and scattered tiny T2-weighted hyperintense foci. B A D F C E Ob/Gyne Books Full 908 SECTION II Gynecology of suspected appendicitis in the pregnant patient yielded a sensitivity of 90.5%, specificity of 98.6%, PPV of 90.4%, and NPV of 99.5%224 (Fig. 29-44). At ultrasound examination, the, measured; midbody and fundal endometrium; and right and left ovaries with and without the maximum width measured (Fig. 26-8). Additionally, any disease or variant of normal must be assessed and appropriate additional images recorded. Most laboratories now include cine clip acquisition in addition to static images. Color Doppler, power Doppler, and pulsed Doppler are often added to the protocol depend- ing upon the clinical situation and abnormality demonstrated on gray- scale imaging. The use of three-dimensional (3D) sonography also has become standard in many laboratories (Fig. 26-9). By capturing a volume of data, 3D imaging permits a display of any desired plane through the uterus, cervix, ovaries, and adnexa and optimizes assess- ment of the entire endometrial canal. 3D imaging is particularly useful for the assessment of intrauterine device (IUD) positioning and sub- mucosal myomas, as well as uterine fundal contour and morphologic appearance in the setting of suspected congenital anomalies1,12-14 (Fig. 26-10). PELVIC ANATOMY The pelvis, so-called because of its resemblance to a basin, is divided into two structurally continuous compartments, the true (or lesser) pelvis and the false (or greater) pelvis, by an oblique plane passing from the sacral promontory, the arcuate and pectineal lines, and the superior margin of the symphysis pubis (Fig. 26-11). The circumfer- ence of this plane is called the linea terminalis, or pelvic brim.15 The true pelvis is the lower portion and is bounded anteriorly by the pubis and pubic rami, posteriorly by the sacrum and coccyx, laterally by the fused ilium and ischium, and inferiorly by the muscles of the pelvic floor. The false pelvis is bounded laterally by the flanged portions of the iliac bones, the base of the sacrum posteriorly, and the abdominal wall anteriorly and laterally. In the absence of masses in the nongravid patient, the uterus, ovaries, adnexa,, wall is very thin (squamous cell carcinoma). C A B Other Findings Air bronchograms and bubble-like lucencies or pseudo- cavitation may be seen within lung cancers, in particular with adenocarcinoma.36 Occasionally, dilated mucus- ﬁlled bronchi (bronchocele, mucocele, mucoid impac- tion) are seen distal to a carcinoma obstructing a segmental or subsegmental bronchus. Ground-glass attenuation may be seen as a component of nodules and is associated with a greater risk of malignancy than that of purely solid nodules. It is more commonly associated with adenocarcinoma,70 which may present as a purely ground-glass opacity. Central Tumours The cardinal imaging signs of a central tumour are collapse/consolidation of the lung beyond the tumour and the presence of hilar enlargement, signs that may be seen in isolation or in conjunction with one another. 328 SECTION B The Chest and Cardiovascular System FIGURE 15-16 Tumour calciﬁcation. Large bronchial carcinoma invading the mediastinum demonstrates coarse and cloud-like calciﬁcation. FIGURE 15-17 Lobar collapse. The tumour in the bronchus intermedius is causing partial middle and lower lobe collapse. FIGURE 15-14 CT showing a cavitating squamous cell carci- noma in the left lung. The wall of the cavity is variable in thickness. FIGURE 15-15 Calciﬁed infectious granuloma engulfed by lung cancer. CT shows a cluster of densely calciﬁed small nodules almost at the centre of a small carcinoma. Collapse/Consolidation in Association with Central Tumours Obstruction of a major bronchus often leads to a combi- nation of atelectasis and retention of secretions with con- sequent pulmonary opacity, but collateral air drift may partially or completely prevent these postobstructive changes. Secondary infection may occur beyond the obstruction. The following features suggest that pneumonia is sec- ondary to an obstructing neoplasm: 1. The shape of the collapsed or consolidated lobe may be altered because of the bulk of the underly- ing tumour., source_sentence: What are the complications of San Francisco?
sentences: the effect of con- comitant problems such as partial volume or movement artefacts. Combined Protocols: One-Stop-Shop Procedure. Computed tomography (CT) venography has been con- sidered as a part of a one-stop-shop procedure in order to diagnose VTE.58 After administering one bolus of con- trast medium, ﬁrst the pulmonary arteries are investigated followed by additional late-phase imaging of the deep venous system from the calves up to the inferior vena cava to detect DVT. Although this combined procedure is feasible and has the advantage of detecting DVT in pelvic veins and IVC, which is not possible with CUS, recent studies have shown that in comparison with CTPA alone, this combined technique results in only limited increase in sensitivity with a comparable speciﬁcity.59 A major drawback of CT venography is the signiﬁcant increase of radiation, which at this moment does not justify its routine use in patients with suspected PE (Fig. 23-22). Alternatively, CTA with ECG-gating can be performed in patients presenting with acute chest pain without sig- niﬁcant increase in radiation dose. During one data acqui- sition, information can be obtained on the most important vascular diseases causing acute chest pain: acute coronary syndrome, aortic dissection and acute pulmonary embo- lism.60 The use of dual-source CT or systems with high numbers of detector rows may overcome the initial limita- tions of ECG-gated CTPA, providing faster acquisition times, better image quality in patients with abnormal cardiac rhythms, and lower radiation dose.61 The downside of such a protocol is the increase in complexity both for the technician and the reader, with an increase in post- processing and interpretation time. CTPA During Pregnancy. During pregnancy and puerperium, the incidence of VTE is two- to fourfold higher and is one of the most important causes of mater- nal mortality. As diagnosing DVT in patients with, excellent results. High- frequency, small-footprint transducers should be used in small children. Most ultrasound machines have pediatric settings that are a good starting point for many examinations. Sedation is almost never required, and distraction techniques such as showing movies are very effective. At all ages, the ultrasound technologist is probably the most important factor in obtaining high-quality images. Find a technologist who works well with children, learn from him or her, and encourage him or her to teach others. Nuclear Medicine The practice of pediatric nuclear medicine is highly variable between institutions in terms of the type and number of procedures performed. Basic nuclear medicine studies including diuretic renal scans (for urinary tract obstruction), hepatobiliary (e.g., HIDA) scans (for biliary atresia), and cystograms (for vesicoureteral reflux) are still the backbone of a pediatric nuclear medicine practice. 18-F FDG-PET is increasingly being used, however, for the staging and follow-up of pediatric malignancies such as lymphoma and sarcomas (bone and soft tissue). The 123I-MIBG scan is an examination that is almost unique to pediatrics and is still extensively used for the diagnosis, staging, and follow-up of neuroblastoma. Details of nuclear medicine imaging technique and protocols are beyond the scope of this text but the reader should be aware of the North American Consensus Guidelines for Pediatric Administered Radiopharmaceutical Activities which provide recommended activities for commonly used radiopharmaceuticals. This can be an invaluable resource when you are in practice and are asked to do a nuclear medicine study on a child. MRI MRI is a dominant imaging modality in pediatrics, in part due to the fact that images can be obtained without use of ionizing radiation. This benefit has very likely been given greater weight than it deserves, but MRI has other advantages as well, including high soft tissue contrast and the ability, sagittal image of the cervical spine (different patient than in A). Two enhancing lesions are present in the anterior dural sac (arrowheads), surrounded by cerebrospinal ﬂ uid. These were neuroﬁ - bromas. C, T1 contrast-enhanced axial image of the cervical spine (same patient as in B). A neuroﬁ broma is present in the intradural space (solid arrow) and extends into the epidural space in the neural foramen (open arrow). This is a dumbbell neuroﬁ broma that is intradural and extradural. Nerve sheath tumors and meningiomas constitute 90% of intradural lesions. Conus/ﬁ lum terminale/cauda equina region (include nerve sheath tumor and metastasis in differential for this area). 314 SPINE Figure 13-72 Intradural space: meningioma. T1 contrast-enhanced sag- ittal image of the cervical spine. There is an enhancing mass in the anterior intradural space with a broad-based attachment to the anterior dura. This is a typical appearance for a meningioma. Figure 13-73 Intradural space: paraganglioma. T1 contrast-enhanced sagittal image of the lumbar spine. There is a large mass involving the cauda equina that ﬁ lls the dural sac and erodes the posterior L4 vertebral body, indi- cating it is a long-standing lesion. The center of the mass is low signal from necrosis or hemorrhage. This was a paraganglioma at surgery; the differential diagnosis should include ependymoma, metastasis, and nerve sheath tumor. cauda equina or conus, or acquired from lumbar punctures, in which case they occur in the lower lumbar region. MRI features vary and are nonspeciﬁ c, but generally show a mass of low signal intensity on T1W and high signal intensity on T2W images (higher than spinal ﬂ uid). Dermoid cysts are congenital tumors that arise from epithelial inclusions in the neural groove during develop- ment. They may be located either intradurally or within the cord in equal numbers. They usually, source_sentence: What are the symptoms of Presti?
sentences: for one concept or many concepts in one name Available from https://www.phgfoundation.org/documents/311_1358522182.pdf. Accessed September 29, 2017. 2. Atkinson AJ, Colburn WA, DeGruttola VG, et al. Biomarkers and surrogate endpoints: Preferred definitions and conceptual framework. Clin Pharmacol Ther 2001;69:8995. 3. Falconi A, Lopes G, Parker JL. Biomarkers and receptor targeted therapies reduce clinical trial risk in nonsmall-cell lung cancer. J Thorac Oncol 2014;9:163169. 4. Thompson RH, Kurta JM, Kaag M, et al. Tumor size is associated with malignant potential in renal cell carcinoma cases. J Urol 2009;181:20332036. 5. Lim C, Sung M, Shepherd FA, et al. Patients with advanced nonsmall cell lung cancer: Are research biopsies a barrier to participation in clinical trials J Thorac Oncol 2015;11:7984. 6. Executive Summary. Interim analysis of the NCI-MATCH Trial. 2 0 1 6 . Available from https://dctd.cancer.gov/majorinitiatives/NCI-MATCH_Interim_Analysis_Executive_Summary.pdf. Accessed September 29, 2017. 7. Tam AL, Lim HJ, Wistuba II, et al. Image-guided biopsy in the era of personalized cancer care: Proceedings from the society of interventional radiology research consensus panel. J Vasc Interv Radiol 2016;27:819. 8. Hasanovic A, Rekhtman N, Sigel CS, Moreira AL. Advances in fine needle aspiration cytology for the diagnosis of pulmonary carcinoma. Patholog Res Int 2011;2011: Article ID 897292, 7 pages. 9. Patel IJ, Davidson JC, Nikolic B, et al. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 2012;23:727736. 10. Ridout G, de la Motte S, Niemczyk S, et al. Effect of renal function on edoxaban pharmacokinetics and on population PK/PK-PD model. J Clin Pharmacol 2009;49:1091130. 11. Baron TH, Kamath PS, McBane RD. Management of antithrombotic therapy in patients undergoing invasive procedures. New Engl J Med 2013;368: 21132124. 12. Nutescu EA. Oral anticoagulant therapies: Balancing the risks. Am J Health Syst Pharm 2013;70(10 Suppl 1):S3S11. 1 3 . Fleisher LA,, diaphragmatic hernia has been reported.67,77,78 Although these malformations may be detected in the first trimester, visualization will depend on size, and continued growth may aid detection in the second trimester. In a randomized trial of routine 12-week anatomic survey versus routine 18-week anatomic survey, Saltvedt and colleagues detected 0% of the three diaphragmatic hernias in the 12-week group but 50% of four diaphragmatic hernias in the 18-week group, but this difference was not statistically signifi- cant because of the overall low prevalence of congenital diaphragmatic hernia in the cohort (7/36,108).78 Cardiac Disease Congenital heart disease is one of the most common severe congenital abnormalities, with a prevalence of 8/1000 live births.22,72,79,80 Over the past 2 decades, imaging of the fetal heart in the first trimester has evolved considerably to include full echocardiographic studies, with several authors reporting diagnosis of congenital heart disease in the first trimester22,30,79-81 (Fig. 5-23). In a retrospective study of 2165 sin- gleton pregnancies that underwent fetal echocardiogram from 1997 to 2003 Smrcek and colleagues reported the frequency of congenital heart malformations diagnosed between 11 and 13 weeks, with atrioven- tricular septal defects being the most frequent by about 4.5-fold (18/29), followed by ventricular septal defect (4/29), and tetralogy of Fallot (3/29).28 Additionally, ectopia cordis, hypoplastic left-sided and right-sided heart syndrome, double outlet right ventricle, transposi- tion of the great arteries, absence of the pulmonary valves, aortic ste- nosis, aortic coarctation, left and right atrial isomerism, pulmonary stenosis, truncus arteriosus, tricuspid atresia, and total anomalous pul- monary venous return have all been reported as either isolated findings or in combination as complex congenital heart disease.22,28,81-83 The majority of studies evaluating first trimester fetal cardiac evaluation have included a selected population referred for specialized fetal echo- cardiogram in which the indication most commonly was increased nuchal translucency but, the fetal chest, a four-chamber view of the heart is imaged. Note that the apex of the heart is pointing toward the left side of the fetal chest (Figs. 6.2 and 6.4). Determining that the stomach, descending aorta, and cardiac apex are located on the fetal left side and the inferior vena cava is located on the right side establishes normal visceral situs (Figs. 6.1 and 6.3). Figure 6.1: Schematic drawing of a cross section of the upper abdomen for the assessment of the abdominal situs. The vertical line divides this plane into right and left. The right-sided structures include the gallbladder, the portal sinus, a large part of the liver, and inferior vena cava (IVC). The left-sided structures include the descending aorta, the stomach, and the spleen. Figure 6.3 is the corresponding ultrasound plane. Figure 6.2: Determining fetal situs in longitudinal lie: In A, the fetus is in a cephalic presentation with the fetal spine close to the left uterine wall, resulting in the right side being anterior and left side posterior. In B, the fetus is in a cephalic presentation with the fetal spine close to the right uterine wall, resulting in the left side being anterior and right side posterior. In C, the fetus is in a breech presentation with the fetal spine close to the left uterine wall, resulting in the left side being anterior and right side posterior. In D, the fetus is in a breech presentation with the fetal spine close to the right uterine wall, resulting in the right side being anterior and left side posterior. Note the corresponding transverse ultrasound planes of the chest and abdomen. Blue arrows point to fetal stomach, red arrows to the apex of the heart, and yellow arrows to the descending aorta. See text for details. Several
pipeline_tag: sentence-similarity
library_name: sentence-transformers
metrics: pearson_cosine, spearman_cosine
model-index: name: SentenceTransformer based on abhinand/MedEmbed-small-v0.1
results: task: type: semantic-similarity
name: Semantic Similarity
dataset: name: Unknown
type: unknown
metrics: type: pearson_cosine
value: 0.8767120066593315
name: Pearson Cosine
verified: no, type: spearman_cosine
value: 0.6634507543410023
name: Spearman Cosine
verified: no
Likes: 0 | All-time downloads: 457
Created: 2025-06-08 07:54:11