bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can fetal iliac bone measurement be used as a marker for Down's syndrome screening?
Authors: Zoppi M. A. , Ibba R. M. , Floris M. , Monni G. 
Published: March 2003

AbstractObjectiveThe aim of this study was to assess the application of iliac bone length measurement in screening for Down's syndrome.DesignMeasurement of fetal iliac bone length was prospectively carried out in 609 pregnant women at the time of amniocentesis, and correlated with the results of karyotype analysis.SubjectsFollowing exclusion of cases with chromosomal abnormalities other than trisomy 21, cases with intra‐uterine growth impairment or structural abnormalities and cases with incomplete follow‐up, 466 karyotypically normal fetuses and 14 fetuses with trisomy 21 were included in the analysis.MethodsCentiles, standard deviations, expected values by means of linear regression analysis of the iliac bone, in relation to the biparietal diameter, were calculated in the normal fetuses. In order to identify pregnancies at risk for trisomy 21, where a ‘longer’ than normal iliac bone was expected, three cut‐offs previously proposed by other authors and three new criteria were employed. Sensitivity, false‐positive rate and likelihood ratio were calculated to assay the different cut‐off criteria.ResultsEleven of the 14 (79%) fetuses affected by trisomy 21 had an iliac bone length greater than the 50th centile of normal values. The most useful threshold was an iliac bone length ≥ 2 SD of the normal (29% sensitivity and 2% false‐positive rate).ConclusionsThis study confirms that fetuses with Down's syndrome tend to have a longer iliac bone length measurement than those with normal karyotype. However, due to the different methods used in different centers, the application of this measurement does not offer sufficiently convincing results for it to be used when screening for Down's syndrome. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Cervical length at 23 weeks of gestation: the value of Shirodkar suture for the short cervix
Authors: Heath V. C. F. , Souka A. P. , Erasmus I. , Gibb D. M. F. , Nicolaides K. H. 
Published: March 2003

AbstractObjectiveTo examine the possible benefit of cervical cerclage in women with a very short cervix identified during routine sonographic assessment of cervical length at 23 weeks of gestation.MethodsTransvaginal sonography was used to measure cervical length at 23 weeks of gestation in 2702 women with singleton pregnancies attending for routine antenatal care. In 43 (1.6%) cases the cervical length was ≤ 15 mm. The 43 women in this group were referred to their obstetricians for the further management of pregnancy; in 21 cases, the pregnancy was managed expectantly and in 22 a Shirodkar suture was inserted under spinal anesthesia. The two groups were compared in terms of patient characteristics and pregnancy outcome.ResultsThe 22 patients that were treated with cervical cerclage were not significantly different from the 21 given expectant management in ethnic origin, ponderal index, cigarette smoking or past obstetric history. The median cervical length was 10 mm in both groups. In the cervical cerclage group, 21 delivered after 32 weeks and one (5%) had spontaneous onset of labor and delivery before 32 completed weeks; all 22 infants survived. In the expectant management group, 11 (52%) had spontaneous onset of labor and delivery before 32 weeks; 20 infants survived but one baby died in the neonatal period.ConclusionsIn women with a cervical length of ≤ 15 mm at 23 weeks there is a more than 50% chance of spontaneous delivery at less than 32 weeks. Insertion of a Shirodkar suture in women with a very short cervix may be associated with a ten‐fold reduction in risk for such early delivery. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Screening for chromosomal abnormalities at 10–14 weeks: the role of ductus venosus blood flow
Authors: Matias A. , Gomes C. , Flack N. , Montenegro N. , Nicolaides K. H. 
Published: March 2003

AbstractObjectiveTo assess the possible role of Doppler ultra‐sound assessment of ductus venosus blood flow in screening for chromosomal abnormalities at 10–14 weeks of gestation.MethodsDuctus venosus flow velocity waveforms were obtained immediately before fetal karyotyping in 486 consecutive singleton pregnancies at 10–14 weeks of gestation. All cases were screened for chromosomal defects by a combination of maternal age and fetal nuchal translucency thickness. The peak systolic and diastolic velocities, the velocity during atrial contraction and the pulsatility index were measured.ResultsThere were 63 chromosomal defects (38 cases of trisomy 21, 12 cases of trisomy 18, seven cases of trisomy 13, three cases of Turner's syndrome and three cases of triploidy). In 57 (90.5%) cases there was reverse or absent flow during atrial contraction. Abnormal ductus venosus flow was also observed in 13 (3.1%) of the 423 chromosomally normal fetuses. In the chromosomally abnormal group, compared to the normal group, the median heights of the S and D waves were significantly lower and the pulsatility index was significantly higher. However, multivariate regression analysis demonstrated that only the height of the A wave provided a significant independent contribution in distinguishing between the chromosomally normal and abnormal groups.ConclusionThese preliminary results suggest that assessment of ductus venosus blood flow in pregnancies considered to be at high risk for chromosomal defects may result in a major reduction in the need for invasive testing, with only a small decrease in sensitivity. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Enlarged nuchal translucency and low serum protein concentrations as possible markers for Zellweger syndrome
Authors: de Graaf I. M. , Pajkrt E. , Keessen M. , Leschot N. J. , Bilardo C. M. 
Published: March 2003

AbstractWe present a case of a fetus in which an enlarged nuchal translucency was detected at 12 weeks' gestation. The karyotype was normal. Subsequent ultrasound examination showed no obvious fetal abnormalities apart from a mild pericardial effusion. Serum screening revealed very low concentrations of estriol and human chorionic gonadotropin. After birth the diagnosis of Zellweger syndrome was made. Nuchal translucency screening, estriol level identification and detailed ultrasound scanning may help to identify fetuses affected by this syndrome. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Fetal lumbar spine volumetry by three‐dimensional ultrasound
Authors: Schild R. L. , Wallny T. , Fimmers R. , Hansmann M. 
Published: March 2003

AbstractObjectivesTo evaluate three‐dimensional sonographic volume measurements of the thoracolumbar spine from 16 to 25 weeks of gestation in the normally developing fetus.DesignProspective cross‐sectional study.SubjectsThe study included 103 women between 16 and 25 weeks of gestation. They were enrolled at the time of their anomaly scan. None of the pregnancies was associated with structural anomalies and in each case fetal size was deemed appropriate for gestational age.MethodsThree‐dimensional volume calculation of the 1st and 5th lumbar vertebral body, the 12th thoracic vertebral body and the whole lumbar spine was performed, using the perpendicular frontal, sagittal and transverse planes. The lumbar spine length was determined.ResultsA statistically significant increase in all measurements was found with advancing gestational age.ConclusionsThree‐dimensional ultrasonography allows volume calculation of the fetal spine. Our study provides preliminary data about volume changes in the developing fetal spine between 16 and 25 weeks' gestation. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal sonographic ovarian findings in a random sample of women 25–40 years old
Authors: Borgfeldt C. , Andolf E. 
Published: March 2003

AbstractObjectiveTo investigate the occurrence rate of adnexal lesions in premenopausal women.MethodsA random sample of women 25–40 years old was invited to undergo a transvaginal ultrasound examination, and 335 women were examined. The criteria used to define an adnexal lesion were either a cystic lesion with its largest diameter of at least 25 mm within the pelvic region, or the appearance of solid parts in any lesion regardless of size.ResultsAdnexal lesions were found in 26/335 cases, (7.8%) (95% confidence interval (CI), ± 2.9%). The occurrence rate of ovarian cysts was 22/335 (6.6%) (95% CI, ± 2.7%). There were no differences between the women with or without ovarian cysts related to age, smoking habits, parity or body mass index. At follow‐up 3 months later, 18 of the 22 (82%) cysts had disappeared (95% CI, ± 16%). Women using progesterone contraception (either oral contraception or an intrauterine device with levonorgestrel) had a significantly higher relative risk of 2.7 (95% CI, 1.1–6.9) of functional cysts as compared to women with natural cycles. Polycystic ovaries were found in 10.2% (95% CI, ± 4.2%) of the women not using any hormonal contraception. The mean volumes of the polycystic ovaries were significantly larger compared to those in natural cycles.ConclusionAdnexal lesions are common in asymptomatic women in the age group 25–40 years, but four out of five ovarian cysts disappeared spontaneously after 3 months. The ultrasound appearance of the cyst, the woman's family history and her own feelings must be considered if a persisting cyst is to be surgically removed or followed by repeated transvaginal ultrasound. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Altered hemodynamics in chick embryos after extraembryonic venous obstruction
Authors: Broekhuizen M. L. A. , Hogers B. , DeRuiter M. C. , Poelmann, R. E. , Gittenberger‐De Groot A. C. , Wladimiroff J. W. 
Published: March 2003

AbstractObjectiveTo obtain insight into hemodynamics duringabnormal cardiac development, a chick model was developed recently in which a spectrum of conotruncal anomalies, in combination with abnormal semilunar valves and/or pharyngeal arch artery malformations, was induced through extraembryonic venous obstruction (venous clip) at stage 17 (70‐h incubation).MethodsIn chick embryos of stage 24 and stage 34 control (n = 8; n = 21) and with venous clip (n = 11; n = 18), we simultaneously measured dorsal flow velocities with a 20‐MHz pulsed Doppler velocity meter and dorsal aortic (stage 24) and vitelline artery (stage 34) blood pressures with a servo‐null system. After the hemodynamic recordings were collected, all 58 embryos were subjected to morphological examination. The hemodynamic data were correlated with the morphology. Statistical comparison was performed between control and experimental values.ResultsAt stage 24, venous clip embryos showed impaired looping. Physiologically, only a decrease in peak acceleration was found in these embryos (p < 0.05). At stage 34, a spectrum of conotruncal malformations was seen, that consisted of a ventricular septal defect in combination with abnormal semilunar valves and/or pharyngeal arch malformations. A dextroposed aorta in combination with a ventricular septal defect was diagnosed as double‐outlet right ventricle. Hemodynamically, peak systolic and mean velocities, peak systolic and mean blood flows and stroke volume were increased while the heart rate was reduced after placement of the venous clip (p < 0.05). In both stages, pressure readings showed no statistically significant differences between control and experimental embryos.ConclusionOur findings suggest that the hemodynamic changes seen in venous clip embryos reflect the presence of a compensatory mechanism. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Fetal outcome when the ultrasound estimate of the day of delivery is more than 14 days later than the last menstrual period estimate
Authors: Tunón K. , Eik‐Nes S. H. , Grøttum P. 
Published: March 2003

AbstractObjectiveTo evaluate the effect on fetal outcome of changing the estimated day of delivery as calculated according to ultrasound measurements more than 14 days later than the day estimated according to the last menstrual period.DesignA non‐selected population comprising 15 241 women was evaluated. A study group (the day of delivery based on the ultrasound estimate being changed to more than 14 days later than the estimate based on the last menstrual period) and a control group (the two estimates being within 7 days of each other) were compared regarding various parameters concerning fetal outcome.ResultsChanging the estimated day of delivery, based on the ultrasound evaluation, to a date 14 days later than the day of delivery as estimated according to the last menstrual period did not influence the risk of abortion, perinatal death or transferral to the neonatal intensive care unit. There was a difference of 3 days in the accuracy of the prediction of day of delivery between the two groups. There was a greater number of infants with a birth weight below 2500 g in the study group, but no difference was found between the groups in the number of infants with a birth weight < 2 SD from the mean according to the ultrasound estimate.ConclusionThere was no indication of any adverse consequence of the routine scan and change of estimated day of delivery among 15 000 pregnancies in a non‐selected population. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
The possible impact of a myomatous uterus on the accuracy of fetal biometric measurements
Authors: Bronshtein M. , Zimmer E. Z. , Miselevich I. , Sabo E. , Ohel G. , Löwenstein L. 
Published: March 2003

AbstractObjectiveThe propagation speed of ultrasound beams changes in different media. The aim of the study was to assess the possible measurement error of fetal biometry performed in cases of a myomatous uterus.DesignThree iron phantoms of 30 mm, 50 mm and 70 mm were measured by ultrasound. Each phantom was measured by three different transducers of 3.5 MHz, 6.5 MHz and 7.5 MHz. Measurements were performed in a water bath and the intraobserver variability was assessed. Thereafter phantoms were measured with one of their edges covered by a specimen of a myomatous uterus while their other edge was covered with water.ResultsArtifactual lengthening of the phantoms' size was observed in measurements performed with the uterine myoma. The measurement errors were inversely related to the length of the phantoms and became statistically significant in the phantoms of 30 mm (13.15 ± 3.16% without the myoma vs. 17.38 ± 4.39% with the myoma; p < 0.0001). Measurement errors were independent of the transducer type (p = 0.001, p = 0.01 and p = 0.014 for the 3.5‐MHz, 6.5‐MHz and 7.5‐MHz transducers, respectively).ConclusionsUltrasound measurement errors are expected while examining small fetal organs which are partially overshadowed by a myoma. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Comparison of quantitative ultrasound in the human calcaneus with mechanical failure loads of the hip and spine
Authors: Lochmüller E.‐M. , Eckstein F. , Zeller J.‐B. , Steldinger R. , Putz R. 
Published: March 2003

AbstractObjectiveQuantitative ultrasound of the calcaneus is used clinically for evaluating bone fracture risk, but its association with the mechanical properties at other skeletal sites is not well characterized. The objective was therefore to determine its predictive ability of the mechanical failure loads of the proximal femur and lumbar spine.MethodIn 45 human cadavers (29 males and 16 females, aged 82.5 ± 9.6 years), we determined the speed of sound, broadband ultrasonic attenuation (BUA) and the empirical stiffness index, using a commercial quantitative ultrasound scanner. The proximal femora and the fourth vertebral body were excised and loaded to failure in a testing machine.ResultsFemoral failure loads ranged from 933 to 7000 N and those of the vertebrae from 1000 to 7867 N, their correlation being 0.51 in females and −0.08 in males. Forty percent of the variability of femoral, but only 24% of the variability of the vertebral fracture loads could be predicted with calcaneal speed of sound. In the femur, a combination of speed of sound and BUA improved the prediction (r2 = 50–60%), but not in the spine.ConclusionsThe study provides experimental evidence that calcaneal quantitative ultrasound is capable of predicting mechanical failure at other skeletal sites and has potential to identify patients at risk from osteoporotic fracture. The different association of quantitative ultrasound with femoral and vertebral failure may result from the influence of the cortical bone and a higher microstructure‐related similarity of the calcaneus and the femur. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Assessment of umbilical arterial and venous flow using color Doppler
Authors: Lees C , Albaiges G. , Deane C. , Parra M. , Nicolaides K. H. 
Published: March 2003

AbstractObjectiveTo estimate the umbilical artery and vein blood volume flow using B‐mode and Doppler ultrasound in the second and third trimesters of pregnancy.DesignThis was a cross‐sectional study of 129 singleton, healthy pregnancies at 23–33 weeks' gestation. The umbilical artery and vein cross‐sectional area, time‐averaged velocity and pulsatility index were measured in a free loop of cord, and the fetal weight was estimated. Ranges for each parameter were obtained; from these the blood flow for the vein and artery was calculated, and the average flow corrected for fetal weight was derived.ResultsThe median time for examination was 6 min. The mean crosssectional area and time‐averaged velocity for both the vein and artery increased linearly with gestation. The umbilical artery flow correlated closely with the average vein flow (r = 0.9, p < 0.001). There was a significant, though poor, inverse correlation between the umbilical artery pulsatility index and the average umbilical flow (r = −0.25, p < 0.05). The average umbilical flow (calculated from the mean of arterial and venous flow), corrected for estimated fetal weight, decreased from 189.2 ml/kg per min at 23 weeks to 176.2 ml/kg per min at 33 weeks' gestation.ConclusionThe estimates of fetal umbilical flow obtained by this Doppler method are consistent with previously published data. Averaging the arterial and venous flow is theoretically advantageous in reducing the inherent errors in estimating either the arterial or the venous flow. This method of measuring umbilical flow may have clinical potential in assessing fetal health and disease processes. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Transabdominal first trimester embryofetoscopy as a potential approach to early in utero stem cell transplantation and gene therapy
Authors: Surbek D.V. , Tercanli S. , Holzgreve W. 
Published: March 2003

AbstractObjectiveTo explore the potential of embryofetoscopy for early diagnosis and for access to the fetal circulation in the first trimester of gestation.DesignTransabdominal embryofetoscopy was performed in 14 patients scheduled for termination of pregnancy using a 1‐mm semirigid fibreoptic telescope with a 18 gauge examination sheath and a single‐chip digital camera. A 25 gauge needle was inserted through an additional 21 gauge side port to access the fetal circulation.ResultsFetal head, face, abdomen, complete upper and lower limbs could be visualized in over 80% of cases. On the contrary, the fetal back and external genitalia could be examined in detail only in some cases (35.7% and 64.3%, respectively). Injection of 10–20 ml saline improved visibility in 43% of cases. Funipuncture was successful in two of three attempts.ConclusionsOur experience suggests that embryofetoscopy is a useful tool for early diagnosis in the first trimester of pregnancy. Funipuncture is possible thus providing the means for an early intravascular stem cell application. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Color ultrasonography: a useful technique in the identification of nuchal cord during labor
Authors: Qin Y. , Wang C. C. , Lau T. K. , Rogers M. S. 
Published: March 2003

AbstractObjectiveTo compare the accuracy of intrapartum ultrasound with and without color Doppler for identification of nuchal cord displacement during labor.Methods180 normal pregnant women, admitted in labor, or for induction to labor, were examined independently by two researchers, using either conventional real‐time gray‐scale imaging or color Doppler imaging. A repeat examination was performed by the other researcher using the other ultrasound modality. Nuchal cord displacement was classified as either negative, definite or suspicious. Nuchal cord at birth was classified as either tight or loose.ResultsSixty‐two (34%) cases examined using the two ultrasound imaging modalities presented with nuchal cord at delivery. The sensitivity of color Doppler was 96.8%. The accuracy of color Doppler in detecting nuchal cord during labor was significantly better (P < 0.05) than gray‐scale imaging alone. The results of a restricted sequential t‐test analysis of 53 un‐tied pairs showed an overall preference in favor of color Doppler assessment: statistical significance (P <0.01) was reached after 41 un‐tied pairs.ConclusionsThe tight and loose nuchal cord could not be distinguished by ultrasound. Color Doppler imaging can provide useful additional information to gray‐scale imaging in the detection of nuchal cord displacement during labor. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
The role of enhanced Doppler Ultrasound in differentiation of benign vs. malignant scar lesion after breast surgery for malignancy
Authors: Bäz E. , Madjar H. , Reuss C. , Vetter M. , Hackelöer B. , Holz K. 
Published: March 2003

AbstractAimTo evaluate the benefit of echo‐contrast‐enhanced Doppler sonography in the differentiation of benign vs. malignant breast lesions after surgical removal of a malignant breast mass.MethodsThirty‐eight patients referred for biopsy of a palpable, suspicious scar lesion 1–15 years (mean 3.3 years) after surgery for breast cancer were examined. During baseline ultrasound examination a subjective scoring system of the vascularity, the number, the regularity of vessels' course and their Doppler parameters were assessed. After injection of an ultrasound contrast agent (Levovist®) the same scoring system was applied to the parameters together with enhancement kinetics, enhancement intensity and enhancement pattern.Any increase in the scoring level of two or more characteristics (vascularity, number of vessels, intensity of enhancement in the tumor or regularity score of vessels in the lesion) was defined as suspicious for malignancy. A marked increase of enhancement in the immediate tumor periphery was also regarded as suspicious for malignancy. The sonographic results were assessed prospectively and correlated with the histology of the lesion.ResultsOf the 38 patients with a clinically‐suspicious scar lesion, there were 28 true scars and 10 malignant scar lesions. All scar lesions showed no or slight vascularity on baseline sonography. After Echocontrast‐enhancement a significant increase in tumor vascularity and the number of tumor vessels could be demonstrated in all 10 malignant lesions but in only one of the 28 benign scars.ConclusionScars pose inherent technical problems for optimal mammography. Sonographic evaluation of the vascularity of the lesion with contrast enhancing agents showed improved diagnostic accuracy in the hands of an experienced examiner. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology