bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural history of trisomy 21 fetuses with increased nuchal translucency thickness
Authors: Pandya P. P. , Snijders R. J. M. , Johnson S. , Nicolaides K. H. 
Published: March 2003

AbstractIncreased fetal nuchal translucency thickness at 10–14 weeks of gestation can identify 80% of trisomy 21 pregnancies. However, a potential disadvantage of screening in the first trimester of pregnancy is that earlier screening preferentially identifies those chromosomally abnormal pregnancies that are destined to miscarry. In this study, we report on the outcome of six fetuses with increased nuchal translucency thickness and trisomy 21 whose parents chose to continue with the pregnancy. During the second trimester, the nuchal translucency resolved in five of the cases and in one it evolved into nuchal edema. Therefore, resolution of translucency with advancing gestation is not indicative of a normal karyotype. All pregnancies resulted in live births, suggesting that increased nuchal translucency does not necessarily identify those trisomic fetuses that are destined to die in utero. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Diagnosis of fetal anemia with Doppler ultrasound in the pregnancy complicated by maternal blood group immunization
Authors: Mari G. , Adrignolo A. , Abuhamad A. Z. , Pirhonen J. , Jones D. C. , Ludomirsky A. , Copel J. A. 
Published: March 2003

AbstractWe investigated whether Doppler measurement of the fetal middle cerebral artery peak systolic velocity can be used to detect fetal anemia in pregnancies complicated by maternal blood group immunization. We first studied normal values for the middle cerebral artery peak systolic velocity in 135 fetuses (Group A), and also in 23 fetuses at risk for anemia who underwent 56 cordocenteses to assess the fetal hematocrit (Group B). A test to detect fetal anemia, based on the middle cerebral artery peak systolic velocity, was developed by using the data of the fetuses of Group A and Group B. Successively, the middle cerebral artery peak systolic velocity was prospectively determined in 16 fetuses at risk for anemia who underwent 42 cordocenteses (Group C) to assess the test developed, in a multicenter prospective fashion, by using the data of Group A and Group B.In the normal fetuses an exponential model expressed the increase of the middle cerebral artery peak systolic velocity values with advancing gestation. By using the data of the fetuses of Group A and Group B, four zones of anemia risk were identified. In Group C, none of the anemic fetuses had the middle cerebral artery peak velocity below the normal mean value, whereas all of the anemic fetuses had the peak velocity above the normal mean.The middle cerebral artery blood velocity increases with advancing gestation and is a non‐invasive method of detecting anemia in pregnancies complicated by maternal blood group immunization. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
An adjustable fetal weight standard
Authors: Gardosi J. , Mongelli M. , Wilcox M. , Chang A. 
Published: March 2003

AbstractThe monitoring of fetal weight is an important aspect of antenatal care. To construct an individually adjustable standard, we developed a model to link the predicted birth weight to a fetal weight curve which outlines how this weight is to be reached in an uncomplicated pregnancy. A formula was derived which describes the median fetal weight at each gestation as a proportion of the optimal term weight, and also defines the 90th and 10th centile curves as normal limits.We analyzed a birth weight database of 38 114 singleton, routine ultrasound‐dated pregnancies resulting in term deliveries. By stepwise multiple regression analysis, we derived coefficients for the factors that act as variables on term birth weight in our population. Apart from gestational age and sex, the maternal height, weight at first visit, ethnic group, parity and smoking all have significant and independent effects on birth weight. The variation due to ethnic group appears to be physiological in this population. Smoking is associated with a reduction in birth weight, which is independent of maternal physique and related to the number of cigarettes per day as reported at the first visit.We have developed a software program which calculates, on the basis of pregnancy variables entered at the first visit, an adjusted normal range for fetal size. This can be printed out as a chart and used for antenatal surveillance of growth. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal sonographic diagnosis of a vein of Galen aneurysm: relevance of associated malformations for timing and mode of delivery
Authors: Dören M. , Tercanli S. , Holzgreve W. 
Published: March 2003

AbstractThe term ‘aneurysm of the vein of Galen’ encompasses a range of different midline arteriovenous fistula malformations. Prenatal real‐time and Doppler sonography can contribute to the differential diagnosis of fetal cerebral cystic lesions of various origins, pineal and choroid tumors, and in tracerebral hematoma. Regardless of the type of treatment, perinatal morbidity and mortality are high, often due to cardiac failure. A case of spontaneous delivery at 36 weeks of gestation by a 30‐year‐old woman presenting with a fetal aneurysm of the vein of Galen is described. As the extrauterine cardiac function was normal and a steal phenomenon was not present, expectant management was justified. Five arterial embolizations within the following 4 years were performed as a means of treating the primary lesion. Our case illustrates the fact that elective spontaneous vaginal delivery followed by serial embolization is possible in cases of arteriovenous fistula malformation without signs of cardiac insufficiency. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Fetal lateral neck cysts: early second‐trimester transvaginal diagnosis, natural history and clinical significance
Authors: Achiron R. , Yagel S. , Weissmann A. , Lipitz S. , Mashiach S. , Goldman B. 
Published: March 2003

AbstractThe objective of the study was to explore the natural history and clinical significance of lateral neck cysts during the early second trimester of pregnancy. A survey was conducted of pregnant women at 12–15 weeks' gestation who presented at the ultrasonographic unit between January 1991 and December 1994. During the 4‐year period, of the 1500 fetuses scanned, 42 fetuses with lateral neck cysts were detected by high‐resolution transvaginal ultrasonography. Twenty‐six of the 42 fetuses were seen to have isolated lateral neck cysts, and 16 demonstrated a combination of nuchal thickness of ≥ 4 mm and lateral neck cysts. Natural history, fetal karyotype and pregnancy outcome were compared between these two groups. None of the fetuses with isolated neck cysts had an abnormal karyotype, and all cysts resolved spontaneously at 16–20 weeks. No congenital abnormalities were found among the 26 cases. Four chromosomal abnormalities (three trisomy 21 and one monosomy XO) were detected among the 16 fetuses with combined lesions, resulting in termination of pregnancy in all. Among the remaining 12 fetuses, spontaneous resolution of the neck findings occurred between 16 and 20 weeks' gestation. The finding of isolated lateral neck cysts in the early second trimester is not associated with increased risk of aneuploidy. However, the combination with nuchal thickness of ≥ 4 mm should prompt genetic counselling and consideration of karyotyping, since this delay in maturation of the cervical jugular lymphatic communication may be associated with chromosomal aberrations. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Sonographic size of uterus and ovaries in pre‐ and postmenopausal women
Authors: Merz E. , Miric‐Tesanic D. , Bahlmann F. , Weber G. , Wellek S. 
Published: March 2003

AbstractUterine and ovarian size were measured in 765 pre‐ and postmenopausal women by transvaginal ultrasound. Of these, 263 (premenopausal, n = 155; postmenopausal, n = 108) were found to have neither uterine nor ovarian pathological findings. According to parity, premenopausal women were separated into three groups: nullipara, primipara and multipara. Postmenopausal women were separated into two groups according to years since menopause: ≤ 5 years and > 5 years since menopause.In the premenopausal group, a parity‐related enlargement in uterine size was observed between nulliparous and parous women. After the menopause, a significant reduction in uterine size and in the corpus‐cervix ratio was observed. The reduction in uterine size was related to years since menopause. The endometrial thickness measured in the group of premenopausal women did not exceed 4 mm on day 4 and 8 mm on day 8 of the menstrual cycle; in the postmenopausal group, endometrial thickness did not exceed 5 mm (mean 3.6 mm).In the group of premenopausal women, no parity‐related change in ovarian volume was observed. After menopause, there was an obvious reduction in ovarian volume. Between the two postmenopausal groups, there was a small but significant difference in ovarian volume. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal sonographic tubal patency testing using air and saline solution as contrast media in a routine infertility clinic setting
Authors: Volpi E. , Zuccaro G. , Patriarca A. , Rustichelli S. , Sismondi P. 
Published: March 2003

AbstractTubal patency testing by transvaginal sonography has been implemented in our infertility clinic since 1991. We report our experience with this technique during the last year of routine outpatient activity. A total of 154 infertile patients, including three patients on two occasions, underwent tubal patency testing by transvaginal sonography; 36 also underwent laparoscopy or hysterosalpingography, with a further three undergoing both. A detailed account of the method used to visualize the passage of air and saline through the salpinx is described. The ‘gold standard’ for tubal patency was laparoscopy. In any cases that were doubtful or if there was tubal occlusion, laparoscopy was advised.The diagnoses by transvaginal sonography in the 154 patients consisted of: 106 with bilateral tubal patency (68.8%), 34 with unilateral tubal occlusions (22.1%), and 13 with bilateral occlusion (8.4%); one case was undiagnosed. Tubal disease was present in 2.5 out of the 36 (69.4%) patients undergoing laparoscopy or hysterosalpingography (69.4 %). The sensitivity, specificity, accuracy, positive and negative predictive values were respectively 80, 85, 82.7, 85 and 80% for the 29 patients undergoing transvaginal sonography and laparoscopy. When the number of tubes examined was considered, these values were respectively 85, 91.6, 89.3, 85 and 91.6%. No discordance was observed in the ten patients undergoing hysterosalpingography.Demonstration of the tubal course relies on a positive contrast medium filling the tubal lumen. Air and saline were successful for this purpose. In our study, the results of tubal patency testing by transvaginal sonography were very similar to those of hysterosalpingography, but differed in about 10% of the cases from those of laparoscopy. The most difficult problem to rule out was distal tubal occlusion without hydrosalpinx. Tubal patency testing by transvaginal sonography can be used safely as a first‐step examination of tubal patency. Easy tubal passage can allow medical treatment, while a doubtful or frankly occluded salpinx should be investigated by laparoscopy. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
The lambda sign at 10–14 weeks of gestation as a predictor of chorionicity in twin pregnancies
Authors: Sepulveda W. , Sebire N. J. , Hughes K. , Odibo A. , Nicolaides K. H. 
Published: March 2003

AbstractChorionicity was prospectively determined in 369 twin pregnancies by ultrasound at 10–14 weeks of gestation. Pregnancies were classified as monochorionic if there was a single placental mass in the absence of the lambda sign at the inter‐twin membrane‐placental junction, and dichorionic if there was a single placental mass but the lambda sign was present, or the placentas were not adjacent to each other. In 81 (22%) cases, the pregnancies were classified as monochorionic and in 288 (78%) as dichorionic. Pregnancy outcome was available in 279 cases and all 63 of these pregnancies classified as monochorionic resulted in the delivery of same‐sex twins. Similarly, all 100 different‐sex pairs were correctly classified as dichorionic. These findings demonstrate the high reliability of ultrasound examination at 10–14 weeks of gestation in determining chorionicity in twin pregnancies. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
In utero diagnosis of infra‐diaphragmatic total anomalous pulmonary venous return
Authors: Wessels M. W. , Frohn‐Mulder I. M. E. , Cromme‐Dijkhuis A. H. , Wladimiroff J. W. 
Published: March 2003

AbstractThis report describes the diagnosis of infra‐diaphragmatic total anomalous pulmonary venous return in a fetus at 25 weeks of gestation. Abnormal venous pathways were visualized with real‐time, pulsed and color Doppler ultrasound. The growth of cardiac structures, especially the left ventricle, was evaluated during subsequent ultrasound examinations. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Conotruncal anomalies in prenatal life
Authors: Paladini D. , Rustico M. , Todros T. , Palmieri S. , Gaglioti P. , Benettoni A. , Russo M. G. , Chiappa E. , D'Ottavio G. 
Published: March 2003

AbstractThis retrospective multicenter study represents an analysis of the intrauterine determinants of the prognosis for conotruncal anomalies. Data regarding reason for referral, presence of chromosomal or extracardiac anomalies, pregnancy and surgical outcome were recorded in 67 cases of conotruncal anomalies from three Italian referral units.Chromosomal aberrations affected 11 of the 60 (18.3%) fetuses in which a karyotype was available. Extracardiac malformations were present in 25/67 cases (37.3%). No chromosomal anomalies were present in fetuses with complete or corrected transposition of the great arteries. However, tetralogy of Fallot and double‐outlet right ventricle were associated with chromosomal anomalies in 22% and 38% of cases, respectively, and with extracardiac anomalies in 45% and 46% of cases, respectively. Only 20 of the 67 (31%) cardiac malformations were associated with an abnormal four‐chamber view. There were 28 (41.7%) terminations of pregnancy, six (8.9%) intrauterine deaths and 16 (23.8%) neonatal deaths. Seventeen neonates (25.3 %) are currently alive, and 15 of these have undergone reparative surgery.The prognosis of conotruncal anomalies is poorer when the condition is diagnosed in utero. This is mainly due to the frequent association with chromosomal and/or extracardiac anomalies, often leading to intrauterine or early neonatal death. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Atresia or absence of the left‐sided atrioventricular connection in the fetus: echocardiographic diagnosis and outcome
Authors: Allan L. D. , Anderson R. H. , Cook A. C. 
Published: March 2003

AbstractOur objective was to describe the appearance of atresia of the left‐sided atrioventricular valve on the four‐chamber view of the fetal heart. Twenty‐four cases of atresia of the left‐sided atrioventricular connection were detected over a 2 year period. Cases were analyzed according to the appearance of the four‐chamber view and the connections of the great arteries.All cases were referred because the left‐sided ventricle was smaller than the right. There were five different groups of cardiac anomaly detected. Associated findings varied according to the diagnostic group.It was concluded that it is possible to identify atresia of the left‐sided atrioventricular connection accurately during obstetric ultrasound examination by evaluation of the four‐chamber view. However, the appearance of this view varies with the diagnosis. Each diagnostic group has different implications in terms of associated extracardiac malformations and postnatal management. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Doppler ultrasonography in suspected intrauterine growth retardation: a randomized clinical trial
Authors: Nienhuis S. J. , Vles J. S. H. , Gerver W. J. M. , Hoogland H. J. 
Published: March 2003

AbstractA randomized clinical trial was performed to test the hypothesis that if suspected intrauterine growth retardation (IUGR) is associated with normal umbilical artery Doppler ultrasound findings, hospitalization can safely be avoided.One hundred and fifty women with singleton pregnancies and suspected IUGR were randomized between an intervention (n = 74) and a control group (n = 76). In the intervention group, clinicians were strongly requested not to hospitalize for suspected IUGR if the Doppler findings were normal. ln the control group, the Doppler results were not revealed and the participants received the standard management for suspected IUGR. Endpoints of the trial were: costs in terms of hospitalization, perinatal outcome, neurological development, and postnatal growth.Duration of hospitalization was significantly shorter in the intervention group than in the control group. Contrary to expectations, the hospitalization rate during pregnancy in the intervention group was not below that of the control group. This negative finding was partly due to the admission of patient in the intervention group despite their normal Doppler results. Moreover, the trial might have induced a more critical attitude towards hospitalization in suspected IUGR, decreasing admission in the control group. No clear differences were found in perinatal outcome, neurological development, or postnatal growth.The results suggest that normal umbilical artery Doppler findings in suspected cases of IUGR justify outpatient management. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Ductus arteriosus‐dependent pulmonary circulation secondary to cardiac malformations in fetal life
Authors: Mielke G. , Steil E. , Kendziorra H. , Goelz R. 
Published: March 2003

AbstractThe objective of this study was to describe the characteristic prenatal findings of a ductus arteriosus‐dependent pulmonary circulation secondary to cardiac malformations. B‐mode, color and pulsed wave Doppler echocardiography were performed in seven fetuses with severe pulmonary stenosis or atresia. All findings were confirmed postnatally by echocardiography and cardiac catheterization or autopsy.Severe fetal pulmonary stenosis or atresia was characterized by decreased pulmonary valve diameters, frequently with reduced pulmonary artery diameters, increased flow velocities or absent flow across the stenotic pulmonary valve, increased ascending aorta diameters, slightly increased aortic velocities and normal umbilical and middle cerebral artery Doppler wave forms. 112 all cases, prenatal assessment of neonatal ductus dependence was possible by demonstrating reverse flow across the fetal ductus with peak systolic velocities ranging from 0.9–2.0 m/s and absent diastolic flow. Ductal diameters were slightly decreased, ranging from 2–4 mm.Prenatal detection of a ductus‐dependent pulmonary circulation is a strong indication of the presence of severe pulmonary stenosis or atresia. Its diagnosis allows avoidance of maternal administration of drugs with constrictive effects upon the ductus, interdisciplinary planning of perinatal management, early postnatal confirmation of the diagnosis, and early postnatal intervention, in particular administration of prostaglandins to prevent life‐threatening ductal closure. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Comparison of long‐term psychological responses of women after pregnancy termination due to fetal anomalies and after perinatal loss
Authors: Salvesen K. Å. , Øyen L. , Schmidt N. , Malt U. F. , Eik‐Nes S. H. 
Published: March 2003

AbstractThe objective of the study was to compare psychological responses of women following a pregnancy termination due to ultrasound‐detected fetal anomalies (ultrasound group) with the psychological responses of women following a late spontaneous abortion or a perinatal death (perinatal loss group). The assessments, which were performed on four occasions in the year after the life event, included Montgomery and Asberg Depression Rating Scale, Goldberg General Health Questionnaire, Impact of Event Scale, State‐Trait Anxiety Inventory and Schedule for Recent Life Events. In the acute phase, a few days after the life event, the women in the ultrasound group reported statistically significantly less depressive symptoms and less intrusion and avoidance symptoms than the perinatal loss group. No differences in psychological responses in the two groups were found at the examinations at approximately 7 weeks, 5 months or 1 year. A statistically significantly higher proportion of women in the ultrasound group reported that they had tried to become pregnant in the following year. A few subjects in each group reported persisting high psychological distress throughout the year, but only one woman fulfilled the criteria of a post‐traumatic stress disorder. It is concluded that the long‐term psychological stress response in women to pregnancy termination following ultrasonographic detection of fetal anomalies does not differ from the stress responses seen in women experiencing a perinatal loss. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Application of transvaginal and abdominal three‐dimensional ultrasound for the detection or exclusion of malformations of the fetal face
Authors: Merz E. , Weber G. , Bahlmann F. , Miric‐Tesanic D. 
Published: March 2003

AbstractIn a total of 618 pregnant women between 9 and 37 weeks' gestation, the fetal face was evaluated by two‐dimensional and three‐dimensional ultrasound imaging as part of a level III screening evaluation for fetal anomalies. A three‐dimensional endovaginal probe (5 MHz) was used for examinations at between 9 and 15 weeks, and an abdominal three‐dimensional probe (3.5 MHz) was used after 15 weeks. Three different three‐dimensional image display modes were employed: (1) the orthogonal display; (2) the surface display; and (3) the transparent display.When we studied the three‐dimensional orthogonal displays in 125 cases evaluated by abdominal ultrasound, we found that the facial profile shown in the two‐dimensional image represented the true mid‐sagittal profile in only 69.6% of cases. In the remaining 30.4%, the profile view deviated from a true mid‐sagittal section by up to 20° in one or two planes.In a total of 25 facial anomalies detected by abdominal ultrasound, 20 were clearly demonstrated by both two‐dimensional and three‐dimensional technology. In the remaining five cases, three‐dimensional ultrasound revealed or confirmed an additional defect or abnormality: a narrow cleft lip in an unfavorable position of the fetal face (n = 2), a unilateral orbital hypoplasia (n = 1), a cranial ossification defect (n = 1) and a flat profile in the presence of marked oligohydramnios (n = 1).When transvaginal scanning was used, there were cases in which a detailed surface image of the fetal face could be obtained as early as 9 weeks' gestation. Abdominal scanning routinely yielded high‐quality surface images by 20 weeks. Three‐dimensional ultrasound consistently displayed facial abnormalities with greater accuracy and clarity than conventional two‐dimensional imaging. This particularly applied to chromosomal aberrations and syndromes associated with subtle facial abnormalities requiring a detailed evaluation.Not only does three‐dimensional ultrasound help in appreciating the severity of a fetal defect, but it can also provide more convincing evidence of a normal fetus than conventional two‐dimensional sonograms. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology