bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congenital diaphragmatic hernia: ultrasonic measurement of fetal lungs to predict pulmonary hypoplasia
Authors: Bahlmann F. , Merz E. , Hallermann C. , Stopfkuchen H. , Krämer W. , Hofmann M. 
Published: March 2003

AbstractObjectiveThe purpose of this study was to assess the value of biometric lung measurements for the prediction of severe fetal pulmonary hypoplasia in congenital diaphragmatic hernia and to determine whether a correlation between lung measurements and autopsy findings or neonatal outcome could be established.DesignProspective study, between 1991 and 1997.SubjectsNineteen fetuses with congenital diaphragmatic hernia.MethodsIn addition to standard biometry, sonographic measurement of the transverse thoracic diameter, sagittal thoracic diameter, fetal lung diameters at the level of the four‐chamber view and lung/thoracic circumference ratio were performed. These were compared with the standard curves defined by Merz and colleagues. Autopsy examinations were performed to determine lung weight, lung weight/body weight ratio and radial alveolar count.ResultsFive fetuses (26%) were terminated before 24 weeks of gestation. All of these fetuses had lung measurement values below the 5th centile. Eleven of 14 fetuses (78.6%) with pulmonary hypoplasia diagnosed after 24 weeks of gestation died postnatally. The mortality rate was 70% (7/10) in the fetuses without associated anomalies. The sonographic diagnosis of fetal pulmonary hypoplasia was made in all fetuses who died postnatally. All fetuses with a lung diameter/thoracic circumference ratio below 0.09 died. Three fetuses, which had values within the normal range, survived. In contrast, measurements of the bony thorax (transverse and sagittal thoracic diameters, thoracic circumference) did not provide an indication of the presence of fetal pulmonary hypoplasia. Pulmonary hypoplasia was confirmed at autopsy in all fetuses on the basis of lung weight, lung/body weight ratio or radial alveolar count. Concomitant with pulmonary hypoplasia was polyhydramnios in ten fetuses (71.4%), mediastinal shift in 11 fetuses (78.6%), intrathoracic herniated stomach in six fetuses (42.9%) and associated malformations in four fetuses (28.6%). Postnatal mortality for these conditions was 80%, 78.6%, 100% and 100%, respectively. Postnatal mortality was 75%, 70% and 100% in the fetuses with an isolated diaphragmatic hernia.ConclusionThe results of this investigation suggest that the assessment of fetal lung diameter and the use of the lung diameter/thoracic circumference ratio are further useful prognostic parameters in the management of congenital diaphragmatic hernia. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Histological analysis of the uterine junctional zone as seen by transvaginal ultrasound
Authors: Tetlow R. L. , Richmond I. , Manton D. J. , Greenman J. , Turnbull L. W. , Killick S. R. 
Published: March 2003

AbstractObjectiveThis study aimed to investigate the histology of the subendometrial halo, the junctional zone between the endometrium and myometrium.MethodsThirteen ex vivo uteri removed for treatment of menorrhagia were studied. In each case, the subendometrial halo, as seen by transvaginal ultrasound, was marked using a Nottingham breast location biopsy needle. A standard histological examination was performed. Full thickness blocks of the anterior uterine wall were taken and standard serial 5‐µm tissue sections were prepared from each block. Subsequent morphometric analysis followed staining with Feulgen reagent, using a CAS 200D quantitative image analysis system. Additionally, anti‐CD31, an antibody stain for vascular endothelium, was used.ResultsThe histological examination showed the subendometrial halo to consist of apparently normal myometrium. Morphometric analysis demonstrated a greater total nuclear area in the subendometrial halo than the outer myometrium, but no difference in individual nuclear size between the two zones. CD31 stained a greater total area in the inner myometrium.ConclusionsThese results suggest that the subendometrial halo is a distinct compartment of the myometrium comprising tightly packed muscle cells with an increased vascularity. Such architecture would increase the density of this tissue layer, altering its acoustic impedance, and account for its echopenic appearance on ultrasound. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Central arterial hemodynamics in small‐for‐gestational‐age fetuses before and during maternal hyperoxygenation: a Doppler velocimetric study with particular attention to the aortic isthmus
Authors: Brantberg A. , Sonesson S.‐E. 
Published: March 2003

AbstractObjectiveHemodynamic changes indicating a normalization of fetal blood flow redistribution during maternal oxygen administration have been suggested to be of positive prognostic value in growth‐restricted fetuses. The aortic isthmus has been suggested as a site for early detection of blood flow redistribution as well as for verification of a response to maternal hyperoxygenation. The present study was performed to investigate whether this concept could be confirmed in a study involving fetuses assumed to have only a moderate disturbance in fetoplacental hemodynamics.Design and SubjectsTwenty‐five singleton fetuses with an estimated weight less than −2 SD below the gestational age‐related mean and without any malformation or chromosomal aberration were studied between 27 and 38 (median 34) weeks of gestation.MethodsVelocity waveforms from the mitral valve, aortic valve, middle cerebral artery, aortic isthmus and umbilical artery were recorded before and during maternal breathing of 100% oxygen.ResultsNine fetuses demonstrated absent or reversed end‐diastolic velocity (ARED) in the aortic isthmus while forward flow was present in the umbilical artery. The cerebral artery pulsatility index (PI) increased with oxygen administration and there was a decrease in the aortic isthmus PI. Variables obtained from the other recording sites did not change with maternal hyperoxygenation.ConclusionsARED in the aortic isthmus appears to be an early sign of blood flow redistribution in this group of fetuses. Maternal oxygenation results in velocity waveform changes that suggest an increase of cerebral vascular resistance and a redistribution of blood from the brain to the vascular beds supplied by the descending aorta. The aortic isthmus is a suitable site to verify this response. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
P50Ultrasonographic research of gonadas at a true hermaphroditismis
Authors: Latypov A. S. , Teregoulova L. E. , Bubis I. G. 
Published: March 2003

BackgroundThe differential diagnosis between the various forms of violation of a structure of gonadas at the patients with a female phenotype represents a problem, especially at a primary inspection.MethodWe represent a case of ultrasonographic diagnostics an ovotestis at a true hermaphroditismis in our practice. There was used linear transabdominal and convex transrectal transducers on ultramark‐9 device.ResultsThe young woman (17yo) who has addressed to the gynecologist concerning a primary amenorrhoea, was examined by ultrasound in the Hospital. There were detected a male's structure internal sexual ductuses and presence of gonadas located below usual position of ovaries with structure, estimated as a testicula. The Morris syndrome was diagnosed. At the consequent inspection in center, specializing in genetic ultrasound, specific echostructure of the gonadas was detected, appropriated to their mixed structure (ovotestis), thus a true hermaphroditismis with a female phenotype was diagnosed. The consequent karyotyping (46XX/46XY (16:4)) has confirmed the preliminary ultrasonographic diagnosis.ConclusionThe sufficient qualification of the sonographist conducting a ultrasonic research, knowledge of a ultrasonographic picture of the this pathology, allows correct diagnostics already before lab stage of an inspection, using even the routine equipment and review.
WS14‐05Technique of ‘three‐dimensional’ volume mode sectional planar imaging
Authors: Jackson D. N. , Aptekar L. , Thompson K. K. 
Published: March 2003

BackgroundThree‐dimensional imaging of superficial fetal abnormalities is well established. We prospectively evaluated if a technique of sectional planar imaging could interrogate nonsurface fetal abnormalities without changing transducers or requiring postrendering software.MethodPatients referred for perinatal consultation received traditional 2‐D scanning and simultaneous volume mode imaging. Fetal abnormalities were visualized with a sectional technique similar to ‘tomogram’ slices. No post image rendering manipulation was required. Twelve patients had correlative MRI scanning. Neonatal images were obtained when possible.ResultsStructural fetal abnormalities amenable to volume rendering were found in 192 of 600 referral patients. Of these, 49% (94/192) benefited from 3‐D planar imaging. Consistently improved counseling occurred with abdominal wall defect (11/11), cystic hygroma (8/8), neural tube defect (8/8), skeletal dysplasia (5/5), hydrops (5/5), ovarian mass (4/4), myoma (9/11), and fetal chest mass (2/3). Moderate image concordance was seen for nuchal thickness (4/8), renal dysgenesis (27/50), and placental mass or separation (7/12). Lowest concordance was seen for echogenic bowel (0/17), isolated SUA (0/9), and CPC (4/41).ConclusionComplex syndromes with superficial and deep architecture are accessible with a simple volume mode planar scanning technique. The additional information is immediately available and useful in counseling of these syndromes.
Mid‐trimester uterine artery Doppler screening as a predictor of adverse pregnancy outcome in high‐risk women
Authors: Coleman M.A.G. , McCowan L.M.E. , North R.A. 
Published: March 2003

Objective To assess the value of uterine artery Doppler ultrasound screening, when performed in a clinical setting, to predict complications of impaired uteroplacental blood flow in high‐risk women.Design A prospective audit.Subjects A total of 116 pregnancies in 114 women at high risk of pre‐eclampsia and/or small‐for‐gestational‐age (SGA) babies attending a maternal–fetal medicine clinic at National Women’s Hospital, a tertiary referral hospital, Auckland, New Zealand.Methods Uterine artery Doppler screening was performed as part of clinical practice between 22 and 24 weeks’ gestation. A resistance index (RI) was calculated from each uterine artery and the presence or absence of a notch was determined. An RI of > 0.58 was defined as abnormal and an RI of ≥ 0.7 was defined as very abnormal. The main outcome measures were: pre‐eclampsia, SGA baby (birth weight < 10th centile), placental abruption, intrauterine death, ‘all’ and ‘severe’ outcomes.Results Thirty‐two (27.5%) women developed pre‐eclampsia, 31 (26.7%) had SGA babies, 23 (20%) were delivered at < 34 weeks because of pregnancy complications, and there were three (2.6%) placental abruptions and three (2.6%) perinatal deaths. The sensitivity of any RI of > 0.58 for pre‐eclampsia, SGA, ‘all’ outcomes and ‘severe’ outcome was 91%, 84%, 83% and 90%, respectively. The specificity of any RI of > 0.58 for these outcomes was 42%, 39%, 47% and 38%, respectively. The positive predictive value of any RI of > 0.58 for the same outcomes was 37%, 33%, 58% and 24%, respectively. Among women with both RI values of ≥ 0.7, 58%, 67%, 85% and 58% developed pre‐eclampsia, SGA, ‘all’ and ‘severe’ outcomes, respectively. In women with bilateral notches, 47%, 53%, 76% and 65% developed the respective outcomes. Women with both RI values of ≥ 0.7 and women with bilateral notches had relative risks of 11.1 (95% CI 2.6–46.4) and 12.7 (95% CI 4.0–40.4) for developing severe outcome, respectively. Only 5% of women with both RI values of < 0.58 developed a severe outcome.Conclusion In high‐risk women, uterine artery Doppler waveform analysis performed best in the prediction of severe adverse outcome and was better than clinical risk assessment in the prediction of pre‐eclampsia and SGA babies. Further studies are necessary to determine how information from uterine artery Doppler studies should modify current practice in high‐risk women.
F28Correlation of saline hysterosonographic and hysteroscopic diagnosis
Authors:   B. Tekin, Hassa H. , Yildrim A. , Şenses T. 
Published: March 2003

ObjectiveTo investigate correlation of an office procedure saline sonohysteroscopic analysis with an invasive procedure diagnostic hysteroscopy.InterventionDiagnostic analysis of infertile patient in Osmangazi University Reproductive Health Center.Materials and methodsIn Osmangazi University, Reproductive Health Center, saline hysterosonographic analysis of the uterus, as an office procedure is done to all seconder infertile patient and primer infertile patients who have any suspicion to have an uterine anomaly or adhesion. Also if ultrasound examination of the uterus show endometrial thickness more than 5 mm after the end of menstruation saline hysterosonographic analysis (SHG) was performed.ResultsSHG is an easy and speedy method to use in office procedure. There were 38 cases of SHG showing disturbance of uterine cavity; 28 had polyp like lesions, 7 cases of suspected synechia. There were 11 patients who had normal SHG but recurrent pregnancy loss; these patients had normal findings in hysteroscopic analysis. After endoscopic procedures, 7 cases of synechia were verified, 5 cases out of 28 had submucous myomas, the others polyps. Effectiveness of the shg according to the hysteroscopic analysis is thus excellent. Correlation between the two methods, shows us that SHG can replace diagnostic hysterocopic analysis.ConclusionIn case of doubt, diagnostic analysis of the uterine cavity, can be done by SHG; hysteroscopy is superior to the SHG by its capability of treatment (surgery).
F51Development of power Doppler as a quantifiable tool for assessing fetal perfusion: fractional renal vascular volume
Authors: Welsh A.W. , Eckersley R. , Blomley M. , Cosgrove D. , Fisk N.M. 
Published: March 2003

BackgroundPower Doppler allows the display dynamic range to be increased by up to 10–25dB by coding the amplitude rather than the velocity component of the Doppler frequency shift. Though this means an improvement in image quality, the real advantage of the additional information coded within this signal lies in the potential for quantification of flow (as vascular volume).MethodIsolated measurements of amplitude do not have meaning unless they can be standardised to remove the effects of machine settings and attenuation. Two important functions are necessary for this: 1. Correction of the nonlinearities of the energy scale bar (purpose‐designed software ‐CQ Analysis, Kinetic Imaging Ltd, Liverpool). 2. Standardisation to a local area of 100% blood flow (the fetal aorta) to define a fractional regional vascular volume. Multiple clips of fetal renal perfusion were stored to mo disk using the Acuson SequoiaTM for offline computer analysis.Results150 fetuses were examined (24–40 weeks). Fetal vascular branching could be seen throughout the renal parenchyma in > 80% of fetuses, with clear fluctuations in the fetal cardiac cycle and statistically significant energy values to the aorta and renal parenchyma. Standardising the peripheral volume flow to the aorta gives a fractional vascular volume of approximately 10–20%.ConclusionsFurther work is underway to improve reproducibility of this technique, to develop an accurate index of fetal renal perfusion.AcknowledgementsAlec Welsh is supported by a Research Training Fellowship from RCOG/WellBeing.
F89Retrospective case control study evaluating the outcome of pregnancy and delivery in patients with myomas
Authors: Sandberg J. , Herbst A. , Andolf E. 
Published: March 2003

BackgroundThe aim of the present study was to compare the outcome of pregnancy and delivery of patients with myomas to normal controls.MethodThe cases were found by searching for the diagnosis ‘myoma in pregnancy’ on the ultrasonography data base from the period of August 1992 to November 1999. Cases were followed up in the delivery data base. The control group was matched for age, parity and pregnancy complications.ResultsSeventy cases with the diagnosis were found among 21 925 deliveries giving an incidence of 3.2 per 1000. Seventeen (26.6% of the cases) were delivered by Caesarian section, compared to 22 out of 128 (17.2%) in the matched control group. The difference was not statistically significant. The rate of Caesarian section and maternal age was higher than in the general population. There was no difference in Apgar score between babies delivered from cases and controls. Neither was there any notable difference in the amount of bleeding between the two groups. No mentionable difference could be seen in the length of gestations.ConclusionIn this study no difference could be seen in the outcome of pregnancy and delivery in cases with myomas. Cases were older and had a higher rate of Caesarian section than the general population.
A correlative study of prenatal ultrasound and post‐mortem findings in fetuses and infants with an abnormal karyotype
Authors: Isaksen C. V. , Eik‐Nes S. H. , Blaas H.‐G. , Torp S. H. , Van Der Hagen C. B. , Ormerod E. 
Published: March 2003

AbstractObjectiveTo compare ultrasound and post‐mortem findings in 98 fetuses and infants with an abnormal karyotype.DesignCriteria for inclusion were an ultrasound examination at the National Center for Fetal Medicine (NCFM), an abnormal karyotype, and an autopsy performed during the period 1985–94.ResultsTrisomy 18 and 21 were the two most common abnormal karyotypes. The highest number of congenital anomalies was observed in cases with trisomy 13 and 18; congenital heart defects (CHD) were most prevalent among fetuses with trisomy 18. In 80% of cases there was full agreement between the ultrasound and autopsy findings; in another 8% of cases there was nearly complete concordance. Thus, in 88% of cases, the main prenatal sonographic diagnosis was correct. In 6% major autopsy findings were not detected by ultrasound examination, in 1% none of the autopsy findings were detected by routine ultrasound and in 5% ultrasound findings were not verified at autopsy. Where the correlation was related to individual autosomal trisomies, structural anomalies were most often correctly diagnosed in fetuses with trisomy 13, with the main diagnosis correct in all cases; second in accuracy were the ultrasound diagnoses in fetuses with trisomy 21 with the main diagnosis correct in 96%; for trisomy 18 the concordance was less good, with the main diagnosis correct in 71%.ConclusionThe present comparison of sonographic diagnoses with post‐mortem findings demonstrates good accordance between the two methods. It also demonstrates the importance of awareness of the anomalies known to occur with different aneuploidies. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Three‐dimensional multiplanar ultrasound for fetal gender assignment: value of the mid‐sagittal plane
Authors: Lev‐Toaff A. S. , Ozhan S. , Pretorius D. , Bega G. , Kurtz A. B. , Kuhlman K. 
Published: March 2003

AbstractObjectiveTo evaluate the feasibility and accuracy of fetal gender assignment from three‐dimensional ultrasound (3D US) data at 10–24 weeks' gestation.MethodsThree‐dimensional ultrasound volume data on 47 fetuses were reviewed and divided into groups: 10–14, 15–18, and 19–24 weeks. Fetal genitalia were studied in axial and sagittal planes for gender assignment, using published criteria. The most valuable plane for assignment was noted. Gender assignment was compared with gender at birth.ResultsGender assignment was possible in 44 of 47 fetuses; 25 assigned male and 19 female. Between 10 and 14 weeks the mid‐sagittal plane alone was diagnostic for all fetuses. Accuracy of assignment between 11 and 14 weeks was 100%. Between 15 and 18 and 19 to 24 weeks, male assignment was 100% accurate. Female assignment was 100% accurate between 15 and 18 weeks. Accuracy decreased to 60% in the 19 to 24 week group, however, in two of the five cases in which gender was wrongly assigned to be male, the assignment was prospectively considered doubtful due to poor resolution of volume data. Excluding these two cases, accuracy for female assignment in the 19–24 week group was 100%.ConclusionUsing 3D US, gender assignment was possible in 44 of 47 of fetuses, as early as 11 weeks' gestation. In early gestation, 11–14 weeks, accuracy of male and female gender assignment was 100%. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Use of free‐hand three‐dimensional ultrasound software in the study of the fetal heart
Authors: Guerra F. A. , Isla A. I. , Aguilar R. C. , Fritz E. G. 
Published: March 2003

AbstractObjectiveTo propose a new approach to the study of the fetal heart using free‐hand three‐dimensional (3D) ultrasound software.MethodsWe studied a total of 28 fetuses, of which 26 were normal and two were known to have heart pathology. In all of them a B‐mode scan was performed. After obtaining a four‐chamber view, and keeping the transducer in the same position, the free‐hand 3D‐View software was activated. A sequence of frames was stored. Additional information was recorded looking from the four‐chamber view towards the outflow tract, and also adding color Doppler.ResultsWe obtained a multiplanar display of one B‐mode and two perpendicular M‐modes in all cases studied. In this multiplanar mode, Y and X axes represent distance and Z axis represents time. We were able to obtain M‐modes and a variation of color‐M‐mode in any desired position. Moving the information along the Z axis, a frame sequence of the B‐mode was obtained. Using this approach we observed one case of fetal supraventricular extrasystoles and other having an interventricular septum defect.ConclusionsThis modality gives a new perspective of fetal heart scanning using the free‐hand 3D‐View software, in which there is benefit from many of the advantages of the 3D software, although the power of this procedure must be improved. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Severe polyhydramnios in twin reversed arterial perfusion sequence: successful management with intrafetal alcohol ablation of acardiac twin and amniodrainage
Authors: Sepulveda W. , Sfeir D. , Reyes M. , Martinez J. 
Published: March 2003

AbstractWe present two cases of twin reversed arterial perfusion (TRAP) sequence complicated by severe polyhydramnios during the second trimester. Both cases were successfully managed at 27 and 26 weeks with ultrasound‐guided intrafetal alcohol ablation of the acardiac twin and amniodrainage. The pump twins were delivered at 35 and 37 weeks, respectively, and both had uneventful postnatal courses. These cases suggest that, in the setting of severe polyhydramnios, prenatal intervention in TRAP sequence could certainly improve the otherwise poor prognosis of the pump twin. Targeting the main intra‐abdominal vessel of the acardiac twin rather than its umbilical cord seems to be a good alternative in the prenatal treatment of these cases. The option of percutaneous intrafetal alcohol injection is widely available and less invasive, simpler and easier to perform than recently advocated endoscopic techniques. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Sonographic diagnosis of congenital megalourethra at 13 weeks of gestation
Authors: Lam Y.H. , Tang M.H.Y. 
Published: March 2003

AbstractCongenital megalourethra is a rare disorder characterized by the congenital absence of the corpus spongiosum and/or corpus cavernosum, leading to dilatation of the urethra. We present a case of congenital megalourethra diagnosed by ultrasound examination at 13 weeks of gestation. Transabdominal and transvaginal sonography showed gross megacystis, bilateral hydronephrosis and a cystic dilatation of the penis. Transabdominal needle embryoscopy confirmed a balloon dilatation of the fetal penis. The pregnancy was terminated by suction curettage. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology