bluuebunny/crossref_metadata_2025_split huggingface dataset:
P120Prenatal demonstration of polyvalvular disease in a fetus with trisomy 18
Authors: Gembruch U. , Germer U. , Denzel S. , Gloeckner‐Hofmann K. 
Published: March 2003

A polyvalvular disease of cardiac valves is a common finding in early trimester fetuses with trisomy 18 at autopsy (Hyett et al. Am J Med Genet 1997; 69: 207). Prenatal diagnosis of this disease, however, is very rare.Case reportNuchal translucency screening was performed in a 26‐year‐old gravida 1 at 13 + 5 weeks. IUGR (CRL 65 mm) with nuchal translucency thickness of 3.0 mm, retrogenia and cardiomegaly (CTR > 0.5) was shown. Umbilical artery Doppler indices were normal (PI 1.44), but in the ductus venosus a reversed blood flow during atrial systole was demonstrated (PIV 4.18, PVIV 2.9). Echocardiography showed ‘doming’ of the pulmonary and aortic valves with poststenotic dilatation. Doppler echocardiography demonstrated severe stenoses of the pulmonary and aortic valves (maximal velocities: 1.8 m/s and 2.13 m/s, respectively) and holosystolic insufficiencies of tricuspid and mitral valves (maximal velocities: 2.12 m/s and 2.04 m/s, respectively). The CVS revealed trisomy 18 (47,XY, + 18). 6 days later, fetal demise was diagnosed. Abortion was induced by an intra‐amnial injection of Rivanol. Autopsy confirmed the severe stenoses of both great arteries without additional cardiac malformation.ConclusionsThe case reports the option of Doppler echocardiography in early pregnancy to diagnosed severe stenosis of the great arteries and confirmed the data of autopsy studies, that fetuses with trisomy 18 in early pregnancy have polyvalvular diseases, presumably being a lethal factor.
P134Uterus sonographic volume evaluation in post menopausal women and its variation
Authors: Santos F. F. A. , Machado M. R. M. , Dertkigil M. S. J. , Marussi E. F. 
Published: March 2003

BackgroundThe aim of this study was evaluate the uterine volume in postmenopausal women considering parity, years since the last menstrual bleeding, abnormal vaginal bleeding and hormonal replacement therapy (HRT).MethodUterine size was measured in 100 postmenopausal women by pelvic and/or transvaginal US, that had gone to routine examinations.ResultsThe mean age was 61.5 years (± 9.3) and the mean menopausal age was 48 years (± 5). Forty percent was under HTR and the mean parity was 4.0 (± 3). Abnormal vaginal bleeding was present in 13% of the patients. The patients were divided into three groups: I (nullipara), II (1 or 2 deliveries), III (3 or more deliveries). The uterine volume was, respectively, 39, 45 and 47 cm3. Patients under HTR had the mean uterine volume 51 cm3 and the others 42 cm3. Patients with 5 or less years since menopause had a mean uterine volume of 51 cm3 and the women with 6 or more years had 44 cm3. The mean uterine volume in patients with abnormal vaginal bleeding was 62 cm3 (± 35) and in the assynthomatic ones was 43 cm3(± 21).ConclusionsThe uterine volume had a tendency to be smaller in patients without HTR, low parity and more years since last menstrual period, but have no statistical significance. However the volume was significantly bigger in women with abnormal vaginal bleeding.
P14Sonographic features of the cervix in the midtrimester as a predictor of preterm delivery
Authors: Fukami T. , Sekiya T. , Yoshimatsu K. , Otabe T. , Tsukada K. , Ishihara K. , Araki T. 
Published: March 2003

BackgroundThe purpose of this study was to predict preterm delivery by transvaginal ultrasound in the midtrimester.MethodThis prospective study was conducted on 568 outpatients with normal pregnancy up to 16 gestational weeks. After the patient's consent was obtained, serial transvaginal ultrasound scanning (TVS) was planned at 2–4 weekly intervals from 16 to 27 gestational weeks, and used to assess cervical length, cervical gland area and internal os dilatation.Results(1) The preterm delivery (37 weeks gestation) rate of the patients was 3.0% (17/568). (2) Of the three predictive factors of preterm delivery namely shortened cervical length (30 mm), absence of cervical gland area, and internal os dilatation, the most useful monographic feature of the cervix was absence of cervical gland area examined at 16–19 weeks gestation. (3) The combination of these factors at 16–19 weeks gestation improved the predictive value (sensitivity 35%, specificity 99%, positive predictive value 88%, negative predictive value 96%).ConclusionFor the prediction of preterm delivery by TVS in the midtrimester, the most appropriate gestational period was at 16–19 weeks, and the best predictive factor was a combination of the absence of cervical gland area with shortened cervix and internal osdilatation.
P141Benign mucinous ovarian cysts: transvaginal sonography with color Doppler features
Authors: Pascual Ma.A. , Tresserra F. , Ubeda A. , Grases P.J. , Hereter L. , Labastida R. 
Published: March 2003

AimTo evaluate the accuracy of transvaginal sonography with color Doppler (TVSCD) in identifying mucinous ovarian cysts.Material and methodsFive hundred 18 adnexal masses were diagnosed by TVSCD before surgery. We identified those adnexal masses in which an ultrasonographic diagnosis of mucinous ovarian cyst was done. This diagnosis was based on the presence of a cystic lesion with thin, grape‐like appearing septa and diffuse internal echoes. This diagnosis was compared with the pathological features.ResultsA total of 49 mucinous cysts were diagnosed by TVSCD, 26 of them were histologically confirmed. Twenty‐three cysts were misdiagnosed (9 were serous, 4 were interpreted as malignant and one was an endometrioma). TVSCD was unable to diagnose 14 out of 40 mucinous cysts confirmed by histology. The ultrasonographic features most frequently seen as suspicious of malignancy were thin, grape‐like appearing septa (84.6%) and diffuse internal echoes (53.8%). The sensitivity, specificity, and positive and negative predictive values and accuracy of TVSCD were 65%, 95.2%, 53.1%, 97%, and 92%, respectively.ConclusionsThe accuracy of TVCD for the diagnosis of benign mucinous cysts is very high, being the most frequently cause of confusion simple serous cysts.AcknowledgementsThe authors are grateful to the Càtedra d'Investigació en Obstetrícia i Ginecologia (Universitat Autónoma de Barcelona).
P142Endometrioma simulating ovarian cancer in a postmenopausal woman – report of one case
Authors: Kavak Z. N. , Başgül A. 
Published: March 2003

BackgroundExternal endometriosis is principally a disease of active reproductive life which is seldom found during postmenopausal years because of estrogen deprivation. Endometriosis is a great mimicker of other pelvic pathologies especially in postmenopausal years. We report here, a case of ovarian endometrioma in a postmenopausal woman simulating ovarian cancer. Ultrasonographic features, clinical presentation, differential diagnosis and treatment modalities of this rare case are presented and discussed.Case76‐year‐old woman gravida 3 para 2 presented with an asymptomatic pelvic mass discovered on gynecologic examination. An ultrasound examination was requested to investigate the nature of this mass. She was otherwise symptom‐free surprisingly except for occasionally occuring bilateral pelvic pain. Longitidunal sonograms showed an irregular, partially solid and cystic mass in the right adnexal region. A transverse scan showed the presence of a complex right adnexal mass measuring 6 × 7 × 7 cm in diameter which was considered most likely to be malignant. CA‐125 level of her was slightly elevated. Urgent laparatomy revealed no evidence of malignancy and the mass proved to be an endometrioma histologically. Most possibly, the presence of old blood within the tumor simulated a solid component. The patient was vigorously reassured and hormone replacement therapy was given in the postoperative follow up period.
P143Primary bilateral fallopian tube cancer – case report
Authors: Wojcieszyn M. , Błaszczyk K. , Biernat M. , Krzystyniak M. , Poreba R. 
Published: March 2003

IntroductionFallopian tube cancer is one of the rarest neoplasm of female reproductive tract. Primary, bilateral presence of the cancer is especially rare. Diagnostic difficulties cause, that it is often found in very advanced state. The authors have presented the case of primary bilateral cancer of the fallopian tube, qualified to surgical treatment on the base of sonographic examination.57 years‐old women was examined using transvaginal ultrasound due to increasing pain in the lower part of the abdomen and abnormal discharge out of the vagina. During the examination fluid in the uterus cavity and cystic, oblong, winding structures in both adnexa, looking like distended oviducts were found. Typical ovary tissue wasn't visible. On the base of history and examination laparotomy was ordered. During the surgery multiple adhesions in the pelvis and extended fluid filled fallopian tubes were found. The hysterectomy and bilateral adnexectomy was performed. Pathological examination revealed presence of bilateral papillary adenocarcinoma of the fallopian tubes. Out of the oviduct no neoplastic cells was found.ConclusionExtended fluid filled oviducts found during sonographic examination may be the first sign of fallopian tube cancer.
148Blood flow changes after uterine artery embolization in the treatment of adenomyosis and myomis: preliminary report
Authors: Lee E.‐H. , Sunwoo T. W. , Ahn C. S. , Lee M.‐H. , Lee W. H. 
Published: March 2003

BackgroundThe aim of this study was to evaluate prospectively the changes of blood flow following permanent embolization of uterine arteries using polyvinyl alcohol in the treatment of uterine adenomyosis or myomas.MethodsFrom August 1998 to May 1999, 114 cases of uterine artery embolization were performed for the patients having symptomatic adenomyosis (n = 63) or myomas (n = 51). They were underwent baseline (n = 114) and follow‐up ultrasound on 1 week (n = 106), 3 (n = 102) and 6 months (n = 23) after embolization. The peak systolic velocity (PSV) and resistive index (RI) were calculated in the isthmic portion of uterine arteries and intratumoral vessels.ResultsOne week after embolization, uterine blood flow was markedly decreased comparing with pre‐embolization status. After 3 months, blood flow was recovered up to 56% of pre‐embolization state but not increased significantly on 6 months examination. Color flow was not detected within the myomas after embolization.

Changes in PSV and RI

Pre
1 week
3 month
6 month

PSV (cm s−1)
54.7
23.0
30.5
32.0

RI
0.76
0.84
0.80
0.79

ConclusionUterine blood flow was markedly decreased immediately after embolization and increased up to the half level of pre‐embolization status on 3 months examination.
P155The pathological breast in gestation‐puerperal period
Authors: Machado M. R. M. , Santos F. F. A. , Marussi E. F. , Pereira S. L. , Vissotto S. L. 
Published: March 2003

BackgroundThe aim of this study was to describe the appearance of breast tissue in a breast inflammatory disease and in the inflammatory breast tumour during gestational‐puerperal period using ultrasound and to evaluate the contribution of this exam in differential diagnosis.MethodWe will describe two cases with increase of volume breast, analysed by two‐dimensional ultrasound, performed on an ACUSON XP4A using a 7,5 MHz linear, focused probe with Colour Doppler.ResultsThe two patients showed typical inflammatory characteristics, similar symptoms and the same appearance of breast tissue in ultrasound. The two exams appears as parenquymal disorganisation breast tissue, increase width skin, hypoechoic ill undefined masses with some internal echoes, thick walls and septations.ConclusionsIn some cases, the differential diagnosis between breast tumours associated to inflammatory appearance and inflammatory diseases, during pregnancy and puerperal period are very difficult. The Doppler evaluation is helpful as well as clinical history and epidemiology. Sometimes, only the hystological aspects will provide the right diagnosis.
P158The representation of obstetric ultrasound scan among obstetricians and ultra‐sonographers: a descriptive exploratory study
Authors: Quayle J. , Wojciechowski V. , Ueno L. S. , Bunduki V. , Miyadahira S. , De Lucia M. C. S. , Zugaib M. 
Published: March 2003

BackgroundUltrasound is one of the most known exams performed during prenatal period for diagnosis and screening, but little is known about obstetricians' perceptions associated to the exam. The aim of this study was to assess psychological representations related to obstetric ultrasound scan among obstetricians who were also ultrasonographists and those who were not.MethodPsychological interview with 54 obstetricians of our Institution with different level of specialization.Results55% believe that only a specific training is necessary to be an ultrasonographist, while 35% consider a title essential to perform the exam. Most of the subjects (98%) believe the exam has influences on the pregnant woman bonding with her baby, due to fetal visualization and the proximity feeling it favors. Almost all (93%) consider the possibility of early diagnosis the main feature of the exam while 20% mention the possibility of diagnostic mistakes and their repercussion. When asked to produce projective associations, content analysis points out to aspects associated to the qualities of the exam, particularly ‘fidelity’, precision and power.ConclusionThere is a massive idealization of the exam and little difference between ultrasonographists and obstetricians. This should be approached during professional training to help them deal with the bonding aspects they themselves consider important.
P22The efficacy of IUGR treatment with arginin—the ultrasound assessment: preliminary report
Authors: Sieroszewski P. , Suzin J. , Surkont G. , Karowicz‐Bilińiska A. 
Published: March 2003

ObjectiveTo study the efficacy of IUGR treatment with arginin with the use of ultrasound biometry measurements.Design and methodsA pilot study was performed on 45 pregnant women with IUGR fetuses (EFW < 10%ile). 30 patients were treated with arginin 2 g daily po during 20 days (I group). 15 patients were not treated (control‐II group). After 3 weeks ultrasound measurements were repeated.ResultsThe increase in EFW was greater in I group (587 g vs. 321 g, P < 0.005). After delivery we noticed differences in weight between both groups, but they were not statistically significant (2753 g vs. 2495 g, NS). Percentage of IUGR newborns was higher in 11 group (29% vs. 73%, P < 0.005).Conclusions1. EFW (ultrasound assessment) is useful to supervise IUGR fetuses treated with arginin. 2. Arginin treatment of IUGR fetuses is often skuteczne. The project is ongoing. (KBN 4 P05E 01616).
P26Congenital Rubella syndrome and fetal exencephaly – case report
Authors: Andrade J. Q. , Miyadahira S. , Curtis S. P. , Figueiredo C. A. , Yamamoto R. M. , Zugaib  
Published: March 2003

Exencephaly is characterized by a complete or partial absence of the skull'cap, follwed by abnormal development of the cerebral tissue.We report a case of a 31‐year‐old, white patient, on the 9th. week of her second gestation who presented with fever, coryza and myalgia. The gestational period was calculated based on the first ultrasonography, and the maternal sorology for rubella was positive (IgG and IgM).The patient was send to the department of Fetal Medicine‐HCFMUSP for evaluation. Morphologic ultrasonography and another sorology for rubella were performed. On the 12th gestation week, ultrasonography revealed absence of the skullcap and the presence of cerebral tissue floating in the amniotic fluid. Maternal sorology still showed positive (IgG and IgM). The patient suffered a miscarriage and the maternal (fetus and placenta) was analyzed at the Virology Department of Adolfo Lutz Institute. The virus of rubella was isolated in all the examined organs, and the presence of congenital rubella was confirmed.Considering that the etiology of this malformation is still umknown and is associated with a severe congenital infection we speculate that is coul be a consequence of the massive fetal compromise caused by the rubella virus.
P34Mechanical ileus diagnosed with transvaginal ultrasonography
Authors: Klarić P. , Grubisic G. , Zovak M. , Tuèkar N. 
Published: March 2003

BackgroundThe aim of this work is to present a rare case of mechanical ileus diagnosed with ultrasound and confirmed on radiology.Thirty‐six years old women underwent an operation because of an endometric cyst and left adnexectomy was done. Mechanical ileus occurred on the fifth postoperative day. A level of liquid in bowel was seen at radiology. At ultrasound we saw on left hemiabdomen distended bowel and a thin, wire‐like hyperechogenic structure with no vascularization, thick about 5 mm. This structure was surrounded by the bowel. Laparotomy detected the bowel surrounded by a wire‐like thin fibrinoid structure which was extended from uterus corn to the left pelvic wall and caused mechanical ileus. After release of this tissue the bowel was in normal condition and peristaltics was restored next day.ConclusionIt is possible to observe a localization of mechanical ileus with vaginal sonography.
P37Ileal atresia and thrombo‐embolic liver calcifications, a possible complication after treatment with intrauterine laser coagulation therapy for twin to twin transfusion syndrome
Authors: Van Zalen‐Sprock R. M. , Schaap A. H. P. , Van Wijngaarden W. J. , Schnater J. M. , Aronson D. C. , Bleker O. P. 
Published: March 2003

BackgroundTwo fetuses with complications after laser coagulation therapy for twin to twin transfusion syndrome (TTTS) are described.Case 1In this patient laser coagulation of the connecting placental vessels was performed at 21 weeks of gestation. Two weeks after this treatment the donor twin had died. Sonography of the survivor showed progressive intestinal distension from 24 weeks onwards. After birth a laparotomy was performed and an ileal atresia was found.Case 2In this patient laser coagulation was performed at 19 weeks of gestation. Premature rupture of membranes occurred at 21 weeks and both fetuses died. At autopsy thrombo‐embolic calcifications were found in the liver of the smallest, donor twin.DiscussionWhereas duodenum atresia is considered a ‘true’ congenital anomaly, jejuno/ileal atresia is thought to be caused by a mesenteric vascular accident during fetal life, which leads to necrosis. Intra‐uterine laser coagulation therapy seems promising in the treatment of TTTS. Although it cannot be proven, this therapy must be regarded as one of the possible causes for the thrombo‐embolic processes described in the two cases.
P49Prenatal diagnosis of myelocystocele‐cloacal exstrophy in a male neonate with a abnormal penis and urethra
Authors: De León J. A , Pintado P. , Viñuela M. , Herrero E. , García F. , Aguarón A. , Pérez Fernández R. 
Published: March 2003

IntroductionCloacal exstrophy results from a migration failure of the lateral mesodermal folds of the infraumbilical anterior abdominal wall, and rupture of the resulting enlarged, persistent cloacal membrane before the eighth week of gestation. Myelocystocele is a defect of the medular channel characterizased by a cystic that contain dural and arachnoid layer and the ependymal lining layer, respectively. The association of persistent cloaca and caudal spinal anomalies is thought to be related to cell loss in the caudal cell mass, which affects caudal spinal column formation and cleavage of the cloaca by the urorectal septum. Cloacal malformation occurs in approximately 1 in 65 000 live male births. Prenatal ultrasound may lead to the diagnosis in selected cases.Case reportWe report an unusual case of prenatally detected with a myelocystocele and cloacal malformation. Additional anomalies included an omphalocele and malformations of the upper urogenital tract, skeleton, and vertebral column. Labor was induced at 34 weeks' estimated gestational age. It finish by eutocical delivery. A 2154‐g male was born, Apgar 6/8, pH 7.32. The newborn was taken to NCIU and the neonatal outcome was favourable.
P57Twin pregnancy with a hemiacardiac fetus
Authors: Košec V. , Hodek B. 
Published: March 2003

BackgroundFetal acardia is a rare anomaly occuring exclusively in monozygotic multiple pregnancies with an incidence of 1:35000 deliveries or in 1% of monozygotic twins. Since 1920, rudimentary developed heart of an acardiac twin, mostly called ‘hemiacardius’ or ‘pseudoacardius’, has been recognized in eigth cases. Four of them have been discovered during autopsy.We are showing a twin pregnancy of a 25‐year‐old woman with a hemiacardiac and a normal fetus, which was conducted in our Maternity Hospital. In the 22nd week of amenorea a suspicion of acardia of a deceased fetus with multiple malformations was expressed for the first time by ultrasound. With help of amniocenthesis we defined a normal male kariotype of a live twin and by ultrasound we carefully observed its morphology and growth. Furthermore, in the course of the pregnancy, mother's coagulation parameters were controlled weekly. In the 33rd week of gestation an extreme polyhydramnios developed, so amniodrainage was performed twice. The pregnancy was finished in the 36th week of gestation with a caesarian section: a live male child – 2330/46 and a hemiacardiac fetus – 2800 g with multiple malformations were born. The live twin was discharged from hospital three weeks later as a healthy baby.
P59Prenatal diagnosis of fetal rubella infection by ultrasound‐guided cordocentesis
Authors: Park J. S. , Roh J. W. , Moon J. B. , Jun J. K. , Yoon B. H. , Moon S. Y. , Syn H. C. , Lee H. P. 
Published: March 2003

ObjectiveOur purpose was to compare the accuracy between rubella‐specific IgM and polymerase chain reaction (PCR) for the diagnosis of fetal rubella infection by ultrasound‐guided cordocentesis.Method30 pregnant women with the evidences of rubella infection were enrolled. Fetal rubella infection was diagnosed by rubella‐specific IgM using microparticle enzyme immunoassay (MEIA) and rubella virus PCR with the blood obtained by ultrasound‐guided cordocentesis after 21 weeks of gestation. Neonatal outcomes were evaluated by physical examination at birth and rubella‐specific IgM if possible.Results20 cases were evaluated by IgM and PCR, and 10 cases only IgM. No fetus showed positive IgM antibody, and 8 of 20 cases showed positive PCR in cord blood, and 6 in amniotic fluid. One infant with negative rubella‐specific IgM by cordocentesis before completed 22 weeks resulted in positive IgM at birth, low birth weight, strabismus and developmental delay. These findings were compatible with congenital rubella syndrome. No case showed congenital rubella syndrome in the fetuses with positive rubella PCR.Conclusion(1) The incidence of fetal rubella infection may be very low in mothers with rubella infection. It is suggested that prenatal diagnosis should be performed even if maternal infection occurs in early pregnancy; (2) Cord blood rubella‐specific IgM is more accurate than PCR for the prenatal diagnosis of congenital rubella syndrome; (3) Cordocentesis for rubella‐specific IgM detection should be done after 22 weeks of gestation for accurate diagnosis.