bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can 3-dimensional Ultrasound Change Gynecological Ultrasonographic Examination?
Authors: Bau Santiago , Sabatel Rosa , Mercé Luis T , Alcázar Juan Luis , Barco María Jesús , Troyano Juan , Bajo José 
Published: June 2010

Abstract

Objective
To verify whether 3D transvaginal ultrasonography is as accurate as 2D conventional ultrasonography and whether it provides additional advantages in gynecologic diagnosis.

Material and methods
We performed a prospective study in 46 women who underwent 2D and 3D transvaginal scans successively. Three 3D volumes (uterus and each ovary) were acquired and evaluated 4 months later on a personal computer. We compared 2D and 3D scans in relation to sonographic diagnosis and biometry and the time spent.

Results
There was complete agreement between 2D and 3D techniques for sonographic diagnosis (31 normal exams, 16 adnexal cysts and seven myomas), except for the visualization and measurement of the uterine cervix. The mean time for 2D scans was 3.29 ± 1.32 minutes and was 2.96 ± 0.58 minutes for 3D examination (P = 0.076). The time required to acquire 3D volumes was only 1 hour, freeing 1 hour and 32 minutes for the performance of new scans.

Conclusions
Transvaginal 3D ultrasonography can be more efficient than conventional 2D ultrasonography in gynecologic diagnosis.
Primary Care in Obstetrics and Gynecology — A Place for Advanced Ultrasound?
Authors: Honemeyer Ulrich 
Published: June 2010

AbstractThe evaluation of adnexal masses based on transvaginal sonography (TVS) and when their size is too big- transabdominal US can be facilitated and refined by using color Doppler (CD), power Doppler (PD), and pulsed Doppler(PW), including three-dimensional ultrasound (3D US). With these modes, we obtain information about vascularity and flow indices, and their distribution within a mass. Considering the fact that neoangiogenesis is a main feature of malignancy, this is essential information. Thus, we are able to assume the benign or malignant character of an adnexal mass, make the right choice of additional imaging or biochemical tests, and then channel the treatment appropriately. This is subsequently demonstrated for simple cyst, hemorrhagic cysts, endometrioma, dermoid, serous papillary cystoma, ectopic pregnancy, and ovarian carcinoma.Abnormal uterine bleeding (AUB) is a common problem in primary care. Compared to transabdominal approach, TVS improves the detection rate of underlying uterine pathology. In conditions like endometrial hyperplasia, polyps, submucous leiomyoma, and endometrial cancer, CD, PD, PW and contrast enhanced transvaginal ultrasound may optimize sonographic evaluation. Saline infusion sonohysterography (SISH) in out patient department (OPD) is an alternative to invasive diagnostic hysteroscopy in patients with AUB.Care for maternal and fetal well-being during pregnancy is a main task in OPD. The assessment of fetal pathology is almost entirely based on Ultrasound. Several illustrations of fetal anomalies detected during 1st trimester and 2nd trimester screening, of abnormal findings in feto-maternal Doppler ultrasound, and fetal pathology demonstrated in 3D/4D ultrasound mode, conclude this review of advanced ultrasound in primary care.
Long-term Outcome of Pregnancies with Increased Nuchal Translucency and Normal Karyotype
Authors: Orosz L , Lukács J , Szabó M , Kovács T , Zsupán I , Orosz G , Tóth Z , Török O 
Published: June 2010

AbstractObjectivesThe aim of this study was to examine the prevalence of major and minor anomalies according to the increase of NT thickness.MethodsThis is a long-term retrospective study in which singleton gestations of euploid fetuses with increased NT were analyzed. NT measurement was performed in the first trimester examination according to the criteria of fetal medicine foundation (FMF) when the fetal crown-rump length (CRL) was 45 to 84 mm. The cases were followed up from 1 to 5 years postpartum to assess the presence of CHD and to point out other anomalies that could be associated with increased NT.ResultsThe outcome of 133 cases could be analysed out of 198 pregnancies of which in 55 cases some congenital anomalies (minor or major) were revealed up to the 5 years of life (prevalence of 41.4%). The prevalence of CHDs, including the defects of the great vessels, stood out among the others. In the group with NT between 95th and 99th centiles four cases with minor heart problems were identified (11.1%, 4/36). The rate of major cardiac defects proved to be 13.3% (6/45) in the group with NT between 3.5-4.4 mm, and 17.3% (9/52) in the group with NT > 4.5 mm. Among the 35 healthy children with various minor health problems not related to the presence of increased nuchal translucency there were 7 cases with hydrocele. In 3 of them it was associated with unilateral inguinal hernia but in 3 it was isolated and one was part of a complex malformation (The rate of other organ-specific anomalies did not prove to be significant). In the whole study population only thirteen cases (9.8%) ended up in intrauterine death, or arteficial abortion.ConclusionThe prevalence of major cardiac defects as well as other major anomalies increases with fetal nuchal thickness. Since the prevalence of CHD is 100 times higher in the population of fetuses with NT above 4.5 mm, specialist fetal echocardiography should be offered in the second trimester together with other follow-up investigations. Among the children without any major abnormalities, a high number of minor anomalies were revealed during the long-term follow-up. These anomalies do not have significant disadvantage to the quality of life, but some of them necessitates short or long-term medical treatment and this should also be leveled with the future parents. Despite the numerous investigations the exact etiology of increased NT remains unknown. The relatively high prevalence of hydrocele in the newborns in our material raises the question wheather it is related to the presence of NT in the fetal period because of abnormal lymphatic development or alterations in the extracellular matrix. Further long-term follow-up studies could probably contribute to find explanation on the etiology of increased NT in the first trimester. These data can be used when counseling parents of euploid fetuses with increased fetal NT.
The Use of Transvaginal Ultrasound by Emergency Physicians in Medical Student Education
Authors: Zafar Nadah B , Greer Veronica , Woolard Robert H 
Published: June 2010

Abstract
Paul L Foster School of Medicine at Texas Tech University Health Sciences Center in El Paso offers the students a faculty (both clinician and basic scientists) guided clinical presentation based curriculum. Emergency physicians have been an integral part of this curriculum. Bedside transvaginal ultrasound has become an adjunct to the history and physical examination for the evaluation in a timely manner of acute pelvic and lower abdominal pain and vaginal bleeding in the female of reproductive years. Discussion of the approach to diagnosis is divided into two broad categories; evaluation when there's a positive pregnancy test (first trimester) and a negative pregnancy test. The discussion also illustrates how the emergency physician can, using ultrasound, introduce, integrate, and review, the pertinent basic sciences (anatomy, embryology, pathology, physiology, microbiology and biochemistry) with the medical student.
Delivering Bad News: Aspects to Consider When Training Medical Students and Residents
Authors: Loaiza Jose Leonardo , Arroyave Ana Maria 
Published: June 2010

Abstract
Ultrasound advances have made a tremendous impact in the field of obstetrics and gynecology. The routinely use of this technology has allowed doctors to diagnose medical conditions in real time. When ultrasound reveals a serious diagnosis or a finding of concern (i.e. fetal demise, fetal malformation, a suspicious mass), communicating bad news to the patient and family represents a challenge that most doctors don't feel comfortable doing. In the following section we will present a clinical vignette, that involves a fetus with multiple structural malformations diagnosed by ultrasound, to show some general principles that can help physicians to break bad news. We also highlight the importance of incorporating formal training in medical school to help students become familiar and more comfortable delivering bad news.
Gynecologic Ultrasound as a Pharmacosurveillance Tool
Authors: Quest Dale 
Published: June 2010

Abstract
A traditional medical school curriculum does not formally prepare physicians to participate in evaluation of safety and effectiveness after medications enter the market. This article provides examples where ultrasound has unrealized potential as a noninvasive tool for longitudinal assessment of drug safety and effectiveness in the real-world. The examples are intended to sensitize medical schools and medical students to opportunities for physicians to advance therapeutic evaluation of drugs as they are used for approved and unapproved indications in actual practice.
Screening for Fetal Malformations
Authors: Theodora M , Antsaklis A , Daskalakis G 
Published: June 2010

Abstract
Even though the issue of routine sonography for low-risk pregnant women continues to be controversial mainly because randomized trials have failed to demonstrate clear benefit on pregnancy outcome, detection of different fetal malformations seems be one of the main indications for performing scans in pregnancy. Due to progress made in ultrasound technology and the experience of sonographers it is feasible to diagnose congenital anomalies as early as the end of the first trimester. Nevertheless most targeted studies are performed at 18 to 20 weeks of gestation. The highest rates of detection of congenital anomalies are seen in tertiary care settings such as a university medical center. In high-risk cases a consulting perinatologist is commonly the physician most likely to integrate the ultrasound findings.
Three-dimensional and Power Doppler Ultrasound of the Follicle and Endometrium on the Day of hCG Administration
Authors: Panchal Sonal , Nagori CB 
Published: June 2010

Abstract
The advances in ultrasound technology has changed the management of infertility. With the advent of color Doppler, pulse Doppler, 3D US and then 3D power Doppler the previously unexplained causes of failure of fertilization and implantation can now be explained. 3D and 3D power Doppler can now be used for the assessment of the maturity of the follicle and receptivity of the endometrium and can give better idea about the functional maturity of the follicle and the endometrium, to decide the timing of hCG administration for all assisted reproductive techniques for better pregnancy rates. The accuracy of diagnosis and monitoring of infertility treatments such as ovulation induction has greatly increased because of the availability of sophisticated ultrasound technology and equipment.1
Ultrasound Evaluation of Abnormal Early Pregnancy
Authors: Ahmed Badreldeen , Kupesic Sanja , Carrera Jose Maria 
Published: June 2010

Abstract
Ultrasound examination has become the “golden standard” in follow-up of the development and complications in early pregnancy. With introduction of transvaginal sonography a possibility for early morphological and biometrical ultrasound examinations has been significantly improved. The essential aim of an early pregnancy ultrasound is not only to diagnose a pregnancy, but also to differentiate between normal and abnormal pregnancy. Application of color Doppler ultrasound has enabled functional hemodynamic presentation and evaluation soon after implantation.
Diagnosis of Fetal Anomalies in Developing Country: Experiences in Indonesia
Authors: Salim Azen , Wiknjosastro Gulardi Hanifa , Surya I Gede Putu , Karsono Bambang , Karkata I Made Kornia , Wibowo Noroyono , Andonotopo Wiku , Sanjaya I Nyoman Hariyasa 
Published: June 2010

Abstract
Although three-dimensional ultrasound (3DUS) has been available for more than 10 years in Indonesia, there was no publishing article from our region which systematically evaluates our experiences in this most recent ultrasound technologies and its application to obstetric. 3DUS is revolving into a technology with various range of applications in numerous fields because it helps overcome some of the key limitations related to two-dimensional imaging. It is through this review that we attempt to develop a continuous line of understanding the current diagnostic benefits of 3D and 4DUS in diagnosis of fetal abnormalities and consider the utility and role of this type of imaging in the routine clinical practice.
Ultrasonic Assessment of Infertility
Authors: Honda Ikuko 
Published: June 2010

Abstract
Ultrasonographic changes of endometrium, ovaries and salpinges detected by realtime B-mode and 3D ultrasound indicate effective treatment of infertility not only in the Assisted Reproduction Technology (ART) but also in the conventional management where essential plan for the therapy is indicated. The articles concerning ultrasonographic assessments of fecundity and infertility are reviewed. Although the ART has become ordinary treatment of infertility, the pregnancy rate is yet unsatisfactory and it is important to select cycles where favorable conception is predicted in order to increase pregnancy rate in ART. Although antral follicle count (AFC) is the index for predicting ovarian response to human menopausal gonadotropin (hMG) stimulation, it is able to select stimulation options for a poor responder of low AFC value. Since three-dimensional (3D) ultrasonography with power Doppler angiography (PDA) indicates an organ blood flow as a whole, they are important tools for the evaluation of perfusion. The assessment of perifollicular blood flow in preovulatory follicles may be useful for predicting conception and cancelling in vitro fertilization (IVF) in poor vascularity cycle. Since rich endometrial vascularity assessed by 2D and 3D flow signs and the low impedance to flow suggests well perfused endometrium and the high receptivity in the embryo transfer (ET), and vice versa, it would be recommended to limit the number of embryos for the ET in the high receptivity, while to cryopreserve the embryo in case of bad flow signs and wait the cycle of favorable perfusion in order to successfully transfer the embryo.
The Role of Magnetic Resonance Imaging in the Diagnosis of Fetal Malformations
Authors: Lituania M , Fondelli MP , Passamonti U , Saitta L , Cerchiaro A , Arcuri T 
Published: June 2010

Abstract
Even if ultrasonography still remains the primary prenatal investigation technique for the assessment of fetal development, magnetic resonance imaging (MRI) plays an important role for the study of fetal morphology and pathology.
MRI has been shown to be particularly useful for the evaluation of the central nervous system (CNS), the latter being a common site of pathology such as cerebral and spinal malformations.
MRI is contributive in defining fetal neck, thoracic, abdominal, and pelvic masses. This can be especially helpful when differing opinions exists as to the etiology of a mass.
Ultrasonography, a non invasive, low cost, real time technique, still represents the investigation of choice in prenatal screening, not only regarding the CNS. Nevertheless several cases need a diagnostic complement by means of MRI, that increases the diagnostic potential of ultrasound .
The additional information from MRI is important in prenatal counseling, delivery planning and planning for pre- or postnatal intervention.
An Attempt to Discover Antenatal Etiological Factors for Cerebral Palsy: What does 3D and 4D Ultrasonography Add?
Authors: Azumendi Guillermo , Marton Ingrid , Kurjak Asim , Herman Mislav 
Published: June 2010

AbstractCerebral palsy (CP) is a nonprogressive condition affecting developing fetal or infant brain resulting in disorders of movement and posture which are sometimes accompanied by disturbances of cognition, sensation, perception, behavior and seizures. The incidence of CP being 2 to 2.5 per 1000 live births did not considerably change in the last decades. Improvement of perinatal care did not result in the decreasing prevalence of CP. Consensus Statement of International Cerebral Palsy Task Force and its modification presented the essential criteria to define an acute intrapartum event sufficient to cause CP. These criteria were not helpful in allocating the time of brain injury, proving that etiology of CP is difficult to investigate. Better markers of acute intrapartum injury should be defined, although much evidence exists that most causes of CP are prenatal. Advances in 3D and 4D ultrasound (US) give opportunities to investigate fetal morphology and behavior. By 4D US, head, body and limb movements can be visualized simultaneously. The earliest phase of development can be studied in detail, making 4D superior compared to 2D. Is applicable neurological test for fetus available? This question is complicated, because even postnatally several neurological methods of evaluation exist, while hardly accessible fetus has less mature brain. Inexistence of reliable neurobehavioral assessment method for the fetuses is discouraging. The scientific community should intensify efforts in finding out simple, clinically applicable, and reproducible fetal neurological test(s), with fair sensitivity and specificity.
Fetal Ventriculomegaly
Authors: Pooh KyongHon , Pooh Ritsuko K 
Published: June 2010

Abstract
The causes of fetal ventriculomegaly vary. Ventriculomegaly can be caused by not only obstruction of cerebrospinal flow tract but also brain maldevelopment or other reasons. Recent advanced imaging technology and approaching technique of transvaginal sonography have contributed to an accurate prenatal diagnosis and clearly revealed fetal intracranial condition. However, management of the condition and counseling of parents are still difficult, because the initial cause, absolute risk, and degree of resulting neurological deficit cannot be determined with confidence. Ventriculomegaly is evaluated according to atrial width > 10 mm and mild ventriculomegaly is defined as an atrial width of 10 to 15 mm. In ventriculomegaly cases, accurate detection of intracranial structure and additional abnormalities is required. Furthermore, ventriculomegaly may resolve spontaneously or progress during pregnancy. Therefore, detailed neuroscan by advanced imaging technology, detailed extra-CNS scan, longitudinal serial scan during pregnancy are mandatory for proper counseling and management. Longitudinal observation study of not only short-term but also long-term neurological prognosis will be required.
Ultrasound of the Placenta
Authors: Zalud Ivica , Holzman Jennifer , Bartholomew Marguerite Lisa 
Published: June 2010

AbstractThis review covers ultrasound evaluation of the normal and abnormal placenta with clinical correlation. Normal placental function is essential for a healthy pregnancy outcome as well as for maternal, fetal, childhood, and adult health. Abnormal placental function may result in a compromised pregnancy, creating pathology for the fetus and mother alike. Despite the fact that placental anatomy, function, and location has far-reaching effects for the parents and the developing offspring, ultrasound examination of the placenta is often considered secondary to the fetus by expectant parents and sonographers as well. Location, size, shape, and architecture are easily ascertained with two-dimensional techniques. Three-dimensional ultrasound and Doppler techniques have opened up the frontier of placental function and have set the stage to make placental evaluation as fascinating as that of the fetus.Learning objectivesTo assess normal placenta by ultrasound.To discuss abnormal placenta and umbilical cord.To understand placentation in multiple gestation.
Adnexal Masses in Pregnancy: Diagnosis and Management
Authors: Graham George M 
Published: June 2010

Abstract
The widespread use of ultrasound in obstetrics has led to an increase in the diagnosis of asymptomatic adnexal masses in pregnancy. Ultrasound is an accurate and safe method for diagnosing the etiology of an adnexal mass and distinguishing benign from malignant pathology. The management of an adnexal mass in pregnancy is controversial. Historically, it was recommended that any adnexal mass be removed electively in the second trimester to exclude malignancy and prevent complications such as torsion, rupture, and obstruction of labor. More recent recommendations have limited surgical intervention in pregnancy to symptomatic adnexal masses and those that are highly suggestive of malignancy. Surgery in pregnancy is associated with an increased risk of adverse pregnancy outcomes. However, laparoscopy appears to be a safe alternative to laparotomy for benign masses when performed by experienced surgeons.

Learning objectives

To list the differential diagnoses of adnexal masses in pregnancy

To interpret ultrasound images of adnexal masses and distinguish benign from malignant masses

To describe the management options for adnexal masses in pregnancy, including the indications and options for surgical intervention.
Postmenopausal Dilemmas: The Role of Ultrasound
Authors: Murphy R Bryan , Zalud Ivica 
Published: June 2010

AbstractThe postmenopausal patient presents unique challenges in ultrasound. With age being a major risk factor for most malignancies, the results of the examination can result in a clinician being more apt to conduct more invasive tests or elect for a surgical cure. This article is aimed to review the common gynecological pathology in post- menopausal patients and how ultrasound can aid the clinician in diagnosis and management. As noninvasive and nonradiation imaging modality, pelvic ultrasound allows valuable approach to assessment of anatomy and pathology of the uterus and adnexa in postmenopausal patients. Validity for the delineation of morphological characteristics of pelvic abnormalities is widely tested and already applied to routine clinical care. The early detection of pelvic carcinoma is still the most attractive for further studies.Learning objectivesTo discuss how ultrasound can help in management of postmenopausal bleedingTo present the role of ultrasound in diagnosing pelvic massesTo understand ultrasound contribution in screening for pelvic malignancies.
Evaluation of Fetal Arrhythmias
Authors: Graham George M 
Published: June 2010

Abstract
Fetal arrhythmias are not uncommon. The diagnosis of a fetal arrhythmia is challenging and normally requires referral for a detailed fetal echocardiogram. The first step in the ultrasound evaluation should be distinguishing whether the arrhythmia is an irregular rhythm, a bradycardia, or a tachycardia. This can be done by evaluating the arrhythmia using simultaneous atrial and ventricular M-mode or pulsed Doppler. Although the majority of fetal arrhythmias are self-limited and benign, some are potentially life-threatening for the fetus and for these cases a multidisciplinary approach to treatment may be required.

Learning Objectives

Know the different types of fetal arrhythmias
Understand how fetal arrhythmias are diagnosed
Know which fetal arrhythmias require treatment
Just Images: Obstetrics
Authors: Bartholomew Marguerite Lisa , Fujimoto Chrystie 
Published: June 2010

Abstract
Diagnostic ultrasound in the field of obstetrics is used to evaluate fetal anomalies and well-being. These images are used to develop a differential diagnosis that can later be correlated with postnatal outcomes. The following cases are a small sample of recent challenging fetal anomalies at our institution that were detected on prenatal ultrasound.

Objectives

Interpret ultrasound images of fetal anomalies
Assimilate the interpretation of images into a differential diagnosis
Correlate prenatal imaging with postnatal outcomes