bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost‐effectiveness of one‐stage ultrasound screening in pregnancy: a report from the Helsinki ultrasound trial
Authors: Leivo T. , Tuominen R. , Saari‐Kemppainen A. , Ylöstalo P. , Karjalainen O. , Heinonen O. P. 
Published: March 2003

AbstractThe objective of this study was to evaluate, in a controlled clinical trial, the costs of standardized one‐stage ultrasound screening in pregnancy in relation to the reduction in perinatal mortality. A trial population of 9310 pregnant women was randomly allocated to ultrasound screening or a control group. Two obstetric hospitals and 64 recruiting antenatal health centers were involved. The costs included actually realized costs, i.e. positive costs, and gains, i.e. negative costs, resulting from lower health‐care use. Cost‐accounting data were obtained by a questionnaire to all attenders and measurements at the screening, and later complemented by a questionnaire to a random sample of 534 screened women. Internal accounting and other hospital data, national statistics and health‐market sources were also used. The actually realized cost of each avoided perinatal death was FIM 84 378 ($21 938), while the net over‐all estimate combining all positive and negative costs showed a cost saving of FIM 65 680 ($17 077). The total positive unit cost of ultrasound screening was FIM 393 ($102). Longer ultrasound examination time and more numerous advanced examinations were rewarded by clearly fewer perinatal deaths and a better cost‐effectiveness ratio. One‐stage second‐trimester ultrasound screening is cost‐effective when all significant costs and effects are taken into account. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasound‐guided transcervical resection of uterine septa: 7 years' experience
Authors: Ohl J. , Bettahar‐Lebugle K. 
Published: March 2003

AbstractThis study evaluates the performance in our center of Querleu's transcervical resection of uterine septa. The procedure uses cold scissors under ultrasonographic guidance. Ninety‐three patients were treated during a 7‐year period. Follow‐up examination in patients having an obstetric history prior to resection, excluding those suffering from infertility, showed a decrease in premature deliveries (9.4% vs. 13%) and miscarriages (24.5% vs. 78%), and a dramatic increase in term deliveries (62.3% vs. 5.7%). The anatomical and functional results, as well as the complication rate, were similar to those observed following hysteroscopic metroplasty. The advantages of an ultra‐sound‐guided approach are the easy estimation of fundus thickness, the potential of resection regardless of the stage of the menstrual cycle and avoidance of costly equipment. For these reasons we have adopted it as our standard procedure. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Management of non‐immune hydrops: 8 years' experience
Authors: Anandakumar C. , Biswas A. , Wong Y. C. , Chia D. , Annapoorna V. , Arulkumaran S. , Ratnam S. 
Published: March 2003

AbstractDuring a period of 8 years (1985–92), 100 fetuses were diagnosed to have non‐immune hydrops on the basis of ultrasonographic findings and absence of rhesus isoimmunization. Both the mother and the fetus were thoroughly evaluated by a set protocol that included a detailed fetal abnormality scan with echocardiography and fetal blood sampling. A cause for non‐immune hydrops could be identified in 81% of the fetuses. Cardiovascular abnormalities (23%) and α1‐thalassemia (22%) were almost equally common etiological factors in the South‐East Asian population under investigation. A chromosomal abnormality was detected in 10% of the fetuses with non‐immune hydrops. Twenty‐six fetuses were found to be suitable for in utero therapy. In utero therapy included one or more of the following: (1) fetal intravascular blood transfusion; (2) direct fetal drug therapy; and (3) fetal pleuroamniotic shunting. Eighteen of the 26 babies (69.2%) were alive and well at 1 month after delivery. It is concluded that in well‐selected cases appropriate in utero fetal therapy can lead to significant improvement in fetal salvage. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Doppler velocimetry of intraplacental fetal vessels in the second trimester: improving the prediction of pregnancy complications in high‐risk patients
Authors: Jaffe R. , Woods J. R. 
Published: March 2003

AbstractThe purpose of our study was to assess the value of fetal intraplacental velocimetry in predicting adverse pregnancy outcome in high‐risk patients. Thirty‐two women with pregnancies of 22 to 25 weeks' gestation were evaluated. They had demonstrated abnormal first‐trimester Doppler characteristics, yet had normal second‐trimester umbilical artery velocimetry. Doppler waveforms were obtained and the ratio between intraplacental and umbilical artery resistance indices was calculated.Abnormally high ratios of intraplacental to umbilical artery resistance indices were associated with a significantly higher incidence of pregnancy complications. Among women with abnormal ratios, 17 (80%) of 21 pregnancies had later complications, whereas among those with normal ratios, only two (18%) of 11 women experienced later complications.This study demonstrates that analysis of the ratio between intraplacental and umbilical artery resistance indices in the second trimester improves the diagnostic value of Doppler velocimetry in pregnancies at risk for later obstetric complications. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal ultrasonography for all placentas that appear to be low‐lying or over the internal cervical os
Authors: Smith R. S. , Lauria M. R. , Comstock C. H. , Treadwell M. C. , Kirk J. S. , Lee W. , Bottoms S. F. 
Published: March 2003

AbstractThe purpose of this study was to determine in what percentage of cases the assessment of placental localization using transabdominal sonography (TAS) was changed after transvaginal sonography (TVS) was applied. TVS was prospectively performed on all pregnant women of at least 1.5 weeks' gestation, when the placental edge using TAS appeared to be over or within 2 cm (low‐lying) of the internal cervical OS. The time required for the TVS scan and the distance of the placental edge from the maternal cervical OS were recorded. Of the 168 patients entered into the study, 131 were analyzed. Landmarks were poorly seen in 5O% of the cases when using TAS. In 66 cases, the placenta appeared low or possibly over the internal cervical os using TAS, but a definitive diagnosis could not be made due to suboptimal visualization. In the remaining 6.5 cases, visualization of the internal os and placental edge was possible using both TAS and TVS. In this group, there was a change in the diagnosis in 26% of the cases after TVS was performed. Our results suggest that optimal visualization of the placental edge and internal cervical os is usually difficult with TAS when the placenta appears low‐lying or over the internal cervical os. The assessment of placental localization was changed in over one‐quarter of cases (26%) after transvaginal sonography was performed. The use of transvaginal ultrasound should be seriously considered when the placenta appears to be low or over the internal cervical os by transabdominal ultrasound. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Luteal phase defect: comparison between Doppler velocimetry, histological and hormonal markers
Authors: Kupešić S. , Kurjak A. , Vujisić S. , Petrović Z 
Published: March 2003

AbstractThe aim of this prospective study was to investigate the relationship between the ultrasonographic appearance of the endometrium, histological dating by biopsy, hormonal profile and impedance within the segmental uterine and ovarian circulation for assessment of luteal phase function. A total of 61 infertile patients undergoing endometrial biopsy were studied by transvaginal B‐mode and color and pulsed Doppler ultrasound. Uterine, radial, spiral, ovarian and intraovarian artery impedance throughout the natural ovarian cycle were related to histological and hormonal markers of uterine receptivity. Plasma levels of follicle stimulating hormone, luteinizing hormone (LH) and estradiol were measured on cycle days 5 and 10 and measurements were continued daily until the detection of the LH surge. Endometrial biopsy was performed 7 days after ultrasonically and hormonally detected ovulation. Progesterone levels were evaluated on the day of endometrial biopsy and 3 days later. After all the data were collected, the patients were divided into two groups, according to the histopathology: 15 patients with normal endometrial dating and 43 patients with a delayed endometrial pattern (i.e. luteal phase defect). One patient with an asynchronous endometrium and two anovulatory subjects were excluded from further evaluation.A significant difference between patients with a luteal phase defect and the control group was obtained for impedance in the uterine (p < 0.05), radial (p < 0.05), spiral (p < 0.00l), ovarian (p < 0.05) and intraovarian arteries (p < 0.001) during the luteal phase. The endometrium showed secretory transformation when serum levels of progesterone were higher than 15 ng/ml.Segmental uterine and ovarian artery perfusion demonstrates a significant correlation with histological and hormonal markers of uterine receptivity. Therefore, blood flow impedance in the corpus luteum and spiral arteries may aid in assessing luteal phase adequacy. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
The effect of nuchal translucency measurement on second‐trimester biochemical screening for Down's syndrome
Authors: Kadir R. A. , Economides D. L. 
Published: March 2003

AbstractIn this study we examined the effect of introducing first‐trimester nuchal translucency measurement on the second‐trimester maternal serum screening for trisomy 21. The detection rate, false‐positive rate, likelihood ratio and positive predictive value of the double marker test before and after introduction of nuchal translucency measurement were determined. The detection rate of nuchal translucency screening for trisomy 21 was 83% (5/6) with a 1.3% false‐positive rate, a 63.8 likelihood ratio and a positive predictive value of 22.7%. After the introduction of nuchal translucency measurement, the likelihood ratio for a positive result and positive predictive value of the biochemical screening decreased from 9.1 to 5 and 2.7% to 0.45%, respectively. Our results show that nuchal translucency measurement is not only an effective method of first‐trimester screening for Down's syndrome but also has implications for the likelihood ratio and positive predictive value of second‐trimester biochemical screening. Since the biochemical test is now applied to a population with a decreased risk of trisomy 21, a positive test will be less likely to indicate Down's syndrome than when nuchal translucency measurement was not applied. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Comparison of prenatal ultrasound and postmortem findings in fetuses and infants with central nervous system anomalies
Authors: Isaksen C. V. , Eik‐Nes S. H. , Blaas H.‐G. , Torp S. H. 
Published: March 2003

AbstractDetection of fetal developmental abnormalities by ultrasound examination of pregnant women has become a specialized field of medicine. Quality control of this field requires detailed examination of aborted fetuses. In 408 fetuses and infants with developmental anomalies, the prenatal ultrasound findings were compared with the postmortem findings. This study focused on 140 central nervous system (CNS) anomalies. Criteria for inclusion were an ultrasound examination at the National Center for Fetal Medicine (NCFM) and an autopsy performed during the period 1985–94. Results of the ultrasound and autopsy examinations were systematized into six different categories.Hydrocephaly and anencephaly were the most frequent abnormalities, together accounting for 50% of the CNS anomalies. In 20 cases (14%), the CNS anomalies were associated with other important anomalies or chromosomal aberrations. In 125 of the cases (89%), there was complete concordance between the ultrasound and autopsy diagnoses. Of the 15 CNS cases with discrepancies, seven had nearly complete concordance; if we include these, the correlation was 94%.In conclusion, this study confirms that developmental anomalies in the central nervous system are frequent and that ultrasound diagnoses are in good concordance with the autopsy diagnoses. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Variation of embryonic/fetal heart rate at 6–13 weeks' gestation
Authors: Montenegro N. , Ramos C. , Matias A. , Barros H. 
Published: March 2003

AbstractThe aim of this study was to investigate changes in heart rate, namely the intraindividual variation, in normal embryos/fetuses between 6 and 13 weeks' gestation. A prospective study was performed of 41 singleton pregnancies undergoing routine ultrasound examination during the first trimester of pregnancy. For each case, the embryonic/fetal heart rate was measured on three consecutive occasions with a mean interval of 4 min.The difference in heart rate values between the serial measurements varied from 0 to 18 beats/min and was significantly associated with gestational age (Spearman r = 0.26, p < 0.01). In the group of 15 fetuses (examined before 10 weeks' gestation), the difference between measurements (median = 0 beats/min, range 0–8 beats/min) was significantly lower (z = 2.48, p < 0.05) than in fetuses assessed after 10 weeks of gestation (median = 3, range 0–18 beats/min).Reliable and reproducible information concerning embryonic/fetal heart rate may be obtained from a single measurement, especially when pregnancies are examined before 10 weeks of gestation. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Perinatal outcome and prognostic factors in prenatally diagnosed congenital diaphragmatic hernia
Authors: Geary M. P. , Chitty L. S. , Morrison J. J. , Wright V. , Pierro A. , Rodeck C. H. 
Published: March 2003

AbstractObjectiveThe purpose of this study was to assess perinatal outcome in cases of prenatally diagnosed congenital diaphragmatic hernia and identify the prognostic value of various prenatal factors.DesignRetrospective review of fetal medicine, obstetric and histopathology records in all 34 cases of congenital diaphragmatic hernia identified prenatally between 1992 and 1996 at a tertiary referral fetal medicine unit.ResultsOverall survival was 18%. None of those with bilateral (0/1) or right‐sided (0/5) congenital diaphragmatic hernia survived, whereas 21% (6/28) of those with left‐sided hernias survived. Prenatal karyotyping was performed in 71% (n = 24) and five chromosomal abnormalities were identified. The pregnancy was terminated in 15 cases (44%). In the 19 continuing pregnancies, the survival rate was 32% (6/19). In those with an isolated congenital diaphragmatic hernia, the survival rate was 38% (5/13), and in those in which the hernia was isolated and left‐sided, the survival rate was 56% (5/9). In ongoing pregnancies diagnosed after 24 weeks, the survival rate was 33% (2/6) compared with 31% (4/13) in pregnancies diagnosed at ≤ 24 weeks. Of those infants who had surgical repair, six out of seven (86%) survived.ConclusionsThese data clearly demonstrate an improved prognosis in fetuses with an isolated left‐sided congenital diaphragmatic hernia. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Neurological morbidity after fetal supraventricular tachyarrhythmia
Authors: Schade R. P. , Stoutenbeek P. , de Vries L. S. , Meijboom E. J. 
Published: March 2003

AbstractBackgroundFetal tachyarrhythmia is a well‐documented entity which, in the absence of pharmacological intervention, may lead to congestive heart failure, fetal hydrops and eventually fetal demise. The success rate of the implemented treatment is generally measured by survival and achievement of control of the arrhythmia. We report on the occurrence of associated cerebral damage in three patients with fetal tachycardia.MethodsWe describe three patients with a history of fetal supraventricular tachyarrhythmia who developed cerebral complications.ResultsTwo patients had cerebral hypoxic‐ischemic lesions and one had hemorrhagic lesions present at birth. They had developed severe congestive heart failure and fetal hydrops secondary to fetal tachyarrhythmia, and there were no other obvious causes for the cerebral pathology. Two of these patients were referred to us antenatally. Therapy was instituted and resulted in control of the tachycardia and resolution of hydrops. The third patient was referred to our clinic shortly after birth because of severe circulatory problems secondary to fetal tachyarrhythmia.ConclusionFrom these observations, we believe that a fetus with tachyarrhythmia and subsequent hydrops is at increased risk for the development of cerebral complications, due to the circulatory disturbances and sudden changes in heart rate which may lead to fluctuations in cerebral perfusion. This would imply that it is of the utmost importance to aim at immediate and complete control of the heart rate in the treatment of fetal tachyarrhythmia. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Assessment of endometrial receptivity for gestation in patients undergoing in vitro fertilization, using endometrial thickness and the endometrium‐myometrium relative echogenicity coefficient
Authors: Leibovitz Z. , Grinin V. , Rabia R. , Degani S. , Shapiro I. , Tal J. , Eibschitz I. , Harari O. , Paltieli Y. , Aharoni A. , Zeevi J. , Ohel G. 
Published: March 2003

AbstractObjectiveTo evaluate the outcome of fertilization(IVF) treatment in relation to the sonographic parameters of the endometrium.Design and methodsSeventy‐five patients with no uterine pathology (age 31.1±5.4 years) treated in our IVF clinic for various indications were assessed during 75 cycles in which good‐quality (grades 1 and 2) embryos were transferred. Controlled ovarian stimulation was achieved by the long protocol (gonadotropin releasing hormone agonist and gonadotropins). The bilayered endometrial thickness (BET), estradiol, luteinizing hormone and progesterone serum levels were measured in 272 tests. A special computer program was used to measure endometrial echogenicity relative to myometrial echogenicity. The gray‐level data were analyzed on the basis of the midsagittal sonographic uterine image. Endometrium‐myometrium relative echogenicity coefficient (E/M REC) values were computed and displayed graphically along the anteroposterior axis of the endometrial layers in the upper part of the uterine cavity. The area under the E/M REC curve within the BET limits was defined as the relative echogenicity area (REA) and was used as a measure of endometrial echogenicity. Each cycle was sampled in six time segments representing desensitization, follicular and luteal phases. Assigning the day of ovum pick‐up as day 0, the time segments of each cycle were: first, day −20 to day −11; second, day −10 to day −6; third, day −5 to day −2; fourth, day 0; fifth, day +7 to day +14; sixth, day +15 to day +21.ResultsA total of 276 embryos were transferred (3.68 ±1.01 per cycle), of which 223 were of good quality (2.97 ±1.51 per cycle). An intrauterine pregnancy was diagnosed in 29 patients. All patients in this study had a BET of > 5 mm in the third and the fourth time segments. There was no significant difference in BET and REA between pregnant and non‐pregnant patients tested in the first to the fifth time segments of the IVF cycles. Both BET and REA measured in the sixth time segment were significantly higher in pregnant compared to non‐pregnant patients.ConclusionsOur results suggest that the proposed sonographic assessment of the endometrium shows no benefit in characterization of uterine receptivity in IVF patients with a reactive endometrium. High BET and REA values can indicate pregnancy during the sixth time segment, when the decidualization of the endometrium is well established. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of interrupted inferior vena cava as an isolated finding: a benign vascular malformation
Authors: Celentano C. , Malinger G. , Rotmensch S. , Gerboni S. , Wolman Y. , Glezerman M. 
Published: March 2003

AbstractWe report two cases of interrupted inferior vena cava with azygous continuation diagnosed as an isolated finding during routine prenatal scans. Visualization of the venous vasculature of the abdomen and thorax in the mid‐sagittal plane failed to visualize the segment of the inferior vena cava between the kidneys and the liver. A vessel with venous flow was observed parallel, adjacent and posterior to the aorta between the kidney and the right atrium. This blood vessel connected with the superior vena cava. Axial planes of the thorax confirmed the presence of two vessels running paravertebrally. A detailed ultrasound examination of the fetal anatomy failed to demonstrate other anomalies. The neonatal course of both fetuses was uneventful. Isolated interruption of the inferior vena cava can be a vascular malformation without known pathological consequences. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology