bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post‐Cesarean section pain secondary to intussuscepting colonic adenocarcinoma
Authors: Steinberg L. , Nisenbaum H. L. , Horii S. C. , Salhany K. E. 
Published: March 2003

AbstractThe differential diagnosis for lower abdominal and pelvic pain following Cesarean section includes many causes, such as endomletritis, abscess, pelvic hematoma, wound complications, pelvic vein thrombophlebitis, gastrointestinal dysfunction and obstruction. Colonic obstruction secondary to intussusception is a rare cause. We present a case of post‐Cesarean section pain in a 26 year‐old patient due to obstructing colocolic intussusception secondary to colonic adenocarcinoma. Review of the literature failed to identify a previous case report of colonic adenocarcinoma with intussusception presenting early in the postpartum period. The diagnosis was initially made by ultrasound, and later corroborated by computed tomography, harium enema and laparotomy. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Persistent patent urachus with allantoic cyst: a case report
Authors: Tolaymat L. L. , Maher J. E. , Kleinman G. E. , Stalnaker R. , Kea K. , Walker A. 
Published: March 2003

AbstractPatent urachus results when there is a persistence of an allantois remnant which normally undergoes atresia during embryological development. It can lead to an abdominal wall defect similar in appearance on ultrasound to an omphalocele.A 34‐year‐old primigravida presented at 19 weeks' gestation for evaluation of a cystic mass arising at the umbilical cord insertion. The initial impression of the referring physician was an omphalocele. The mass arose from the abdominal wall and the umbilical cord inserted into the membranous covering of the mass, which appeared to be fluid‐filled and separate from but contiguous with the urinary bladder. Serial sonography followed the progression of the abdominal wall mass. At term, the patient underwent primary Cesarean section with delivery of a 4494‐g male infant. The infant underwent repair and closure of the patent urachus and plastic reconstruction of the abdominal wall.When the urachus remains patent, it can lead to a urinary fistula which mimics the ultrasound appearance of an omphalocele. However, patent urachus is associated with a much lower rate of abnormalities than omphalocele, yielding a better fetal prognosis. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Results of chromosomal analysis in fetuses with cardiac anomalies as diagnosed by first‐ and early second‐trimester echocardiography
Authors: Gembruch U. , Baschat A. A. , Knöpfle G. , Hansmann M. 
Published: March 2003

AbstractChromosomal analyses were performed in 36 fetuses with cardiac anomalies diagnosed by echocardiography at 11 + 1 to 15 + 6 weeks of gestation. Karyotyping was successful in 35 cases and 17 (48.6%) had anomalies, including five with Turner's syndrome, seven with trisomy 18, four with trisomy 21 and one with triploidy. The commonest cardiac anomaly observed in trisomy 21 was a complete atrioventricular canal; in trisomy 18 was ventricular septal defect; in Turner's syndrome was a hypoplastic aortic arch in combination with hypoplasia of the left ventricle and left ventricular outflow tract; and in the case of triploidy was a ventricular septal defect. These findings confirm the opinion that, in fetuses with chromosomal anomalies, there is a high incidence of cardiac defects. Furthermore, there is a distinct pattern of cardiac defects associated with each chromosomal anomaly. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Second‐trimester measurements of placental volume by three‐dimensional ultrasound to predict small‐for‐gestational‐age infants
Authors: Hafner E. , Philipp T. , Schuchter K. , Dillinger‐Paller B. , Philipp K. , Bauer P. 
Published: March 2003

AbstractObjectiveThe objective of this study was to investigate the value of second‐trimester three‐dimensional sonographic placental volume measurements to predict infants who are below the 10th Gentile for birth weight.Subjects and methods Placental volume measurements were performed using three‐dimensional ultrasound in 382 women with normal singleton pregnancies at 16–23 weeks' gestation. Logistic multivariate regression consisting of variables considered to influence birth weight was used to predict infants with a birth weight below the 10th centile from the placental volume measurements.ResultsPrognostic influence could be shown for placental volume (p ≤ 0.0001), gestational week at the time of measurement (p = 0.0002) and maternal weight at the time of registration (p = 0.0025). Values for specificity and sensitivity achieved by choosing an ‘optimal’ cut‐off point of 0.16 for the estimation probability for a small‐for‐gestational‐age (SGA) infant were low at 82.5% and 52.5%, respectively.ConclusionsThree‐dimensional sonograpbic measurement of the placental volume alone is not a satisfactory technique for predicting SGA infants. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Blood flow changes in the ovarian and uterine arteries in women with polycystic ovary syndrome who respond to clomiphene citrate: correlation with serum hormone concentrations
Authors: Zaidi J. , Jacobs H. , Campbell S. , Tan S. L. 
Published: March 2003

AbstractObjectiveOur purpose was to study the hemodynamic changes in the uterine and intraovarian vessels in women with polycystic ovary syndrome (PCOS) and to relate the vascular changes to hormonal indices.MethodsSix women with a history of previous anovulatory cycles and/or oligomenorrhea and/or elevated serum luteinizing hormone concentrations in addition to polycystic ovaries underwent induction of ovulation with clomiphene citrate. Serial transvaginal ultrasonography was performed on menstrual cycle day 2, daily from the estimated day of ovulation minus 6, 6‐hourly from the estimated day of ovulation minus 2 or when the mean follicular diameter was greater than 16 mm (whichever was earlier) until 6 h after follicular rupture, and once 7 days after follicular rupture. At each scan, uterine and intraovarian blood flow was assessed by transvaginal color Doppler ultrasound, and serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol and progesterone were assessed by fluoroimmunoassay.ResultsAll six women demonstrated ultrasonographic features of ovulation. Follicular peak systolic blood flow velocity (Vmax) and ovarian stromal Vmax in the dominant ovary increased during the follicular phase of the menstrual cycle and reached a peak at 36 and 42 h after the onset of the LH surge of 30.7 ± 4.6 cm/s and 37.0 ± 3.9 cm/s, respectively. There was no significant change in the ovarian stromal Vmax of the non‐dominant ovary. There was no significant change in the pulsatility index (PI) in either the follicular or the ovarian stromal vessels during the menstrual cycle. The changes in follicular Vmax correlated significantly with changes in serum concentrations of FSH, LH and progesterone. Uterine artery time‐averaged maximum velocity (TAMX) declined to its lowest levels at LH surge minus 6 days, and thereafter increased. In contrast, the PI increased during the follicular phase of the cycle, reaching a peak at LH surge minus 4 days, and thereafter declined. The changes in uterine artery PI correlated inversely with serum estradiol and serum progesterone concentrations.ConclusionsWomen with PCOS have significant differences in intraovarian and uterine artery hemodynamics, both at the baseline ultrasound scan and during the clomiphene‐induced menstrual cycle, compared with women with normal ovaries. The intraovarian and uterine artery vascular differences are likely to be due to a primary disorder within the polycystic ovary and their different hormonal status. Clomiphene citrate may have an effect on uterine artery blood flow. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
The umbilical artery pulsatility index in the first trimester: is there an association with increased nuchal translucency or chromosomal abnormality?
Authors: Brown R. , Di Luzio L. , Gomes C. , Nicolaides K. H. 
Published: March 2003

AbstractObjectiveThe aim of this study was to examine the possible association between umbilical artery pulsatility index (PI) at 10–14 weeks of gestation and either increased fetal nuchal translucency (NT) or fetal chromosomal abnormality.DesignThis was a prospective study of women undergoing chorionic villus sampling (CVS). Subjects A total of 458 women undergoing CVS were studied; in 418 cases the karyotype was normal and in 19 cases fetal trisomy 21 was identified.SubjectsA total of 458 women undergoing CVS were studied; in 418 cases the karyotype was normal and in 19 cases fetal trisomy 21 was identified.MethodsData from the women with a normal fetal karyotype and in whom the NT was also normal were used to calculate reference ranges for the umbilical artery PI. Associations were sought between umbilical artery PI and increased NT and between the PI and fetal trisomy 21. Results We found no association between umbilical artery PI and NT, nor was there a difference in the PI between chromosomally normal pregnancies and those with fetal trisomy 21.ConclusionThe results suggest that fetoplacental vascular resistance per se does not contribute to increased NT and that measurement of the umbilical artery PI does not contribute to the first‐trimester detection of fetal trisomy 21. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Objective and subjective assessment of abnormal uterine artery Doppler flow velocity waveforms
Authors: Bower S. , Kingdom J. , Campbell S. 
Published: March 2003

AbstractObjectiveAbnormal uterine artery Doppler waveforms in the second trimester of pregnancy can predict adverse outcome. The presence of a diastolic notch is a better predictor than measurement of impedance indices. A notch has generally been assessed subjectively, which has raised questions as to the reproducibility of the method. The aim of this study was to compare subjective and objective assessments of 50 abnormal waveforms.DesignThis was a retrospective study of 50 abnormal uterine artery waveforms collected during a previous screening study. Subjective and objective assessments were compared and related to adverse outcomes. Five impedance indices incorporating a measurement of the diastolic notch were compared. Three indices predictive of adverse outcome were compared to subjective assessment.ResultsThere was good agreement between experienced operators in their subjective assessment of uterine artery waveforms. Adverse outcome was predicted by only moderately or severely abnormal waveforms. Three impedance indices predictive of adverse outcome were the pulsatility index (PI), A/C and (D – C)/B (where A is the peak systolic, D is the maximum diastolic and B is the end‐diastolic frequency, and C is the nadir of the notch). The cut‐off values combining the highest sensitivity for the lowest false‐positive rate were 1.5 for PI, 3.0 for A/C and 0.15 for (D – C)/B. A PI of 1.5 had the highest sensitivity (100%) and positive predictive value (55%) for adverse outcome in this preselected group. These three indices were compared to subjective assessment using the kappa index and the (D – C)/B ratio had the closest agreement, although all three indices showed at least moderate agreement. The cut‐off values of 1.5, 3.0 and 0.15 for PI, A/C and (D – C)/B, respectively appear to differentiate between mildly abnormal waveforms and moderately/severely abnormal waveforms.ConclusionObjective assessment of uterine artery waveforms using cut‐off values of PI, A/C and (D – C)/B provides an estimation similar to that provided by subjective assessment by an experienced operator. These ratios will now need to be used prospectively in an unselected population to compare their screening properties. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of atypical cystic lesions of the fetal scalp
Authors: Okaro E. , Broussin B. , Ville Y. 
Published: March 2003

AbstractTwo cases of cystic lesions of the fetal scalp are described. They were initially thought to be meningoceles, but the brain was normal on ultrasound examination and there were no associated abnormalities. In the first case, by 26 weeks' gestation, the original cystic lesion had regressed to a dense tissue mass; in the second case, the cyst remained as a small anechoic mass.Postnatal assessment in the first case revealed a plexiform skin lesion measuring 40 x 15 mm on the left parietal bone. This was mobile and not attached to the underlying structures. The skull showed no obvious defect and a cranial scan was normal. In the second case, an epidermal cyst was diagnosed. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Intravaginal saline as a contrast agent for cervical sonography in the obstetric patient
Authors: O'Brien J. M. , Allen A. A. , Barton J. R. 
Published: March 2003

AbstractObjectiveTo determine whether intravaginal saline alters visualization of the cervix during endovaginal sonographic examinations.DesignA prospective trial with comparison of sonographic measurements of cervical length prior to and after administration of an intravaginal contrast agent.SubjectsPatients with an indication for endovaginal ultrasonographic assessment of the cervix were considered as candidates for the study.MethodsAfter assessment of cervical dimensions and contour of the internal cervical os, 10 ml of normal saline was placed intravaginally via a needleless syringe. Pre‐ and post‐contrast sonographic examinations of the cervix were compared.ResultsTwenty‐six patients were enrolled. No differences were observed in the identification of funnelling (37% in each group, p = 1.0) or the quantification of cervical length for the entire cohort (p = 0.95). However, in a subset of patients in whom the external os was not satisfactorily visualized (23%), intravaginal contrast resulted in a mean difference in cervical length pre‐ and post‐saline infusion of 6.4 mm compared to 1.4 mm in patients in whom the external os could be easily identified (p < 0.001). No patient expressed undue discomfort related to the administration of contrast.ConclusionIntravaginal saline assists in visualization of the cervix during endovaginal sonography for selected patients in whom precise identification of the external os is difficult. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Fetal heart rate and umbilical artery velocity variability in pregnancies complicated by insulin‐dependent diabetes mellitus
Authors: Ursem N. T. C. , Clark E. B. , Keller B. B. , Wladimiroff J. W. 
Published: March 2003

AbstractObjectivesTo examine the variability in fetal heart rate and absolute flow velocity, which are possible hemodynamic markers of cardiovascular homeostasis in pregnancies complicated by diabetes mellitus.MethodsDoppler studies of umbilical artery velocity waveforms were performed at 12–21 weeks of gestation in 16 women with well‐controlled type I (insulin‐dependent) diabetes mellitus. From umbilical artery velocity wave‐forms of at least 13 s in duration, we determined absolute values and beat‐to‐beat variability for fetal heart rate and umbilical artery flow velocities and compared these findings with normal controls matched for gestational age.ResultsFetuses of diabetic women displayed increased fetal heart rate variability and umbilical artery peak systolic velocity. Fetal heart rate, umbilical artery time‐averaged velocity and variability in umbilical artery flow velocity were not essentially different between the two groups.ConclusionFetal heart rate variability and umbilical artery peak systolic velocity may be markers for fetal cardiovascular homeostasis in pregnancies complicated by insulin‐dependent diabetes mellitus. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Yolk sac and umbilicoplacental hemodynamics during early human embryonic development
Authors: Mäkikallio K. , Tekay A. , Jouppila P. 
Published: March 2003

AbstractObjectivesTo determine the relationship between the yolk sac and umbilicoplacental circulations during the first trimester of pregnancy.DesignSixteen normal singleton pregnancies were included in this longitudinal study. Transvaginal ultrasonography with color and pulsed Doppler was performed at 5+, 7+, 8+ and 10+ gestational weeks. Fetal heart rate and blood velocity waveforms of yolk sac, umbilical and chorionic arteries were obtained.ResultsThe detection rate of arterial blood flow in the yolk sac increased significantly from 5+ (2/16) to 7+ gestational weeks (12/16). Thereafter, it declined significantly and no arterial blood flow was detected at 10+ weeks. When the arterial blood flow was observable in the yolk sac, all waveforms consisted of continuous diastolic blood flow. There were no significant changes in peak systolic velocity (PSV), time‐averaged maximum velocity (TAMXV), pulsatility index (PI) or resistance index (RI) values of the yolk sac arteries during the study period. In umbilical arteries, blood flow was detected in two of 16 patients at 5+ weeks and in all cases thereafter. The mean umbilical artery PSV (SD) increased from 7.2 cm/s (3.7) at 8+ weeks to 13.0 cm/s (2.9) at 10+ weeks (p = 0.001). No changes in PI values were found and the absence of diastolic flow was typical of the umbilical artery during the study period. In chorionic arteries, blood flow was detected in six out of 16 subjects at the 5+ week, in 14 out of 16 patients at the 7+ week and in every case thereafter. No changes in PSV or TAMXV values were found.ConclusionsOur results showed that the arterial signals in the yolk sac circulation disappeared and the umbilicoplacental circulation increased between 8+ and 10+ weeks of gestation. This indicates that the placenta replaces the yolk sac as an essential source of blood supply to the embryo at that time. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Do heart rate and velocity variability derived from umbilical artery velocity waveforms change prior to clinical pregnancy‐induced hypertension?
Authors: Ursem N. T. C. , Clark E. B. , Keller B. B. , Hop W.C.J. , Wladimiroff J. W 
Published: March 2003

AbstractObjectiveTo investigate the hypothesis that alterations in heart rate variability, peak systolic velocity variability and time‐averaged velocity variability in the human umbilical artery may predict early signs of dysfunctional fetal‐ placental coupling in pregnancies that later develop pregnancy‐ induced hypertension.MethodsDoppler flow velocity recordings from the umbilical artery were performed at 10–20 weeks of gestation in 12 nulliparous women who subsequently developed pregnancy‐induced hypertension. From umbilical artery velocity waveforms of at least 12 s in duration we determined absolute values and beat‐to‐beat variability in fetal heart rate, peak systolic and time‐averaged velocity and compared these findings with those in normal nulliparous pregnant women matched for gestational age.ResultsAbsolute values for fetal heart rate, peak systolic and time‐averaged velocity as well as beat‐to‐beat variability in fetal heart rate did not differ significantly between women later developing pregnancy‐induced hypertension and normal controls. However, variability in peak systolic velocity and time‐averaged velocity were decreased in women who subsequently developed pregnancy‐induced hypertension.ConclusionsWhereas fetal heart rate variability was similar, umbilical artery flow velocity variability was reduced in women developing pregnancy‐induced hypertension compared with controls. It is proposed from this study that variability of the umbilical artery flow velocity is associated with mechanical changes in the vascular bed of women who later develop pregnancy‐induced hypertension. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis and follow‐up of 14 cases of unilateral ventriculomegaly
Authors: Senat M. V. , Bernard J. P. , Schwärzler P. , Britten J. , Ville Y. 
Published: March 2003

AbstractObjectiveTo report prospectively the prenatal diagnosis, management and outcome of 14 cases of unilateral ventriculomegaly.MethodsFourteen fetuses were diagnosed as having one ventricle of ≥ 10 mm, as measured at the level of the atrium.ResultsIn ten cases, the scan showed mild unilateral ventriculomegaly with an atrium width between 11 and 13 mm and this remained stable up to term. Eight of these fetuses had a magnetic resonance imaging scan in utero between 32 and 34 weeks of gestation which confirmed the diagnosis of mild ventriculomegaly without other brain abnormalities and showed a normal cortical mantle. No obvious cause was found and the outcome was normal in all cases. In four cases, the unilateral ventriculomegaly evolved rapidly with an atrium width up to 20–25 mm. Causes included atresia of the foramen of Monro, toxoplasmosis, brain atrophy and Weaver syndrome. Three underwent termination of pregnancy and the postmortem examination confirmed the diagnosis. The baby with brain atrophy and schizencephaly had a ventriculoperitoneal shunt placed at 1 month of age and has severe developmental delay at 9 months.ConclusionThe prognosis of unilateral ventriculomegaly is uncertain. Examination of both ventricles during the anomaly scan should be performed, as should ultrasound follow‐up of these cases up to the end of the third trimester. Fetuses with an isolated, mild, stable unilateral ventriculomegaly seem to have a favourable neurological outcome. However, fetuses with rapidly evolving unilateral ventriculomegaly or cases associated with other brain abnormalities may have a poor neurological outcome. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
The association between congenital heart disease and Down syndrome in prenatal life
Authors: Paladini D. , Tartaglione A. , Agangi A. , Teodoro A. , Forleo F. , Borghese A. , Martinelli P. 
Published: March 2003

Objective To assess the relationship between congenital heart disease (CHD) and Down syndrome (DS) in utero.
Design Retrospective case series.
Subjects Fifty‐two fetuses with a cytogenetic diagnosis of DS managed at our Fetal Cardiology Unit in the study period. In particular, two populations of fetuses with DS were studied: a group of 41 DS fetuses referred to our unit for fetal echocardiography due to the chromosomal anomaly and a second group of 274 fetuses referred because of suspected CHD, 11 of which were found to have DS.
Methods All fetuses were submitted to detailed ultrasound evaluation of fetal anatomy. Associated extra‐cardiac anomalies, and presence and type of CHD, were recorded for all fetuses. Karyotyping was obtained by means of cordocentesis or amniocentesis. Necropsy or neonatal echocardiograms were sought for confirmation of the prenatal diagnosis.
Results In the group of 41 fetuses with known DS, the incidence of CHD was 56% ([atrioventricular septal defect (AVSD) 44%, ventricular septal defect (VSD) 48%], the remainder having other heart defects). Conversely, considering the incidence of DS in fetuses with CHD, 43% of all AVSDs (53% of AVSD with normal visceral situs) were associated with DS, whereas none of the 39 cases of VSD was associated with trisomy 21. Ventricular septal defects were diagnosed only in fetuses referred to our center with a known diagnosis of aneuploidy.
Conclusions We have confined that more than half of the fetuses with DS bear a CHD, which is an AVSD in 44% of cases. Conversely, 43% of fetuses with an AVSD have trisomy 21. For VSDS, the situation is controversial, due to the relatively low detection level of this heart defect at the routine mid‐trimester obstetric scan.