bluuebunny/crossref_metadata_2025_split huggingface dataset:
WS03‐09Unilateral early timed vaginal ultrasound guided follicular aspiration (ETFA) 10–12 h after hCG prevents the syndrome of serious ovarian hyperstimulation
Authors: Tomazevič T. , Meden‐Vrtovec H. , Geršak K. , Bokal E. 
Published: March 2003

AimTo prevent the syndrome of severe ovarian hyperstimulation in IVF/ET cycles at high risk for the syndome of ovarian hyperstimulation by early timed unilateral ultrasound guided aspiration of one ovary (12 h after hCG).Method.We evaluated the preventive effect of ETFA by analysing the data on 821 cycles at high risk for SOHSS performed during the years 1987–99. In all cycles the high risk for SOHSS was defined by the estradiol values > 3000 pg/ml and more than 8 follicles > 14 mm plus intermediate and small follicles in each ovary on ultrasound.ResultsIn the group of :729 female infertility cycles at high risk for SOHSS with preventive ETFA there were no cases of SOHSS. In the control group of 92 IVF/ET female infertility without ETFA there were 12 cases of SOHSS (P < 0.0001). No difference in live birth rate (17% vs. 16%) was noted. The results prove the preventive effect of ETFA. It is based on early timed withdrawal of paracine substances which are present in the follicular fluid.ConclusionThe vaginal ultrasound guided ETFA is another successful option to decrease the incidence of severe OHSS in assisted reproduction.
WS04: Menopausis WS04‐01Transvaginal sonography of the endometrium and sonohysterography in the menopause
Authors: Zoricic D. 
Published: March 2003

BackgroundAll endometrial sampling methods are invasive. Therefore in sympyomatic women and for women at risk of developing endometrial pathology in menopause a technique that could reduce the number of biopsy procedures would be of a great value. This technique would be relatively non‐invasive, easy to learn and perform, cost effective and well accepted by the patients. The objective of this study was the assessment of the diagnostic potency of ultrasound measurements by comparison with the usual histological investigation.MethodEndovaginal ultrasonography (measurement of endometrial thickness and morphology of endometrium) prior to endometrial sampling was done in 160 postmenopausal patients. 143 D&C, 15 hysteroscopies and 2 laparotomies were performed to collect endometrial tissue. Indications for endometrial sampling were bleeding in 72%, ultrasound suspicion of endometrium in 18%, or other (cervical or adnexal pathology) in 10% of patients. Sonohysterography, as an improvement over conventional ultrasound methods, was done in 12 cases (7.5%). Pathologic findings were compared to preoperative ultrasonography.ResultsUltrasound measurement of endometrial thickness combined with morphology and sonohysterography detected more than 90% endometrial pathology (sensitivity 96%, specificity 92%).ConclusionWe found endovaginal ultrasound as useful tool at identifying endometrial diseases in menopause. For a postmenopausal woman with vaginal bleeding with a 10% pretest probability of endometrial cancer, her probability of cancer is less than 1% following a normal endovaginal sonography and sonohysterography. Ultrasound should be considered as investigational and cannot be used as the only methods to evaluate abnormal bleeding in menopausal patients.
WS05‐4Assessment of uterine vascularity in endometrial cancer
Authors: Szabó I. 
Published: March 2003

BackgroundThis study was conducted to assess uterine blood flow characteristics in endometrial cancer and to evaluate the influence of myometrial invasion and cancer grading for uterine circulation.MethodTransvaginal color doppler was performed on 97 women with endometrial cancer (11 in stage IA, 33 in stage IB, 37 in stage IC, 7 in stage II, 8 in stage III, and 1 in stage IV) and 51 asymptomatic postmenopausal women (control group). Intratumoral and main uterine artery blood flow was recorded and the peak systolic velocity (PSV) and impedance indices (RI, PI) were calculated.ResultsIn 90 of the 97 postmenopausal endometrial cancer patients (92%) abnormal blood flow with low impedance levels (RI: 0.39 ± 0.08; PI: 0.51 ± 0.15) was found within the endometrial echo or very close to it. Impedance indices in the main uterine arteries were significantly (P < 0005) lower in women with endometrial cancer than in normal postmenopausal woman. Uterine blood flow was not modified by the cancer grading. There was, no difference in impedance indices of the uterine arteries between myometrial invasion of < 50% and > 50%.ConclusionThese results suggest that uterine blood flow analysis in endometrial cancer could not predict the tumor staging and grading, but this examination can provide additional discriminatory information on tumor vascularity which can then be used with morphology for more accurate diagnosis.
WS08: Fetal brain WS08‐01Three‐dimensional‐ultrasound of the embryonic/early fetal brain
Authors: Blaas H.‐G. K. 
Published: March 2003

In the growing embryo, the brain is the first organ system to develop in such a way that it can be imaged in detail with transvaginal ultrasound. The extension of the transvaginal ultrasound technique to 3D imaging makes it possible to obtain new ultrasound images of the developing embryonic brain in planes not available in the original scan plane, to present form and shape, and to calculate volume. New information about the embryonic brain development can be obtained: volume measurements of the embryonic brain compartments reflect the phylogenetic development. The ‘old’ rhombencephalon is large during the early phase, while the ‘young’ hemispheres are very small. During a few weeks, this correlation becomes reversed. Using 3D animations this dynamic developmental process can be visualized.Ultrasound technology has reached a level where the diagnosis of embryonic malformations can be made. At present, we are at the borderline of being able to diagnose holoprosencephaly when the embryo is seven to eight weeks. At nine weeks, 3D images of anomalies such as holoprosencephaly and spina bifida have been made. We may expect the rapidly developing 3D technology, with the option of anyplane slicing, to help us establish early diagnoses in the future. Such multiplane presentations of a diagnosis will contribute to increasing the diagnostic accuracy.
WS09‐07Ultrasound, Doppler and contrasts in metastases from gynecologic tumor
Authors: Schmillevitch J. 
Published: March 2003

The breast cancer metastases can be analyzed by ultrasound in ganglial and visceral organs.The detection of metastatic lymphonod in the axillar, cervical or supraclavicular regions and intrammamarian changes both the cancer staging and therapeutic planning. Benign lymphonode usually have an oval shape, hilum hyperechogenicity, narrow cortex and show hilar vascularization or radical central symmetric vascularization and absence of peripheral flow at Color Doppler. Malignant lymphonode are usually rounded hyporechoic, without hilar hyperechogenicity, and, in color Doppler, present multifocal aberrant vascularization, tortuous vessels or flow in the periphery.The most frequent visceral metastases of breast cancer are hepatic, the suprarenal glands and ovaries.About 86% of breast cancer hepatic metastases are hypoechoic. Ovarian cancer metastases can be detected mainly in pelvic tumors, peritonium tumors, glanglial, abdominal wall, hepatic and splenic metastases and ascites.Our study of 10 cases of splenic metastases of ovarian cancer has demonstrated six hyperechoic tumors, two hypoechoic and two tumors with necrosis.The use of color Doppler and Powerangio has demonstrated weak or moderate vascularization in glanglial and visceral metastases of gynecological tumors. The use of contrast (Levovist) has shown a more detailed vascular analysis by detecting vessels that were not identified in color Doppler and Powerangio without contrast.
WS01‐07Borderline urinary tract malformations
Authors: D'ottavio G. , Paduano L. , Rustico M. A. , Meir Y. J. , Lenardon P. , Rosadini A. , Mandruzzato G. P. 
Published: March 2003

BackgroundUltrasonography is an effective diagnostic tool for identifying fetal urinary tract anomalies (UTA). Serious obstructive or dysgenetic abnormalities are often clearly detected and their implications well known. Less clear is the meaning of borderline (asymptomatic at birth) UTA, including: mild pyelectasis (MP), unilateral renal agenesis (URA), unilateral multicystic kidney (UMK) and ectopic kidney (EK).MethodWe determined the outcome of pregnancies and long‐term renal function in 120 cases of prenatally detected borderline UTA. A prospective protocol was proposed to the parents which comprised ultrasound evaluation every 3 months until the age of 24 months, and renal function assessment in case of suspected worsening of prenatal findings.ResultsA total of 120 fetuses had a borderline UTA (MP n = 58, URA n = 14, UMK n = 32, EK n = 16). Eighteen of them showed some postnatal complication including: associated anomalies (3 cases), need for surgical intervention (6 cases), vesico‐ureteral reflux (VUR, 5 cases) and repeated infection (4 cases).ConclusionsFetal pyelectasis, rarely requires neonatal intervention if the diameter of pelvis is included between 5 and 10 mm in the second trimester. Nevertheless, the risk of associated chromosome abnormalities should be ruled out if other risk factors are present. Unilateral multicystic kidney carries a high risk of nephrectomy and contralateral VUR, whereas unilateral agenesis or ectopic kidneys seem to carry limited, if any, negative implications, with the exception of possible undetected, associated anomalies.
WS12‐05Umbilical and fetal cerebral circulation and fetal growth
Authors: Petrović O. , Rukavina B. 
Published: March 2003

BackgroundFetal growth is determined by its genetic potential and growth support. The aim of our prospective study was to find out does the growth support (placental factor and blood flow) or genetic potential play a primary role in fetal growth.MethodFrom 27 to 41 gestational weeks an umbilical artery (RI1), a middle cerebral artery resistance index (RI2) and umbilical‐cerebral (U/C) ratio were measured. Several US measurements in 3–4 week intervals of the same pregnancy were done. After delivery, fetuses were divided into the three groups (AGA, LGA, SGA) according to their birth‐weights. Pregnancies with gestational diabetes were excluded from the study.ResultsThere were not statistically significant differences between the average values of RI1 (age related) in the groups of AGA and LGA fetuses. However, the mean values of RI1 (according to gestational age) in the mentioned two groups of fetuses were significantly lower than in the group of SGA fetuses, as well as their mean values of U/C ratios.ConclusionPlacental factor is equally and efficiently functioning in the both groups of AGA and LGA fetuses. The genetic regulating factor of fetal growth can be adequately expressed in conditions of appropriate uteroplacental and umbilical blood supply. In other words, in identical or at least similar conditions of umbilical blood supply, fetal growth is exclusively influenced by its genetic potential.
WS12‐02Anticipating twin‐to‐twin transfusion syndrome: the putative role of venous return evaluation in the first trimester
Authors: Matias A. , Montenegro N. 
Published: March 2003

BackgroundTwin‐to‐twin transfusion syndrome (TTTS) complicates 10–15% of monochorionic (MC) and is associated with high perinatal mortality and morbidity.MethodSixteen MC twin pairs were evaluated between 10–14 weeks for delta nuchal translucency (ΔNT) and Doppler blood flow in ductus venosus (DV). Sequential scans were performed to identify TTTS.ResultsNeither the 12 cases with ΔNT<0.7 mm/normal flow, nor the two cases with ΔNT>0.7 mm/normal flow in DV, developed TTTS. The two cases that combined ΔNT>0.7 mm and abnormal flow in DV eventually developed TTTS.ConclusionThe presence of abnormal blood flow in the DV in MC twins, at 10–14 weeks, may be a precocious anticipatory sign of TTTS.
WS13‐03Dynamics and clinical significance of placental shunt flow in monochorionic diamniotic twins
Authors: Maeda K. , Utsu M. , Hirai T. , Sakata M. , Yamamoto N. , Ohki S. 
Published: March 2003

BackgroundThe aim is to clarify placental shunt flow patterns in monochorionic diamniotic (MD) twins and their clinical outcome after the intervention under unique criteria.MethodThirteen (13) MD twin pregnancies were studied from early pregnancy with 2D and 3D B‐mode, color Doppler, power‐angio mode, Doppler flow velocimetry, cardio‐thoraxarea ratio (CTAR) and preload index (PLI) under tocolysis.ResultsArtery to artery shunt flow was detected by fetalbeat‐to‐beat Doppler color change and cyclic bidirectionalflow at placental surface in 8 MD twin cases but not in 5. Shunt was more clear with 3D color Doppler and power‐angio. Umbilical vein flow pulsation, variable FHR deceleration andcord complications were more in placental shunt flow casesthan its absence. Deep shunt flow was prenatally detected in 2 cases and small anastomses in all postnatal placenta. Pregnancy was terminated by emergency C‐section in cases of uncontrollable contractions, unidirectional shunt flow, large CTAR and PLI (> 0.4) which were frequent in large twins after 30 weeks. Neonatal cardiac failure was more in shunt flow cases than its absence but the outcome was normal. Neonatal PVL and perinatal deaths were less than the MD twins in the past.
WS01‐08Three‐dimensional power Doppler of fetal malformations
Authors: Chaoui R. 
Published: March 2003

BackgroundThe aim of the study was to examine the impact of three‐dimensional power Doppler ultrasound (3D‐PDU) in fetal abnormalities involving the vascular system.MethodEighty seven selected pregnancies were included in the study. ATL HDI‐3000 and 5000 ultrasound equipment with integrated 3D‐Color Power Angio ® software were used. Data acquisition was done by the free‐hand‐technique and images were reconstructed online.ResultsReconstruction was only possible in 56 out of the 87 (64%) considered pregnancies. These were abnormalities of placenta and umbilical vessels (n = 26), intra‐abdominal and intrathoracal anomalies (n = 12), renal malformations (n = 9), central nervous system (n = 4) as well as cardiac defects (n = 5). The main reasons for failure were fetal position and movements, overlapping with signals from neighboring vessels as well as the reduced attempts in 3D in an on‐line system. Details and figures of the potential field of interest in prenatal diagnosis are presented.ConclusionsThe study shows that 3D‐power Doppler can be applied in prenatal diagnosis. The method enables the visualization of main parts of the fetal vascular system under abnormal conditions with the exception of the fetal heart where a trigger system is still needed.
WS14: Three‐dimensional power Doppler in obstetrics and gynecology WS14‐01 3‐D ultrasound in routine check‐up of infertility patients
Authors: Radonćić E. , Funduk‐Kurjak B. , Kupešić Sanja , Kurjak A. 
Published: March 2003

ObjectiveThe aim of this study was to determine whether three‐dimensional ultrasound (3‐D US) can improve the diagnostic ability in a routine check‐up of patients undergoing in vitro fertilisation (IVF) in an office practice.MethodsThree‐dimensional and power Doppler ultrasound were performed on 267 patients undergoing IVF on the first visit, during ovulation induction and aspiration of the oocytes. Patients with suspected uterine anomalies and/or abnormalities of the endometrium (N = 108) were treated by operative hysteroscopy. On the day of oocyte collection, multiplanar imaging and 3‐D reconstruction demonstrated cumuli in follicles greater than 15 mm. Cumulus assessment inside the ovarian follicles was correlated to the number of mature oocytes. Power Doppler reconstruction was performed in the cases when superponing vessels did not allow correct placing of the puncture needle.ResultsOf 108 patients with suspected uterine abnormality, the diagnosis was correct in all cases of endometrial polyp, submucous myoma, arcuate uteri and septate uteri, as confirmed by an office hysteroscopy. Intrauterine synechiae was correctly diagnosed preoperatively in one out of the four cases. The mean (± SD) number of follicles > 18 mm was 8.2 ± 5.8, and total number of follicles demonstrating cumulus in all three planes was 6.4 ± 5.1. The ratio cumuli/retrieved oocytes, cumuli/fertilised oocytes and cumuli/mature oocytes was 6.2 ± 4.2, 5.4 ± 2.8 and 5.9 ± 2.6, respectively.ConclusionsThree dimensional ultrasound can become a standard of routine check‐up of infertility patients allowing improved recognition of the uterine anatomy, characterisation of the surface features, and precise depiction of the ovaries during stimulation cycles. It can enhance and facilitate the morphologic and functional evaluation of the anatomic structures of the inner reproductive organs, thus avoiding the need of invasive diagnostic procedures. Various puncturing procedures can be more precisely performed. The built‐in application of live 3‐D mode may be very helpful in performing invasive procedures, such as oocyte collection.
WS14‐023D color histogram: principles and practice in transvaginal and abdominal sonography
Authors: Pairleitner H. , Steiner H. 
Published: March 2003

ObjectiveThe 3D Color Histogram gives quantitative informations about (changes) of perfusion and vascularisation packed in indices. Aim of the presentation is to illustrate the information gained by the vascularisation and perfusion indices. In addition, to show the reproducibility of the indices according to published studies, preliminary results (transvaginal) obtained in ovarian tumors and preliminary results in phantom measurements to correct the decrease in signal power with depth of insonation using a 3D abdominal probe.ResultsColor Histogram indices are reproducible. Differences of perfusion and vascularisation between benign and malignant ovarian tumors could be observed in a limited number of investigations. The physical component of the decrease in signal power with depth of insonation could be calculated by mathematical algorythms according to first phantom measurements.ConclusionThe 3D Color Histogram gives new possibilities to analyse neoangiogenesis.
WS15: Second and third trimester Doppler II WS15‐01High pathological Doppler flow findings (absent or reverse enddiastolic flow) and fetal outcome
Authors: Schmidt W. , Ertan A. K. 
Published: March 2003

BackgroundReversed enddiastolic Doppler flow velocity waveforms on umbilical velocimetry is regarded to be associated with catastrophical perinatal outcome with a high perinatal mortality ranging from 35% to 100%. This study focused on the differences of fetal morbidity and mortality between the cases with reverse flow and other Doppler flow velocity waveforms.MethodDuring a 10‐year period we found 30 cases with reverse flow in the umbilical artery or fetal aorta (gr. I), we selected 30 cases with absent end diastolic velocities (gr. II), 30 cases with high A/B‐ratio (gr. III) and 30 cases with normal A/B‐ratio (gr. IV). All cases in this study were patients with similar para, gravida, maternal age and gestational ages by delivery (≤ 36 weeks).ResultsThe fetuses with reverse flow showed the highest perinatal mortality of 27% (7% in the gr. II, 10% in the gr. III and 0% in the gr. IV). In the gr. I the neonatal morbidity of 78% was also the highest (59% in the gr. II, 36% in the gr. III and 30% in the gr. IV). 80% of intrauterine fetal death (IUFD) were within this group, while no IUFD has been found in the gr. IV. Furthermore, the incidence of cerebral haemorrhage by the neonates in the gr. I (28%) was also much higher than those in the gr. III (4%) and IV (0%).ConclusionsOur study suggests that reverse flow represents severe fetal condition with the highest perinatal mortalities. The fetal outcome in cases with reverse flow is further worse than those with absent end diastolic flow velocity waveforms. A highest morbidity was also observed by those fetuses, especially high incidences of cerebral haemorrhage. Colour Doppler‐sonography is a very useful tool to identify high risk pregnancy leading worse perinatal outcome and allows to select worst perinatal prognosis if reverse end diastolic flow is detected.
WS15‐02Fetal biophysical profile and kinetic measurement: Doppler contribution
Authors: Troyano J. M. 
Published: March 2003

BackgroundTwo methods are presented for the assessment of fetal behaviours under the application of Doppler effects: (a) Measurement of the velocity wave of fetal limb by vibroacustic stimulating. (b) Hydrodynamic evaluation of the transnasal amniotic velocity wave and its relation to gastric peristalsis.MethodA Doppler device was employed to assess the velocimetry wave from the ‘FEMORAL BONE’ in motion, following vibro‐acoustic stimulation in 138 phisiological pregnancy and Doppler‐aided evaluation of transnasal amniotic hydrodynamics.Results and conclusionAssessment of normal fetal behaviour. Quantification of patterns of reactivity of any body structure. Reduction in the duration of explorations for biophysical profiles. (3–4 min). Fetal reflex responses slow down and become increasingly complex as maturation carries on. Both mean velocity and acceleration of fetal reactive responses experience a gradual decline throughout gestation. The time a fetus takes to respond to a stimulus increases directly with gestational age. Simultaneousness between fetal respiration episodes and phases of gastric distention and activity. (physiological conditions). Fetal active respiration can be unequivocally accounted for by Doppler assessment of the activity of intake/release of amniotic fluid along the high respiratory branches of the pulmonary tree. Amniotic respiratory dynamics are always transnasal in physiological conditions. Velocities of transnasal, decreasing steadily from the 32nd gestational age to the end of gestation.
WS15‐03Fetal centralization
Authors: Montenegro C. A. B. , Lima M. L. A. , Rezende‐Filho J. 
Published: March 2003

We have been studying fetal centralization in the toxemic/IUGR model since 1992, by means of Doppler of the umbilical and middle cerebral arteries and ductus venosus, computerized CTG and cordocentesis.The natural history of fetal centralization may be divided into 3 phases: normoxemic centralization, hypoxemic centralization and decompensation. The natural history of fetal hypoxemia in these models and the patterns of computerized CTG were also described.Having analysed 105 cases of very high‐risk pregnancies in the toxemic/IUGR model with fetal centralization, we tried to define the best parameter to indicate the ideal timing for delivery, and the presence of centralization after 28 weeks gestation appears to seems to indicate it.