bluuebunny/crossref_metadata_2025_split huggingface dataset:
F47The flow redistribution toward the brain: beneficial and adverse effects on the fetal outcome in htypertensive pregnancies
Authors: Salihagic A. , Tobal N. , Perrotin F. , Imily V. , Lansac J. , Arbeille P. 
Published: March 2003

ObjectiveTo predict fetal outcome (abnormal FHR to cerebral lesion) from the degree and the duration of the hypoxia.MethodPregnancies complicated with hypertension and IUGR were submitted to a daily umbilical and cerebral Doppler from first day of admission until delivery. The umbilical (URI), and cerebral (CRI) resistance indices, cerebral‐umbilical ratio (C/U = CRI/URI), and the hypoxia index (HI) were calculated. The HI expresses as the maximum C/U change between admission day and delivery day (in percentage of C/U at admission, or in percentage of C/U cut‐off limit (= 1) if C/U admission < 1) multiplied by number of days of observation.Results68 pregnancies investigated (age: 25 ± 5 years, primipar: 35%, admission date: 30.8 ± 2.5 weeks, delivery at 33.2 ± 2.8, mean weight: 2300 ± 457g. The combination (HI > 200 and C/U < 1) was associated with abnormal FHR in 75% cases, whereas 1 or 2 of these parameter normal was associated with normal FHR in 85% cases (PPV 75% – NPV 85%). The minimal C/U and the HI during the period of observation allowed to predict abnormal FHR at delivery. On 5 pregnancies the period of hypoxia extended over 10–20 days (C/U << 1, HI >> 200), the fetuses died or were handicaped at delivery. The daily cerebral index recording showed a loss of fluctuation from one day to another, which could correspond to a deterioration of the cerebral regulation (vasoplegia). We suggest that the loss of fluctuation could be considered as the last limit before the cerebral lesion have serious chances to develop. In these 5 cases the fetal heart rate abnormalities appeared several days after this limit was passed.
F48Vasoconstrictor effect of the proximal segment of the fetal middle cerebral artery after an external partial occlusion of the umbilical vein (vasoconstrictor reflex)
Authors: López Ramón y Cajal C. 
Published: March 2003

BackgroundWe studied the repercussion of the nuchal cords on the proximal segment of the middle cerebral artery (pMCA) (segment with a rich innervation).MethodWe performed an external partial occlusion of the umbilical vein (through maternal abdominal wall) during 1–2 s to stimulate the baroreflex (pressure test or PT). We performed 76 PT in 36 fetuses. The pMCA was studied sonographically before, during and after the PT through pulsed Doppler and color Doppler energy (CDE).ResultsDuring the PT we observed stop the whole of the umbilical vein flow while maintaining the flow of the umbilical arteries. We observe a vasoconstrictor effect on the pMCA using CDE. This effect reflected a moderate‐severe segmental stenosis in the pMCA, however, flow in the remaining MCA was maintained. Sometimes, the effect vasoconstrictor produced a reverse flow on the pMCA to pulsed Doppler study. Post occlusion a cerebral vasodilatation took place, although in occasions an increased vascular tone persisted. Some fetal movements also could produce a similar effect in the pMCA (spontaneous PT).ConclusionThe PT produces an effect vasoconstrictor in the pMCA. Variations of this reflex can be the origin of some perinatal motor injury of intrauterine origin.
F58Anatomical variation of the fetal venous system
Authors: Hofstaetter C. , Hansmann M. 
Published: March 2003

ObjectiveThis report presents our experience in the prenatal diagnosis of anomalies of fetal veins using high‐resolution and color Doppler ultrasound.DesignIn an observatorial study 15 cases of abnormalities of the umbilical, portal, hepatic and caval venous system have been diagnosed at our division over the past 5 years. The abnormality, the underlying embryologic disorder and the outcome of the pregnancy are presented.ResultsIn group A, 8 fetuses had an abnormal course of the umbilical vein with a patent (n = 3) or absent (n = 5) ductus venosus. No portal veins and absent or abnormal hepatic veins were visualized. Six fetuses (75%) did not have an associated malformation and have survived. Two pregnancies were terminated or ended in fetal demise. In group B, 7 fetuses with an abnormal caval system had a left (n = 5) and right (n = 2) atrial isomerism with a cardiac defect in 6 cases (86%). The pregnancies ended in 4 terminations of pregnancy and two infant deaths. Only an infant with a left atrial isomerism and a normal heart has survived.ConclusionIn a targeted fetal scan the course of the venous system should be carefully examined using color Doppler. Any suspicious finding should be followed by a detailed assessment of the specifity of this abnormality considering the embryological development as well as the associated malformations.
F66Learning ultrasound‐guided invasive procedures in fetal medicine: the learning curve with an automated system
Authors: Nizard J. , Ville Y. 
Published: March 2003

BackgroundLearning ultrasound‐guided invasive procedures in fetal medicine can be done either on training models or directly on patients. Amniocenteses, cordocentesis, and chorionic villous sampling are associated with more complications at the beginning of the learning curve. It is therefore essential to optimise the teaching and reduce the length of the learning curve. We studied the learning curves of 8 inexperienced registrars in ObGyn with and without the use of a new electronic guidance system.Method8 medical students performed 100 invasive procedures (cordocentesis) using a specially designed training model. Four students used the ultrasound‐assisted free hand technique and four students used the same technique but assisted by the electronic guidance system. We studied the overall duration of the procedure and the proportion of this time the student is in control of the needle (the entire needle is visualised on the ultrasound screen).ResultsThe new electronic guidance system reduces the learning curve of ultrasound‐assisted invasive procedures on training models, but increases the length of the procedure.ConclusionThe new electronic guidance system can help teaching junior doctors in ultrasound‐assisted invasive procedures in fetal medicine.
F70Evaluation of adnexal masses with three‐dimensional ultrasound
Authors: Simic M. , Kopjar M. , Zadro M. , Viskovic T. , Knezovic N. , Maricic I. , Alvir I. 
Published: March 2003

Study objectiveTo evaluate the use of 3D ultrasound in preoperative preparation for the laparoscopic operation of adnexal masses.MethodsIn last two years we have started with 3D ultrasound in preoperative evaluation of adnexal masses. Over that period we have had 187 adnexal masses evaluated with 3D ultrasound.ResultsAt the period of first two years since we have performed 3D ultrasound we have had 14 tecofibroma ovarii, 2 Brener tumours, 10 cystadenoma, 14 ovarian carcinoma in different stages, 9 teratomas, 21 dermoid cysts, 62 endometrioid cysts and 55 simplex cysts of the ovary.All of those finding were confirmed at the time of operation (frozen section). Two dermoid cysts were estimated on ultrasound as a malignant disease of the ovary and frozen section finding was benign cystic teratoma.ConclusionSince we started to perform 3D ultrasound in estimation of adnexal masses before surgery (mostly laparoscopy) we have found that adnexal masses with 3D ultrasound verification of intracystic papilla for the patient in fertile period greater than 1.0 cm and for postmenopausal patient greater than 0.5 cm can be of clinical value in early diagnosis of ovarian carcinoma and appropriate therapy.
F82Detailed three‐dimensional fetal echocardiography facilitated by an internet link
Authors: Michailidis G.D. , Simpson J.M. , Karidas C. , Economides D.L. 
Published: March 2003

ObjectivesTo assess whether a complete virtual cardiologic examination can be achieved in stored three‐dimensional volumes of the fetal heart, transmitted to a tertiary fetal cardiology centre via the Internet.MethodsTwenty‐one sequential normal singleton pregnancies. 1–4 cardiac volumes were acquired using a Kretz Voluson 530D scanner. The volumes were sent via the internet to a fetal cardiologist. A detailed fetal cardiac examination, was attempted using the 3D volumetric dataset.ResultsThe mean gestational age was 24 weeks and 3 days. A complete heart examination was accomplished in 81% (95%C.I. 58% to 94%) of cases. The four‐chamber view, and the right ventricle outflow tract were seen in all cases. The ‘three vessel’ view was seen in 91% of the cases, while the left ventricle outflow, long axis view of the aortic arch, SVC/IVC and pulmonary veins in 81% of the cases. The mean time of volume acquisition was 10 min (SD: 2 min) and it was mainly influenced by fetal movements and the transfer time to the main computer. The mean examination time by the fetal cardiologist was 17.8 min (SD 6 min).ConclusionThese preliminary results demonstrate that 3D virtual examination of the heart is possible. Although there are limitations such as the lack of flow and functional information, complete ascertainment of the main cardiac connections was possible in the majority of cases. The use of an internet link has major implications, particularly in situations where the scanning centre is geographically remote from the cardiological centre.
Prenatal diagnosis F92Fetal biometry from 10 to 14 weeks of gestation
Authors: Chatzipapas I. , Spathopoulos Y. , Whitlow B. , Lazanakis M. , Kadir R. , Verdin S. , Economides D. 
Published: March 2003

BackgroundTo determine fetal biometrical reference ranges from 10 to 14 weeks' gestation.MethodsA prospective cross‐sectional study in a University Department of Obstetrics and Gynaecology, London. Four hundred and seventy women from an unselected population underwent a detailed assessment of fetal anatomy at 10+°−14+6 weeks' of gestation (confirmed by crown‐rump length) using transabdominal sonography (TAS), and transvaginal sonography (TVS) (35.3%: 166/470) when necessary. Biparietal diameter (BPD), occipito‐frontal diameter (OFD), head circumference, humerus (HU), abdominal circumference (AC), femur (FL) and foot lengths (FL) were measured and charts for centiles derived using regression analysis and a model of best fit constructed. HC/AC, BPD/OFD, BPD/FL and BPD/FL ratios were derived for each gestational age. Differences in measurements of BPD, HL and FL using TAS and TVS were examined in 39 cases using regression and t‐test analyses.ResultsCentiles (2.5th, 5th, 50th, 95th, 97.5th) were derived for each biometrical parameter. New charts and tables for each biometrical parameter are presented and compared with previously published data. As expected all parameters increased with gestational age. However the BPD/FL ratio decreased significantly at 10–13 weeks and the BPD/OFD and HC/AC ratio did not change. There was no significant difference between TAS and TVS measurements of BPD (T = 0.18, P = 0.86, R2 = 0.846), FL (T = −0.03, P = 0.98, R2 = 0.764) and HL (T = 0.17, P = 0.87, R2 = 0.633), therefore the results were combined.ConclusionWe have constructed new reference ranges for biparietal diameter (BPD), occipito‐frontal diameter (OFD), head circumference (HC), humerus (HU), abdominal circumference (AC), femur (FL) and foot lengths (Fo) from 10+° to 14+6 weeks gestation. These data may be useful in the diagnosis of skeletal dysplasias and chromosomal abnormalities in early pregnancy.
F93Feasibility of the second trimester fetal ultrasound examination in an unselected population at 18, 20 or 22 weeks of pregnancy: a randomized trial
Authors: Schwärzler P. , Ville Y. 
Published: March 2003

ObjectiveThe purpose of this study was to investigate whether of three gestational ages (18, 20 and 22 weeks) any one was associated with a significant advantage in terms of identification of abnormalities, or need for further ultrasound assessment.Subjects and methods1206 women were randomised into 3 mutually exclusive groups: group 1 at 18–18 + 6 weeks, group 2 at 20–20 + 6 weeks and group 3 at 22–22 + 6 weeks. The main end‐points were (i) need for rescan of all or part of the fetal anatomy, (ii) fetal outcome, (iii) placental localisation and (iv) incidence of notches in the uterine artery waveform.ResultsThere was a significantly higher percentage of completed scans in group 2 (90%) and 3 (88%) than in group 1 (76%, P < 0.001), but no significant difference between those scanned at 20 and at 22 weeks. This was associated with a higher incidence of noncephalic presentation in group 1 (46%) than in the other two groups (36%, P < 0.001). Significant differences in completing the assessment of the thorax, heart, spine and skeleton were also observed. The incidence of low lying placenta and of abnormal uterine artery Doppler screening were also higher at 18 weeks than at 20 and 22 weeks (P < 0.001 for both variables), with no difference being seen between groups 2 and 3. The number of fetal anomalies detected in the three groups were, respectively, 3, 2 and 2, and did not differ significantly between the groups.ConclusionsThis study suggests that among an unselected pregnant population, second trimester ultrasound screening is easier to perform and less likely to require an additional scan appointment at 20 −22 weeks than at 18 weeks.
F95Cerebral tissue and vessels growth, during normal pregnancies
Authors: Perrotin F. , Landre F. , Paillet C. , Philippot M. , Lansac J. , Janky E. , Arbeille P.H. 
Published: March 2003

The objective was to study the kinetic of development of the main cerebral structures and vessels from 20 to 39 weeks.Method30 normal pregnancies were included into the study. The conventionnal parameters used for fetal growth assessment were measured: biparietal and, abdomen diameters, skull and abdomen transverse cross section area, femur length. In addition the transverse cross section of the main intracranial structures were measured: Thalami, cerebral ventricles, cerebral peduncles, cerebellum. The diameter of the middle cerebral artery and the flow velocity were also measured at the same rate. These parameters were measured every 3 weeks from 20 to 40 weeks. The fetal weight was evaluated from a simple index checked at delivery against the fetal actual fetal. All these parameters were displayed against time in order to study and compare the kinetic of their progression during normal pregnancies.
Continuing participation supports ultrasound screening for ovarian cancer
Authors: Pavlik E.J. , Johnson Ii T.L. , Depriest P.D. , Andrykowski M.A. , Kryscio R.J. , Van Nagell J.R. 
Published: March 2003

AbstractThe effect of ovarian cancer screening on survival is enabled by women who continue to actively participate in screening. In this report, factors that affect participation are examined. Participants included 13 963 Kentucky women who received 56 392 screens accounting for a 46 113 screening year experience. Background, health history and reasons for participating in transvaginal sonographic screening were collected via a self‐reported questionnaire. Screening participants were characterized as >50 years old, mostly married, well educated, medically insured, health conscious women, living in the vicinity of the screening centre or 51–150 miles away. Approximately 70% of the participants can be considered active in the study based upon a screening visit during the 1997–1998 2‐year period. The probabilities of a return screen at 1, 2, 5 and 7.5 years were 77.8%, 72.0%, 58.7% and 50.6%, respectively. A total of 96% of return visits occurred within 2 years, with 33.7% having intervals of <1 year. Perceived family history was not observed to affect continuation. However, abnormal findings were associated with a shortened participation. These high levels of continuation in ultrasound screening indicate that women take this disease seriously and demonstrate that this disease is of consequence to them. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Preoperative diagnosis of the primary Fallopian tube carcinoma by three‐dimensional static and power Doppler sonography
Authors: Kurjak A. , Kupesic S. , Jacobs I. 
Published: March 2003

Objective To investigate whether three‐dimensional static and power Doppler ultrasound improves the diagnosis of primary Fallopian tube carcinoma.Methods During a 2‐year period five cases of primary Fallopian tube carcinoma were selected from a cohort of 520 patients with a previous scan suggestive of an adnexal tumor.Results Tubal malignancy occurred in patients between 49 and 64 years, with presenting symptoms such as pain, vaginal bleeding and leukorrhea. CA 125 was elevated in three cases of tubal carcinoma with stages II and III, while in two patients with stage I, CA 125 was within the normal limits. Two‐dimensional ultrasound demonstrated sausage shaped cystic masses with papillary projections in two patients and a complex adnexal mass in one patient. Three‐dimensional ultrasound revealed sausage shaped cystic and/or complex masses with papillary projections in all five cases of tubal malignancy. In one patient preoperative 3‐D ultrasound correctly predicted bilateral tumors, while 2‐D transvaginal sonography found only unilateral changes. Additional 3‐D power Doppler examination depicted vascular geometry typical for malignant tumor vessels such as arteriovenous shunts, microaneurysms, tumoral lakes, blind ends and dichotomous branching in each of the cases with Fallopian tube carcinoma.Conclusions Three‐dimensional ultrasound allows precise depiction of tubal wall irregularities such as papillary protrusions and pseudosepta. Improved understanding of anatomical relationships may aid in distinguishing ovarian from tubal pathology. Multiple sections of the tubal sausage like structures enable determination of local tumor spread and capsule infiltration. Study of the vascular architecture in cases of Fallopian tube malignancy is further enhanced using 3‐D power Doppler imaging.
Endometrial thickness and histological abnormalities in women on hormonal replacement therapy: a transvaginal ultrasound/hysteroscopic study
Authors: Omodei U. , Ferrazzia E. , Ruggeri C. , Palai N. , Fallo L. , Dordoni D. , Peruginoa G. 
Published: March 2003

AbstractObjectivesThe aim of this study was to assess if endometrial thickness could be used to select postmenopausal women on hormonal replacement therapy (HRT) at increased risk for endometrial abnormalities. The secondary aim was to assess if endometrial abnormalities were more likely to occur in patients with increased endometrial thickness or in patients with unexpected bleeding.MethodsBi‐endometrial thickness was measured by transvaginal ultrasound (TVS) in postmenopausal patients on sequential or combined HRT regimens. Women following a sequential regimen underwent TVS examination immediately after their withdrawal bleed, always between 5 and 10 days after the last progesterone tablet. A hysteroscopy with endometrial biopsy was performed within 5 days after the TVS examination, when endometrial thickness was ≥ 4 mm, or when unscheduled bleeding was observed.ResultsA total of 190 women were recruited. In 138 women on sequential regimens, the mean value of endometrial thickness was 3.6 mm ± 1.5, and in 52 women on combined regimens it was 3.2 mm ± 1.8 (P = n.s.) Twenty‐eight patients (15%) had an endometrial thickness > 4 mm, 35 patients (18.4%) reported unexpected bleeding. The percentage of abnormal endometrial findings (9%; three of 35) in patients selected for unscheduled bleeding was significantly lower than the percentage of abnormal findings in patients selected for hysteroscopy for endometrial thickness > 4 mm (36%; 10 of 28) (P < 0.01). All patients with unexpected bleeding and endometrial thickness ≤ 4 mm (24 cases) were found to have an atrophic endometrium.ConclusionsEndometrial thickness in patients on sequential HRT, measured soon after withdrawal bleeding, is not significantly different from thickness measured in patients on combined HRT. Patients on HRT with an endometrial thickness of > 4 mm could be considered for histological sampling. The prevalence of abnormal endometrial findings in patients with a thick endometrium is significantly higher than the prevalence observed in patients with unexpected bleeding. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
The bright edge of the endometrial polyp
Authors: Caspi B. , Appelman Z. , Goldchmit R. , Ashkenazi M. , Haruvy Y. , Hagay Z. 
Published: March 2003

AbstractObjectiveTo evaluate the accuracy of sonographic detection of endometrial polyps using a new ultrasound marker denoted ‘the bright edge of the polyp’.MethodsThe ultrasound scans of the uterus were examined for the presence of the bright edge in two groups of women. The first, a retrospective group, included 40 women in whom both a histological diagnosis of endometrial polyps and sonographic scans were available for evaluation. The second, a prospective group, included 80 women scheduled for operative hysteroscopy because of endometrial irregularities detected by sonography. In this group the hysteroscopical and histological results of the removed endometrial tissue were correlated with the sonographic diagnosis.ResultsIn the retrospective group, the bright edge marker, indicative of the presence of a polyp, was detected in 30 out of 40 scans available for evaluation. In the prospective group this marker was detected in 60 women out of 80. Endometrial polyps were confirmed in 56 of these 60 women. In three cases a submucosal myoma was found and in one case the histology showed simple cystic hyperplasia. Two polyps were found in 20 cases where the bright edge had not been detected. This marker has a sensitivity of 96%, specificity of 82%, positive predictive value of 93%, and negative predictive value of 90% in this group at high risk for endometrial abnormalities.ConclusionThe bright edge of the polyp is an accurate sonographic marker for the detection of endometrial polyps in women with endometrial irregularities demonstrated on ultrasound. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of an aortico‐left ventricular tunnel
Authors: Grab D. , Paulus W. E. , Terinde R. , Lang D. 
Published: March 2003

AbstractAortico‐left ventricular tunnel is a rare abnormal communication between the ascending aorta and the left ventricle. Early diagnosis and prompt surgical repair prevent congestive heart failure or consecutive valvular insufficiency. However, in utero diagnosis of this heart malformation has been rarely described and none of those children survived. We report on a case of aortico‐left ventricular tunnel detected at 32 weeks'gestation with a favourable outcome after surgical repair at three months of age. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Diagnosis of abdominal tuberculosis by transabdominal ultrasound‐guided needle biopsy
Authors: Caspi B. , Wolach V. , Von Der Walde J. , Weiss Y. , Appelman Z. , Hagay Z. 
Published: March 2003

AbstractLaparotomy and laparoscopy have been used for biopsy of pelvic masses in the differential diagnosis between abdominal tuberculosis and ovarian cancer. We suggest the use of transabdominal needle biopsy under ultrasound guidance in such cases. Two women developed abdominal distention, one of whom had been receiving medical treatment for known tuberculosis. In both cases, ultrasonography showed a pelvic mass and ascites associated with high levels of CA 125. A transabdominal ultrasonographically‐guided biopsy of the masses with a trucut needle established their tuberculous origin. The transabdominal sonographic needle biopsy is a reliable diagnostic procedure in the differential diagnosis between abdominal tuberculosis and ovarian malignancy. This minimally invasive procedure saves the patient with tuberculosis from unnecessary laparotomy. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology