bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasonographic assessment of the uterine cervix and interleukin‐8 concentrations in cervical secretions predict intrauterine infection in patients with preterm labor and intact membranes
Authors: Rizzo G. , Capponi A. , Vlachopoulou A. , Angelini E. , Grassi C. , Romanini C. 
Published: March 2003

AbstractObjectiveInterleukin‐8 concentrations in cervical secretions have been related to microbial invasion of the amniotic cavity and histological chorioamnionitis. Since a short uterine cervix may be a risk factor for intrauterine infection, we set out to determine the interrelationship between cervical‐secretion interleukin‐8 concentration, cervical length measured by transvaginal sonography and intrauterine infection in women with preterm labor and intact membranes.DesignThe study group comprised 144 pregnant women admitted to hospital for preterm labor and intact membranes. At admission, interleukin‐8 in cervical secretions was assayed. The uterine cervix was evaluated by transvaginal sonography and the cervical index ((funnel length +1)/cervical length) was measured. In all cases, amniotic fluid was obtained by amniocentesis immediately after cervical examination and was cultured for aerobic and anaerobic bacteria including Ureaplasma ureolyticum and Mycoplasma hominis. Placentas were analyzed at delivery for the presence of histological chorioamnionitis.ResultsForty‐three per cent (62/144) of pregnancies delivered preterm and 12.5% (18/144) of the amniotic fluid cultures were positive. Placentas were available from 54 pregnancies which delivered preterm and histological chorioamnionitis was found in 59.2% (32/54) of the cases. Interleukin‐8 concentrations in cervical secretions were significantly higher in the presence of microbial invasion of the amniotic cavity (median 1191.5 ng/ml, range 812–5234 ng/ml vs. median 109 ng/ml, range 12–2231 ng/ml; p ≤ 0.0001) and histological chorioamnionitis (median 982.5 ng/ml, range 430–5234 ng/ml vs. median 435 ng/ml, range 40–1750 ng/ml; p ≤ 0.0001). Similarly, higher values for cervical index were obtained in the presence of a positive amniotic fluid culture (median 1.23, range 0.35–5.88 vs. median 0.29, range 0.024–4.85; p ≤ 0.0001) or histological chorioamnionitis (median 1.18, range 0.043–5.88 vs. median 0.562, range 0.040–2.48; p = 0.011). Multiple logistic regression analysis indicates significant independent associations with a positive amniotic fluid culture and histological chorioamnionitis for the cervical interleukin‐8 concentrations (amniotic fluid culture positive ≥850, histological chorioamnionitis ≥450) and for the cervical index (amniotic fluid culture positive ≤0.58, histological chorioamnionitis ≤0.56).ConclusionsIntrauterine infection is associated with increased interleukin‐8 concentrations in cervical secretions and a short cervix. Their combined analysis may reduce the indications for invasive procedures and improve the selection of women in preterm labor who may benefit from antimicrobial treatment. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Humerospinous distance measurements: accuracy and usefulness for predicting shoulder dystocia in delivery at term
Authors: Klaij F. A. V. , Geirsson R. T. , Nielsen H. , Hreinsdóttir M. , Haraldsdóttir K. R. 
Published: March 2003

AbstractObjectiveTo investigate if the humerospinous distance, as an indicator of shoulder width, could predict shoulder dystocia at term.DesignProspective cross‐sectional study of a stratified reference group of healthy women and a test group of women with risk factors for shoulder dystocia. Measurements were not revealed. Outcome measures were difficulties with delivery of the shoulders and correlation with maternal body mass and birth weight.SubjectsSeventy‐two women with singleton pregnancies at a University Clinic: 32 women at 39–42 weeks for reference and 40 women in an at‐risk test group (weight > 90 kg, weight gain > 20 kg, previous macrosomic baby, history of shoulder dystocia/difficult delivery, clinical suspicion of a large baby). Women with a breech fetus, twins and those not able to deliver vsaginally were excluded.MethodsFetal shoulders were measured from the convergence of the cervical spinous processes at the approximate cervicothoracic vertebral junction to the medial border of the humeral head. Correlations were made with maternal body mass, birth weight, birth weight estimation, ultrasound and postnatal humerospinous measurements.ResultsOne case of shoulder dystocia in a fetus with an average humerospinous measurement occurred in the reference group and there were no cases in the test group. There was no predictive value of a large humerospinous measurement and no correlation with maternal or fetal size. Movement of the fetal arm could change the humerospinous distance considerably, which could account for the difference between a normal and large measurement.ConclusionThe humerospinous distance cannot be used to predict shoulder dystocia. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Arrhythmia in early pregnancy: a predictor of first‐trimester pregnancy loss
Authors: Vaccaro H. , Amor F. , Leyton M. , Sepulveda W. 
Published: March 2003

AbstractObjectiveTo determine the prognostic significance of cardiac arrhythmia detected in the first trimester.DesignCases in which embryonic arrhythmia was detected by transvaginal ultrasound between 6 and 9 weeks of gestation were retrospectively identified and reviewed.ResultsEmbryonic arrhythmia was noted in four of 950 ultrasound examinations. There was associated ventricular bradycardia in three cases, one of which also had an atrial rate below the normal range for gestational age. No cardiac activity was detected at the follow‐up examination 1 week later in three cases. In the other, the embryo was alive but there was severe growth delay and the scan the following week confirmed embryonic death.ConclusionThis report suggests that arrhythmia in early pregnancy is associated with subsequent pregnancy loss. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Fetal mustache in early pregnancy
Authors: Bronshtein M. , Zimmer E. Z. , Offir H. , Blazer S. 
Published: March 2003

AbstractObjectiveThe aim of this study was to determine the incidence in an unselected population of a rod‐like structure on the fetal upper lip (called a ‘mustache’) which we had previously observed as an incidental finding. A secondary aim was to determine whether this was associated with any abnormalities or abnormal outcomes.DesignProspective non‐randomized study.SubjectsThree thousand consecutive fetuses from an unselected population were scanned by one sonologist.MethodTransvaginal ultrasound examinations were performed at 14–16 weeks' gestation. Repeat sonographic examinations were performed at 20–22 weeks' gestation in cases where a mustache was detected, and these neonates were examined by a pediatrician after delivery.ResultsSeven of 3000 fetuses had a mustache‐like structure on the upper lip. The ‘mustache’ disappeared later in gestation. No anomaly of the upper lip was detected after birth in these fetuses.ConclusionA mustache‐like structure on the fetal upper lip in early pregnancy probably represents a normal variant of lip development. It is likely to represent a delay in the normal process of lip fusion during embryonic life. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
The growth of the human embryo. A longitudinal biometric assessment from 7 to 12 weeks of gestation
Authors: Blaas H.‐G. , Eik‐Nes S. H. , Bremnes J. B. 
Published: March 2003

AbstractObjectivesLongitudinal studies of multiple parameters in the first trimester for assessment of embryonic growth are lacking. This study's aim was to register changes in growth over time, by taking several measurements of embryos on successive occasions and evaluating these changes by longitudinal analysis.DesignThis prospective longitudinal study describes the normal embryonic growth in vivo. Inclusion criteria were non‐smoking women with single uneventful pregnancies, regular menstrual periods (28–30 days) and no hormone therapy in the 3 months prior to the pregnancy. Exclusion criteria were pregnancy complications such as diabetes, pre‐eclampsia, delivery of preterm or growth‐restricted infants. Of 36 recruited pregnant women, 29 met these criteria. Each pregnancy was examined five times between 7 and 12 weeks of gestation. This resulted in a two‐level data set, where level 1 consisted of the observations and level 2 consisted of the individuals. The longitudinal data were analyzed with a software package specially created for multilevel analysis.ResultsThe growth of the biparietal diameter (BPD), occipitofrontal diameter (OFD), mean abdominal diameter (MAD), chorionic cavity diameter and amniotic cavity diameter was constant; the growth of the crown‐rump length (CRL) and the yolk sac diameter was not constant. Variation in the data sets was mainly caused by variation between the embryos/fetuses.ConclusionsThe measured parameters except for the yolk sac showed a high degree of uniformity with virtually the same growth velocities. The yolk sac demonstrated uniform growth until week 10 only. Differences between the gestational age based on the last menstrual period and the true gestational age, and/or differences in the early growth of the embryos before the start of the study at 7 weeks, may have contributed to the variation between the individuals. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Single and serial estimates of amniotic fluid volume and umbilical artery resistance in the prediction of intrauterine growth restriction
Authors: Owen P. , Khan K. S. , Howie P. 
Published: March 2003

AbstractObjectivesTo determine whether single or serial estimates of both the amniotic fluid index (AFI) or pulsatility index (PI) of the umbilical artery Doppler waveform can usefully identify infants with anthropometric features of intrauterine growth restriction (IUGR).MethodsA total of 274 women underwent serial antenatal ultrasound examinations at predetermined intervals. Four biophysical parameters were considered: AFI and PI prior to delivery and change in AFI and PI over a 28‐day period in the third trimester. All values were expressed as standard deviation scores. IUGR was diagnosed if the neonate demonstrated skinfold thickness < 10th centile, ponderal index < 25th centile or mid‐arm circumference to occipitofrontal circumference (MAC : OFC) < −1 SD. Receiver operator characteristic curves were used to determine an optimal cut‐off point, and test performance of the biophysical parameters were expressed as likelihood ratios (LR).ResultsThe test performances of all four ultrasound parameters for any of the three diagnostic criteria for IUGR was poor. The highest positive LR was only 2.5 (95% CI 1.5–4.1) for PI prior to delivery in the prediction of ponderal index < 25th centile.ConclusionDespite positive associations between single and serial estimates of AFI and PI with abnormal neonatal morphometry, the likelihood ratios remained low. The results of this study do not support the use of single or serial estimates of AFI or umbilical artery PI in the prediction of IUGR. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Resistance to blood flow in ovarian tumors: correlation between resistance index and histological pattern of vascularization
Authors: Kidron D. , Bernheim J. , Aviram R. , Cohen I. , Fishman A. , Beyth Y. , Tepper R. 
Published: March 2003

AbstractObjectiveTo investigate the correlation between the histological patterns of vascularization and the resistance index (RI) in ovarian tumors.DesignIn a retrospective study, the histological sections of the ovarian tumors with known preoperative RI values were reviewed and the pattern of vascularization was studied.SubjectsTwenty‐two women underwent B‐mode sonography and color Doppler ultrasound within 3 days prior to explorative laparotomy for ovarian masses in the years 1992–93.MethodsThe RI of the ovarian tumors was calculated as the mean of three consecutive waveforms with the lowest RI. The representative histological sections were evaluated for quantity of arterioles and venules, after staining by Masson trichrome and Elastic Van Gieson. The arteriolar fraction (defined as the number of arterioles divided by the sum of the arterioles plus venules) and the density of vessels (defined as the number of arterioles and venules per microscopic field) were calculated in each histological section and correlated with the preoperative RI values.ResultsThe mean RI was 0.36 ± 0.07 for malignant tumors and 0.57 ± 0.03 for benign tumors. Ovaries with malignancies showed significantly lower arteriolar fraction values (0.30 ± 0.12) than those with benign tumors (0.56 ± 0.05) and those with metastatic tumors (0.43 ± 0.2) (p < 0.002 and p < 0.001, respectively). The density of vessels was higher in malignant tumors (8.0 ± 3.8) than in benign lesions (2.7 ± 1.5) (p < 0.01). RI values showed a strong positive correlation (r = +0.85, p < 0.0005) with the arteriolar fraction and a negative and weaker correlation (r = −0.69, p < 0.001) with the density of vessels.ConclusionsRI values are predominantly determined by the proportion of arterioles. The correlation between the histological pattern of vascularization and RI values reflects tumor angiogenesis and increases understanding of the advantages and limitations of measuring vascular resistance by color Doppler ultrasound. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Polycystic ovary syndrome: it is always bilateral?
Authors: Battaglia C. , Regnani G. , Petraglia F. , Primavera M. R. , Salvatori M. , Volpe A. 
Published: March 2003

AbstractObjectiveTo evaluate whether patients with unilateral polycystic ovary showed different ovarian and uterine blood flow from those with bilateral polycystic ovaries, and to investigate whether there was a correlation between the ultrasonographic aspect and different hormonal parameters.DesignAn observational study.SubjectsSixteen patients with unilateral polycystic ovary and twenty patients with bilateral polycystic ovaries underwent clinical, biochemical, gray‐scale and color Doppler ultrasonographic evaluation.MethodsThe following parameters were evaluated: hormonal (luteinizing hormone (LH), follicle stimulating hormone (FSH), LH/FSH concentration ratio, estradiol, prolactin, androstenedione, testosterone), clinical (body mass index, Ferriman‐Gallwey score), ultrasonographic (ovarian volume, number and distribution of subcapsular follicles, stromal score) and Doppler (uterine artery and intraparenchymal vessel pulsatility index, ovarian stromal vascularization), in oligomenorrheic patients in the early follicular phase (cycle days 3–5) or in amenorrheic patients at random.ResultsSignificantly higher androstenedione plasma levels and LH/FSH concentration ratios were observed in bilat‐eral polycystic ovaries. In unilateral polycystic ovaries, gray‐scale and color Doppler ultrasonography showed different features in the affected and the unaffected ovary, similar to the appearance of a polycystic and normal ovary, respectively.ConclusionPolycystic ovary syndrome does not predetermined single ultrasonographic and Doppler pattern. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Cervical pregnancy: assessment with three‐dimensional power Doppler imaging and successful management with selective uterine artery embolization
Authors: Su Y.‐N. , Shih J.‐C. , Chiu W.‐H. , Lee C.‐N. , Cheng W.‐F. , Hsieh F.‐J 
Published: March 2003

AbstractCervical pregnancy is frequently associated with extensive hemorrhage which, in severe cases, may be stopped only by hysterectomy. We report a case of an anembryonic cervical pregnancy diagnosed at 10 weeks, and associated with a large arteriovenous malformation. The patient was conservatively managed with simple selective uterine artery embolization. After embolization, her vaginal bleeding ceased and the level of serum β‐human chorionic gonadotropin decreased rapidly. No additional treatment was given. The patient's postoperative course was uneventful and the cervical mass had disappeared at the follow‐up 4 months later. To the best of our knowledge, this is the first report of conservative management of cervical pregnancy simply by uterine artery embolization. The role of three‐dimensional power Doppler ultrasonography in the assessment of cervical pregnancy and in monitoring the therapeutic response is discussed. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Nomogram of the fetal alveolar ridge: a possible screening tool for the detection of primary cleft palate
Authors: Goldstein I. , Jakobi P. , Tamir A. , Goldstick O. 
Published: March 2003

AbstractObjectiveThe objective of this study was to obtain a nomogram of the fetal alveolar ridge development, as a basis for the diagnosis of primary cleft palate.DesignA cross‐sectional study of 323 normal pregnant women of 14–32 weeks' gestation. Several biometric measurements were obtained throughout pregnancy, including the width of the fetal alveolar ridge.ResultsA nomogram of the width of the fetal alveolar ridge during 14–32 weeks' gestation is presented. A linear growth function was observed between alveolar ridge width and gestational age, biparietal diameter, head circumference, femoral length and humeral length. The alveolar ridge width in all eight cases of cleft palate was above two standard deviations and the 90th centile of our nomogram.ConclusionWe provide a nomogram of the growth of the fetal alveolar ridge between 14 and 32 weeks' gestation. This will aid the detection of primary cleft palate during routine prenatal sonography. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Resolution of presumed arachnoid cyst in utero
Authors: Elbers S. E. L. , Furness M. E. 
Published: March 2003

AbstractWe present a case of presumed arachnoid cyst that was diagnosed at 18.5 weeks' gestation, developed a hematoma at 28 weeks and had virtually resolved by 32 weeks. Expectant management of antenatally diagnosed cases is suggested. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Implementation of nuchal translucency image‐scoring method during ongoing audit
Authors: Herman A. , Dreazen E. , Maymon R. , Tovbin Y. , Bukovsky I. , Weinraub Z. 
Published: March 2003

AbstractObjectiveThe aim of this study was to evaluate the contribution of an ongoing audit, using the image‐scoring method, to the quality of nuchal translucency images and to set the basic standards required from the examiners.DesignEvaluation of nuchal translucency images, before, during and after the implementation of an ongoing audit, without knowledge of the time period or the examiner.SubjectsA total of 315 nuchal translucency scans were performed by three examiners. Methods Each of the retrospective, intermediate and prospective time periods included blind scoring of 105 images. The effect of the ongoing audit was examined by comparing the distribution of the quality groups and the mean final score between the time periods, for all cases and for each examiner separately. Improvement of the criteria was assessed by comparing the rate of scans meeting the demands between the time periods.ResultsThe quality of the images improved significantly as the mean final score changed from 4.62 ± 0.21 to 6.19 ± 0.19 and to 6.91 ± 0.16 (p < 0.0001) and the rate of obtaining acceptable scans rose from 72% to 88% and to 92% (p < 0.001), respective to the three time periods. Whereas the three major criteria improved significantly before and after implementation of the audit (mid‐sagittal section from 48% to 94%, caliper placement from 60% to 75% and skin line from 19% to 77%), the minor criteria remained unchanged (image size 90%, amnion demonstration 25% and head position 77%). The average scores of two examiners, for whom improvement was more pronounced, were used to determine the basic standards required from examiners subjected to the audit as follows: unacceptable, none; intermediate, 5%; reasonable, 65%; excellent, 30%; with a mean final score of 7.25.ConclusionsImplementation of an ongoing audit, using the image‐scoring method, proved to be an efficient method for surveillance and improving the quality of nuchal translucency images. We recommend centers or individuals practicing first‐trimester ultrasound screening to consider its routine utilization, in an unbiased and strict manner. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Functional urinary tract obstruction developing in fetuses with isolated gastroschisis
Authors: Reiss R.E. , Landon M.B. , Jayanthi V.R. , Caniano D.A. , Mutabagani K. , O'Shaughnessy R.W. 
Published: March 2003

Objective To evaluate the frequency and natural history of urinary tract abnormalities developing in fetuses presenting with initially isolated gastroschisis.Methods Serial ultrasounds were performed prospectively on fetuses identified by our prenatal diagnosis program as having a gastroschisis. When abnormalities in the urinary tract were identified prenatally, newborns were evaluated by a pediatric urologist.Results Over a 1‐year period four out of 12 fetuses with gastroschisis developed deformations of the urinary tract. In three fetuses the bladder herniated through the abdominal wall defect. Two also had upper tract dilatation. A fourth fetus developed bilateral hydronephrosis with a normally situated bladder. Once the gastroschisis was repaired none of the newboms had evidence of structural obstruction of the urinary tract, however, hydronephrosis with or without reflux persisted for several months.Conclusions Deformations of the fetal urinary tract can develop secondary to gastroschisis. They do not appear to represent separate malformations and evaluation with fetal karyotyping may not be indicated. When hydronephrosis is present ongoing urologic evaluation of the neonate is indicated.
P114Fetal echocardiography in chromosomally normal fetuses with increased nuchal translucency. A preliminary report
Authors: Puerto B. , Martinez J. M. , Borrell A. , Cararach V. , Fortuny A. 
Published: March 2003

ObjectiveTo determine the value of first trimester screening for congenital heart disease by measurement of nuchal translucency at 10–14 weeks of gestation.MethodologyA transabdominal echocardiography at 20–22 weeks of gestation was performed in 104 singleton pregnancies with chromosomally normal fetuses and an increased nuchal translucency (> 95th centile) at 10–14 weeks. In the last 55 cases an early examination combining either the transvaginal or the transabdominal route at 13–16 weeks was also carried out. The heart evaluation was considered as complete when the four chamber view, with both atria, ventricles and atrioventricular valves, as well as the origin and double crossing of the great arteries were correctly identified. Colour and pulsed Doppler examination were used to assess blood flow through the aortic, pulmonic and atrioventricular valves, in order to detect regurgitation or very high velocities suggesting valve stenosis. The systemic and pulmonary venous return was also identified, and assessed by Doppler when possible.ResultsOnly one structural cardiac defect was detected in this population. It was a tricuspid atresia with ventricular septal defect detected at 14 weeks of gestation.ConclusionAlthough the number of cases is too small to draw strong conclusions, the utility of nuchal translucency as a screening method for congenital heart disease in chromosomally normal fetuses is worth to be confirmed by further investigation.