bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraobserver and interobserver variability of transabdominal Doppler velocimetry measurements of the fetal ductus venosus between 10 and 14 weeks of gestation
Authors: Mavrides E. , Holden D. , Bland J. M. , Tekay A. , Thilaganathan B. 
Published: March 2003

AbstractObjectiveTo assess the intraobserver repeatability and interobserver reproducibility of transabdominal Doppler ultrasound measurements of ductus venosus blood flow in fetuses between 10 and 14 weeks of gestation.DesignA prospective study with the following end‐points: coefficient of variation, intraclass correlation coefficients within and between observers, repeatability coefficient and Cohen's kappa coefficient.Subjects and MethodsDoppler velocimetry indices (maximum peak systolic velocity during ventricular systole, end‐diastolic velocity during atrial contraction, peak systolic velocity/end‐diastolic velocity ratio and pulsatility index for veins) were successfully measured three times by the same trained observer in 67 fetuses. Of these, in 24 fetuses, the measurements were then repeated by a second trained observer. In addition, both observers classified qualitatively the blood flow as being normal or abnormal with regard to the presence or absence/reversal of flow during atrial contraction.ResultsThe intraobserver repeatability of the pulsatility index for veins measurements was considered good with a coefficient of variation of 8.9% and an intraclass correlation coefficient value of 0.62. However, inconsistencies occurred in maximum peak systolic velocity, end‐diastolic velocity and systolic/diastolic ratio measurements, which had coefficients of variation of 19%, 28.5%, and 25.4%, respectively. The corresponding intraclass correlation coefficient values were 0.70, 0.69 and 0.60. Interobserver reproducibility of these indices was unsatisfactory, the coefficient of variation varying between 11.5% and 47.2% and the intraclass correlation coefficient between 0.18 and 0.44. Agreement between the repeated observations with regard to interpretation of normal or abnormal blood flow varied from moderate (interobserver) to very good (intraobserver).ConclusionsThere was considerable variability in all Doppler indices except for the intraobserver repeatability of the pulsatility index for veins measurement. This makes the implementation of the semiquantitative Doppler indices in a screening setting difficult. On the contrary, qualitative classification of the flow velocity waveforms seemed to be a reproducible method. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
The role of ductus venosus blood flow assessment in screening for chromosomal abnormalities at 10–16 weeks of gestation
Authors: Antolín E. , Comas C. , Torrents M. , Muñoz A. , Figueras F. , Echevarría M. , Cararach M. , Carrera J. M. 
Published: March 2003

AbstractObjectiveTo evaluate the role of ductus venosus blood flow assessment at 10–16 weeks' gestation in screening for chromosomal abnormalities.MethodsDuctus venosus blood flow was prospectively evaluated in 1371 consecutive pregnancies between 10 and 16 weeks of gestation. The pulsatility index for veins was calculated. All cases were screened for chromosomal defects combining maternal age and fetal nuchal translucency thickness.ResultsA chromosomal abnormality was found in 20 cases. The overall detection rate, specificity, positive predictive value, negative predictive value and odds ratio for chromosomal abnormalities were 65%, 95.7%, 18.3%, 99.5% and 41 (95% CI 16–108), respectively, when using the 95th centile pulsatility index as a cut‐off.ConclusionsThese preliminary results suggest that evaluation of the ductus venosus pulsatility index at 10–16 weeks' gestation is a useful second‐line screening test for chromosomal defects. A combination of nuchal translucency measurement and ductus venosus assessment might increase specificity while maintaining an optimal detection rate for chromosomal abnormalities. Such a policy could identify 55% of all chromosomal abnormalities and about 69% of autosomal trisomies, reducing the need for invasive testing to less than 1%. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis and follow up of congenital splenic cyst: a case report
Authors: Lopes M. A. B. , Ruano R. , Bunduki V. , Miyadahira S. , Zugaib M. 
Published: March 2003

AbstractWe report a case of congenital splenic cyst that was identified by prenatal sonography at 25 gestational weeks. Serial scans demonstrated an increase in size during the prenatal period but after birth the cyst progressively decreased in size until its complete regression at 6 months of age. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Diagnostic and therapeutic problems in a case of prenatally detected fetal hydrocolpos
Authors: Geipel A. , Berg C. , Germer U. , Ahrens P. , Gloeckner‐Hofmann K. , MÖller J. , Gembruch U. 
Published: March 2003

AbstractWe report on a female fetus with prenatally suspected hydrometrocolpos. Postnatal evaluation additionally revealed ambiguous genitalia, anorectal atresia, vertebral segmentation anomalies and congenital intestinal aganglionosis. Colostomy was performed, but postoperative recovery was complicated by pulmonary hypertension and renal failure, resulting in death at day 18. Postmortem examination furthermore revealed a small ventricular septal defect, as well as rectovaginal and urethrovaginal fistulae, causing massive dilatation of the septated vagina (hydrocolpos). The possibility of an overlapping VACTERL and MURCS association is discussed. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
The relevance of placental location at 20–23 gestational weeks for prediction of placenta previa at delivery: evaluation of 8650 cases
Authors: Becker R. H. , Vonk R. , Mende B. C. , Ragosch V. , Entezami M. 
Published: March 2003

AbstractObjectiveTo determine the correlation between placental position at 20–23 weeks and incidence of birth complications caused by placental position.Subjects and methodsIn an ongoing prospective study, placental position was determined by transabdominal sonography as part of anomaly scanning at 20–23 gestational weeks, followed by transvaginal sonography in uncertain or suspicious situations. Examination was performed in 9532 cases; feedback was obtained from 8650 patients (90.7%).ResultsTransabdominal sonography was followed by transvaginal scan in 363 of 8650 cases (4.2%). In 8551 cases (98.9%), we found normal placental position, with the placenta not reaching the internal os and a Cesarean section rate of 17.1% (1458/8551). The incidence of ‘low placental position’, with the placenta reaching the internal os was 0.66% (57/8650), with a Cesarean section rate of 21% (12/57). In 0.49% (42/8650) of cases, the placenta overlapped the internal os at 20–23 weeks; Cesarean section because of placenta previa or bleeding was performed in 28 of 8650 cases (0.32%). Vaginal delivery was possible in 43% of cases (13/30), when the overlap did not exceed 25 mm. If the overlap exceeded 25 mm (12 cases), no vaginal delivery was reported. There was no reported case of placenta previa missed at the 20–23‐week scan.ConclusionAt 20–23 weeks, a combination of routine transabdominal and indication‐based transvaginal location of placental position is a powerful tool in predicting placenta previa at delivery. The advantage of determining placental position at this stage of pregnancy is a low false‐positive rate compared to at earlier stages of pregnancy. We conclude that an overlapping placenta at 20–23 weeks has the consequence of a high probability of placenta previa at delivery. An overlap of 25 mm or more at 20–23 weeks seems to be incompatible with later vaginal delivery. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
The feasibility of a ‘one stop’ ultrasound‐based clinic for the diagnosis and management of abnormal uterine bleeding
Authors: Jones K. , Bourne T. 
Published: March 2003

AbstractObjectivesWe have established a ‘one stop’ clinic for the management of women with abnormal uterine bleeding based on transvaginal sonography and saline contrast sonohysterography. This report reviews our experience with the first 93 patients attending the clinic.Design and methodsPatients were seen with the intention of performing a transvaginal scan, saline contrast sonohysterography, endometrial biopsy, full blood count and thyroid function tests. The findings were prospectively recorded on a computer database and a management plan formulated.ResultsA transvaginal scan was performed on 89 (95.7%) women, 70 (75.3%) also undergoing saline contrast sonohysterography. An endometrial biopsy was carried out in 67 (72%) women aged 40 years and above, and 79 (84.9%) had blood tests. The median age of patients was 44 (range, 21–78) years. The majority of women presented with menstrual disorders. Uterine pathology was detected on transvaginal scan in 42 (47.2%) cases. Adnexal pathology was detected in 12 (13.5%) of the patients. Endometrial biopsy detected three (4.5%) cases of endometrial atypia, and three (4.5%) cases of adenocarcinoma. A hemoglobin level of < 10 g/dL was detected in 3 (3.4%) patients. A single clinic visit was thought sufficient for 83 (89.2%) women. Medical therapy was started in 47 (50.5%) patients, 15 (16.3%) were brought back for inpatient diagnostic hysteroscopy, and nine (9.7%) were booked for operative endoscopy, while six (6.5%) had conventional surgery; the remainder were reassured.ConclusionsThis study demonstrates that a ‘one stop’ management philosophy based on pelvic ultrasound is feasible. Our data suggest that diagnostic hysteroscopy can be decreased using this approach, and challenge the use of hysteroscopy as the first stage test. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Three‐dimensional sonographic volumetry of the placenta and the fetus between weeks 15 and 17 of gestation
Authors: Hafner E. , Schuchter K. , Van Leeuwen M. , Metzenbauer M. , Dillinger‐Paller B. , Philipp K. 
Published: March 2003

AbstractObjectivesThree‐dimensional sonographic volume measurement enables for the first time direct comparison of the increase in size of different but closely interacting structures like the placenta and fetus. Our aim was to calculate the fetal and placental volumes between weeks 15 and 17 of gestation, to monitor the difference in the increase of the fetal and placental sizes and to determine their mutual relationship.MethodsFetal and placental sonographic volume measurements were made in 356 singleton pregnancies. To measure the relationship between fetal and placental volumes, a quotient was calculated. Regression analyses were performed to analyze the dependence of the fetal and placental volumes and placental quotient on the week of gestation and other influencing variables.ResultsThe mean of the fetal volume increased markedly from 67.8 to 76.6 mL (by 13%) within the 3 weeks of observation, whereas placental volume increased only slightly (111.1 to 114 mL (by 2.6%)). The random variation of placental volumes around the mean in all three gestational weeks was considerably higher than that of fetal volumes, indicating that in this early period of gestation there is little correlation between fetal and placental sizes. Fetal volume correlated better to gestational week than did placental volume.ConclusionThe quotient of fetal and placental volume might assist in the diagnosis of high‐risk pregnancies and the assessment of a normal or large fetus with a small placenta. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Preoperative ultrasound preparation in endometrial cancer
Authors: Szabó I. 
Published: March 2003

Purpose:  The aim of this study was to determine the efficiency of transvaginal sonographic (TVS) in the assessment of myometrial invasion and cervical involvement (preoperative staging) of endometrial cancer as well as to evaluate the influence of myometrial invasion and cancer grading on uterine blood flow characteristics in endometrial cancer.Methods:  Transvaginal 2D, color Doppler and pulsed Doppler ultrasound were performed on 97 women to classify endometrial cancer with respect to myometrial invasion and cervical involvement. According to the FIGO recommendation for surgical staging of endometrial cancer 11 stage IA, 33 stage IB, 37 stage IC, 7 stage II, 8 stage III, and 1 stage IV were identified. Endometrial cancer was diagnosed on the basis of dilatation and curettage. The degree of invasion and the uterine blood flow characteristics were evaluated preoperatively. Ultrasonographic findings were compared to the surgical staging and histopathology of the surgical specimen.Results:  Myometrial invasion (more or less than 50%) evaluated by TVS was accurate in 87 of 97 cases (accuracy 90%, sensitivity 87%, specificity 93%, positive predictive value 92%, negative predictive value 85%). Tumor extension to the cervix was properly assessed in 9 of 14 women in which it was present (sensitivity 64%, specificity 97%, positive predictive value 82%, negative predictive value 94%). In 90 of the 97 patients with endometrial cancer, abnormal blood flow with low impedance levels (RI, 0.39 ± 0.08; PI, 0.51 ± 0.15) was found within the endometrial echo or very close to it. Uterine blood flow was not modified by the cancer grading. Moreover, there was no difference in impedance indices of the uterine arteries between myometrial invasion of <50 and >50%.Conclusion:  These results suggest that 2D TVS evaluation of endometrial cancer is a reliable method for assessing myometrial invasion and cervical involvement. Uterine blood flow analysis could not predict the tumor staging and grading, however, it did provide additional discriminatory information on tumor vascularization which can be used with morphology for more accurate diagnosis. Preoperative ultrasound examination should be seen as an important tool in the establishment of individualized treatment programs for women with endometrial cancer.
Relationship between fetal pulmonary artery blood flow velocity waveform and fetal lung length in pregnancies complicated by oligohydramnios
Authors: Blaszczyk Krysztof , Wojcieszyn M. , Lukasik A. , Swadzba K. , Stokowacka M. , Poreba R. 
Published: March 2003

Objectives:  The objective of this study is to evaluate weather there is a correlation between Doppler velocity waveform parameters obtained from fetal pulmonary artery and fetal lung length considered as one of the lung hypoplasia risk parameters in pregnancies complicated by oligohydramnios.Methods:  A total of 35 singleton pregnancies between 26 and 39 weeks complicated by oligohydramnios due to premature rupture of the membranes, placental insufficiency or idiopathic etiology and 69 normal pregnancies were examined by real time ultrasonography, color and pulse Doppler. Pulse Doppler signal was obtained from the distal part of right or left pulmonary artery after visualization with color Doppler at the level of four chamber view. The systolic to diastolic ratio, resistance index and pulsatility index were used to quantify velocity waveforms. The right lung of the fetus was measured longitudinally from the apex next to clavicle to the base at the top of diaphragm. The results of fetal lung length measurements were compared with namogram given by Roberts.Results:  Statistically significant difference in distal pulmonary artery pulsatility index between normal pregnancies (1.74 ± 0.23) and pregnancies complicated by oligohydramnios (2.72 ± 0.56) with decreased value of fetal lung length (below fifth percentile) was observed. The sensitivity, specificity, positive and negative predictive value of 95, 91, 93, 91%, respectively, were obtained. In the group with oligohydramnios and normal values of fetal lung length, the difference in pulsatility index in comparison with normal pregnancies was not significant. No differences in systolic to diastolic ratio and resistance index between examined groups were found.Conclusions:  Strong relationship between increased pulsatility index value obtained from distal part of pulmonary artery and decreased value of fetal lung length measurement in pregnancies complicated by oligohydramnios was observed. The measurement of pulmonary artery pulsatility index enriched with fetal lung length may give additional information useful in predicting pulmonary hypoplasia risk.
Early diagnosis in ovarian cancer: role of transvaginal ultrasound
Authors: Pascual M. A. , Tresserra F. , Grases P. J. , Dexeus S. 
Published: March 2003

Purpose:  To evaluate the efficiency of transvaginal ultrasound in the early diagnosis of ovarian cancer.Methods:  Screening transvaginal ultrasound has been annually performed during the last 2 years in asymptomatic women without familial history of ovarian cancer. When abnormalities were detected, the procedure was repeated after 4–6 weeks. If the findings disappeared, the study was repeated after 1 year. If the abnormality persisted, study was complemented with tumor markers, computed tomography and laparoscopic surgery. The findings were compared with a control group of women in whom ovarian transvaginal ultrasonography was formally indicated.Results:  A total of 26007 transvaginal ultrasound were performed: 8813 (33.8%) belonged to the screening group and 17194 (66.2%) to the control group. In 14 patients of the screening group, a malignant tumor was diagnosed and histologically confirmed. The mean age of these patients was 45 years old (SD 12). Eleven of these tumors were stage I (seven Ia, and four Ic), two stage IIIc and one was a metastatic melanoma in both ovaries. Six lesions were borderline tumors (five serous and one mucinous). In the control group, 27 ovarian cancers were diagnosed in patients with a mean age of 48 years (SD 17). In this group, 11 tumors were in stage I, and six were borderline.Conclusions:  Although consensus about the benefits of using transvaginal ultrasound as a screening procedure is not conclusive, our data reveals that tumors detected in patients screened with transvaginal ultrasound are in earlier stages when compared with those diagnosed in the control group. No differences were found in age and number of borderline tumors between both groups. Additional studies are needed to support this preliminary findings.
Three‐dimensional ultrasound and treatment of choice in cervical cancer
Authors: Babinszki A. , Artner A. , Szalay J. , Palfalvi L. , Ungar L. 
Published: March 2003

Purpose:  Tumor volume, parametrial involvement, lymph nodal status, urinary bladder and rectum involvement are essential parameters in the treatment planning of early stage cervical cancer. Fertility sparing trachelectomy criteria has become a new diagnostic challenge within the last years. We assumed that three‐dimensional (3D) ultrasound may add useful information for the oncologists in planning the treatment of cervical cancer patients.Methods:  Three‐dimentional transvaginal sonography was performed in all cases to assess tumor volume, parametrial involvement, local and distant spread of the tumor. Tumor vascularization was also examined by 3D power Doppler.Results:  In the last 5 months, 15 patients with early stage cervical cancer, considered for primary surgical treatment, have been examined with 3D sonography prior to surgery. Two out of 15 patients have undergone abdominal radical trachelectomy, 13 were surgically explored with the intention of Wertheim hysterectomy. In one patient, paraaortal tumor spread was suspected on our 3D examination, surgical finding at exploration has proven lymphatic spread extending above the renal blood vessels, that has made the surgeon to abandon first line surgery as a curative intent treatment.Conclusions:  Tumor volume was difficult to measure since most of the early stage patients underwent cone biopsy prior to referral for radical surgery. Macroscopic pelvic lymph node involvement was assessed accurately in all of our patients. Our impression was, that parametrium involvement, especially the caudal third of the parametrium, and the urinary bladder wall could be visualized and assessed more accurately than it was possible with 2D method. Involvement of the upper part of the cervical canal could be examined accurately in candidates for radical trachelectomy. Early experience suggest, that 3D examination of the macroscopic lymph node involvement, parametrial, urinary bladder and rectal wall tumor spread can be helpful for treatment planning of early stage cervical cancer patients.
First trimester Down syndrome screening by nuchal translucency in Thai population
Authors: Panburana Panyu , Ajjimakorn S. , Tungkajiwangoon P. , Jaowisidha A. 
Published: March 2003

Purpose:  To examine the significance of the fetal nuchal translucency (NT) at 10–13 + 6 weeks' gestation in the prediction of DS in a Thai population.Methods:  Total 2353 pregnant women were recruited from January 1996 to June 1999. Almost all women underwent transabdominal scanning (TAS) (Toshiba 140, TAS probe 5.0 MHz Toshiba PVF‐5.00 MT). When the result showed an increased risk for DS (>2.5 mm NT), the pregnant woman was counseled and the invasive test was optional. All the newborns were physically examined thoroughly by pediatricians to detect the markers for major chromosomal anomalies such as DS, trisomy 18 and 13. For the suspected DS or other chromosomal abnormalities, the newborn's blood was sent for the chromosome study.Results:  The mean maternal age was 28.71 + 0.13 years and 2037 pregnant women (86.57%) were <35 years old. The mean gestational age was 11.94 + 1.07 weeks. Sixty‐five pregnant women who had NT > 2.5 mm decided to have the invasive tests. Sixty had normal karyo‐types while five had abnormal chromosome abnormalities (one trisomy 13, two trisomy 18 and two trisomy 21). All of them were >35 years old. Sixty pregnant women with normal chromosome fetuses had detailed ultrasound scanning at 18–20 weeks' gestation and screening for maternal toxoplasmosis, cytomegalovirus, rubella virus, and herpes virus. The infection screen was negative in all cases. There were 20 congenital heart diseases, four fetal deaths in utero at 28–30 weeks, one Bart's hydrops fetalis and 10 abortion. The rest had normal pregnancy outcomes and NT resolved by 20 weeks. There were 316 (13.43%) cases with maternal age >35 years. Twenty‐three had >2.5 mm. NT and all of them had the invasive tests which revealed five abnormal chromosomes (as mentioned above). However, no DS fetuses were detected in <35 years pregnant women. Two hundred pregnant women with normal NT decided to have the invasive tests due to advanced maternal age and all of them had normal karyo‐types. The sensitivity, specificity, positive predictive values and negative predictive values for trisomy 21, 18 or 13 with different cut‐off values for fetal NT were studied. This is the first report of the first trimester NT screening for DS in Thai people. The cut‐off of >2.5 mm NT was used to increase sensitivity. We can detect all the cases of DS with this cut‐off value but one case of DS will be missed if we use the cut‐off of >3.0 mm.Conclusions:  This study revealed the feasibility in NT measurement for DS screening in the first trimester of pregnancy in Thai population. This test can increase detection rate of DS in the high‐risk pregnant women, who did not accept the invasive prenatal diagnosis procedures, as well as in the low risk pregnancy.