bluuebunny/crossref_metadata_2025_split huggingface dataset:
F13The influence of angiotenzin converting enzyme inhibitors on adnexal tumor vascularization
Authors: Jurisic A. , Antic N. , Maglic R. , Tajfl P. , Jankovic S. 
Published: March 2003

BackgroundThe aim of this study was to investigate the influence of antihypertensive therapy with angiotenzin converting enzyme inhibitors (ACE) on adnexal tumor hemodynamic parameters.MethodPatients were classified into the four groups: ace benign (29), ACE malignant (17), benign (188), malignant (71). Hemodynamic studies of tumor vascularization were performed by transvaginal color/power Doppler and Pourcelot resistance indices (RI) were measured in tumor tissue. Statistical analysis was performed by analysis of variance (ANOVA).ResultsA total of 305 patients were examined and 1411 blood vessels were analyzed. In ACE benign group 125 resistance indices were analyzed; in ACE malignant group 136 RIs; in benign group 644 RIs and in malignant group 506 RIs were measured. Mean RI values were BACE = 0.469 ± 0.124, MACE = 0.409 ± 0.096, B = 0.564 ± 0.121 and M = 0.390 ± 0.095. Analysis of variance showed high statistical significance between the groups, where RI in ACE benign group was significantly lowered.ConclusionThe analyzed data in our study indicate that antihypertensive therapy with angiotenzin converting enzyme inhibitors may significantly reduce vascular resistance indices (RI) in patients with benign adnexal tumors who received that therapy at the time of ultrasonographic examination.
F17Expectant management of ectopic pregnancy: is it possible to predict successful outcome
Authors: Elson J. , Banerjee S. , Lawrence A. C. , Wölfer B. , Jurkovic D. 
Published: March 2003

BackgroundThe aim of this study was to examine the value of different clinical, ultrasound and biochemical parameters for the prediction of final outcome in women with ectopic pregnancies which are managed expectantly.MethodClinically stable women with ultrasound diagnosis of tubal ectopic pregnancy were offered expectant management. In all cases the gestational age, morphology, pregnancy size, serum hCG and progesterone levels were recorded. Surgery was indicated in women with a deterioration of clinical symptoms or rising/nondeclining hCG levels.Results51 out of 114 (45%) tubal ectopic pregnancies were managed expectantly. The ectopic pregnancy resolved spontaneously in 33 cases (65%). None of the patients suffered tubal rupture and one patient with low pretreatment haemoglobin received blood transfusion. There were no significant differences in the length of gestation, morphological appearances and mean pregnancy diameter between pregnancies which resolved spontaneously and those requiring surgery. However, both serum hCG and progesterone were significantly lower in tubal pregnancies that resolved spontaneously. By combining serum progesterone at cut‐off level of < 10 nmol/L and serum hCG at < 1000 IU/L a successful resolution of the ectopic pregnancy could be predicted with a sensitivity of 63% and specificity of 93%. The positive predictive value of this test was 79% and the accuracy 85%.ConclusionsSerum hCG and progesterone measurements could be used to predict the likelihood of successful expectant management of tubal ectopic pregnancies.
F32Comparison of conventional two‐dimensional and three‐dimensional multiplanar analysis for evaluation of fetal nuchal translucency
Authors: Koudelka M. , Malý Z. , Novotná  
Published: March 2003

BackroundOne of the most useful US markers for fetal aneuploidy and other structural anomalies is measurement of nuchal translucency (NT). Using conventional 2D ultrasound, irrespective of high quality of current devices, brings problems connected with fetal intauterine possition. Unfavourable position increases intra‐and interobserver variability of measurement or can even disables the evaluation.MethodIn this study the fetal textbook ‘standard’ position for measurement of NT using konventional 2D and 3D was performed in 105 cases in 11th − 14th week of pregnancy, 3x in each case. Two aspects were evaluated: succes of achieving standard position and variability of individual measurement.ResultsThe nuchal translucency with 2D scanner was measurable in 63% of cases. With 3D vaginal scanner, using computed 2D multiplanar analysis the correct and standart plane was achieved in 97% the cases. The exactness of 3D measurement is significantly higher.ConclusionsThe problems with fetal position seems to be solved using 3D computer sonography with its electronic tools as multiplanar 2D and possibility of electronic rotational display of embryo. 3D decreased the interobserver and intraobserver error to minimum. The 3D multiplanar analysis was found to be superior.
F40Response of the fetal pupil in the chromosomal anomalies
Authors: López Ramón y Cajal C. 
Published: March 2003

BackgroundWe studied sonographically the response of the fetal pupil to the stimulus of color Doppler (CD) in fetuses with chromosomal anomalies below 22nd weeks.MethodThe pupils of 28 fetuses were studied sonographically between 15 h‐21 weeks' gestation, diagnosed of a chromosomal alteration through of genetic amniocentesis. The areas of the pupil and iris were compared before and after CD imaging.ResultsThe great majority of the fetuses have some data out of range in the relationship pupil/iris in basal conditions or after CD. Usually, we observed an atypical response (mydriasis before the 19 weeks or miosis after this) and/or an exaggerated response (hyperreflexia).ConclusionThese results affirm that this type of test increases the possibilities in a fetal study of high resolution performed before the 22nd weeks of gestation and it can be a useful indicator like an aneuploidy marker.
F49Subclassification of small‐for‐gestational‐age fetus using fetal Doppler velocimetry
Authors: Kanenishi K. , Yamashiro C. , Tanaka H. , Kuno A. , Yanagihara T. , Hata T. 
Published: March 2003

BackgroundOur purpose was to determine whether small‐for‐gestational‐age (SGA) fetus can be divided to subclassified groups using fetal Doppler velocimetry.MethodFifty‐four pregnant women with SGA infant delivered after 37 weeks of gestation were studied. After 24 weeks of gestation, fetal middle cerebral artery pulsatility index (MCAPI) and umbilical artery pulsatility index (UAPI) were measured at 2‐to 3‐week intervals using Doppler ultrasound. Perinatal outcomes were compared in subclassifid SGA groups using fetal Doppler velocimetry.ResultsThe number of SGA fetuses with normal MCAPI and UAPI (normal SGA group) was 39, and those with significantly low MCAPI but normal UAPI (eventful SGA group) 15, respectively. Birth age and birth weights in eventful SGA group were significantly earlier and lower than those in normal SGA group, respectively (P < 0.05, and P < 0.005). There were significant increases in operative deliveries, abnormal FHR patterns and decreased amniotic fluid in eventful SGA group. However, there were no significant differences in meconium staining of amniotic fluid, low Apgar score, neonatal acidosis, and NICU admission between the two groups.ConclusionThese results suggest that SGA fetus with abnormally low MCAPI but normal UAPI has more poor perinatal outcomes, compared with that with normal MCAPI and UAPI.
F55Venous velocimetry in the surveillance of severely compromised fetuses. Where is the point of no return?
Authors: Hofstaetter C. , Hansmann M. 
Published: March 2003

ObjectiveTo investigate special changes in venous velocimetry of severely compromised fetuses and to determine signs of cardiac decompensation prior fetal demise.MethodsA prospective study in 154 growth‐restricted fetuses. 37 were severely compromised with reverse flow in the umbilical artery. The velocimetry of right hepatic vein and ductus venosus were investigated and the presence of umbilical venous pulsations were registered. The final examination prior to birth or fetal demise were taken for analysis and related to obstetrical outcome defined as gestational age at birth, birthweight and rate of perinatal mortality. Secondly the velocimetry of 15 nonsurvivors was pared with 22 survivors.ResultsThere were a significant (P < 0.05) decrease of the S‐ and ES‐, increase of the A‐velocity and pulsatility in the RHV and a significant (P < 0.05) decrease of all velocities and increase of pulsatility in DV. 24% had a reversed flow in DV and 75% had pulsations. The newborn were significantly premature and small for gestational age. 15 fetuses died perinatally. Special predictors of fetal demise were a further increase or decrease of A‐velocity in RHV and DV. 8/15 fetuses had a reversed flow in DV and 11/1 5 had mainly double pulsations as signs of cardiac decompensation.ConclusionsVenous velocimetry changes significantly in compromised fetuses. Prior to fetal demise the A‐velocity decreases specifically in DV. Especially a reversed flow in DV and double umbilical venous pulsations are omnious signs of left heart decompensation.
F64Intrauterine therapy of fetal obstructive uropathy
Authors: Szaflik K. , Borowski D. , Kozarzewski M. , Kunert A. 
Published: March 2003

BackgroundThe aim of our study was the evaluation of the usefulness of fetal bladder drainage in cases of obstructive uropathy before the 24th week of gestation.MethodsSince January 1997 we have diagnosed 9 cases of fetal obstructive uropathy before the 24th week of gestation. In all cases, oligohydramnios or ahydramnios was also diagnosed. After evaluation of kidneys function on the basis of fetal urine samples, obtained from punctures of fetal bladder (three times in each fetus) we selected 7 fetuses for in‐utero shunting. 2 fetuses presented features of renal cystic dysplasia and its renal function prognostic factors were poor. Those fetuses were not offered intrauterine decompression.ResultsAll the newborns in which intrauterine decompression of the obstructive uropathy was made have had a good perinatal outcome. The mean apgar score was 8 (7–10 points). The weight at delivery was between 1700 and 3300 g. No pulmonary hypoplasia was observed. All the deliveries took place after the 33rd week of gestation (33–38 hbd). The minimum time of drainage was 11 weeks, the maximum 18 weeks.ConclusionsEarly bladder drainage enables delivery of newborns without pulmonary hypoplasia. Drains with a good ‘shape memory’ enable good results, because they are not prone to migration. Shunting should be performed only in selected cases which would not be better managed by early delivery, but who have not yet developed renal dysplasia.
Three‐dimensional power Doppler in obstetrics and gynecology F67Three dimensional follicular and endometrial volume assessment and pregnancy rate in in vitro fertilization patients
Authors: Bjelos D. , Kupesic S. , Kurjak A. 
Published: March 2003

The aim of this study was to assess the role of three‐dimensional (3D) follicular and endometrial volume measurements in predicting the pregnancy outcome of the in vitro fertilization (IVF) programme. For the purpose of this study we evaluated 52 patients on the day of oocyte retrieval and embryo transfer. Follicular volume and endometrial volume were main outcome measures related to the occurrence of a successful implantation. The overall pregnancy rate was 30.8% (16/52). Sixteen pregnant patients demonstrated mean follicular and endometrial volume measurements 4.81 ± 1.92 mL and 5.2 ± 1.9 mL, respectively. In the same time, 36 nonpregnant patients had corresponding measurement of 3.82 ± 1.7 mL and 5.6 ± 2.1 mL, respectively.Presented data demonstrate that 3D volume measurements of the follicles and endometrium on the days of oocyte retrieval and embryo transfer are not predictive of IVF outcome. However, follicular volume measurements are clearly related with the number and quality of the oocytes collected on the day of pick‐up.
F69Three‐dimensional ultrasound in the diagnosis of uterine malformations
Authors: Montenegro C. A. B. , Leite S. P. , Mathias M. L. , Rezende‐Filho J. 
Published: March 2003

Uterine evaluation by means of 3D US is useful in classifying the main malformations, as it allows the visualisation of the frontal plane, impossible to obtain with conventional sonography. In the frontal plane it is possible to classify the uterine abnormalities, according to the fundal surface, the endometrial cavity and the uterine cervix.Arcuate uterus presents with a normal fundal surface, but the endometrial cavity is concave, different from the normal uterus, where it is convex or rectilinear. Septate uterus also shows a normal fundus, but 2 endometrial cavities, due to the septum. Bicornuate uterus is characterised by a fundal indentation (≥ 1 cm) and 2 endometrial cavities. Didelphic uterus is identical to complete bicornuate uterus, but the duplication extends to the cervix, which is doubled. Unicornuate uterus exhibits only one half of the uterus and does not seem to present any diagnostic pitfall, although it may present with a rudimentary cornus, that may or not communicate with the main cavity.Septal vascularization may be identified in slightly over 70% of the cases with this abnormality. Power Doppler is helpful in identifying those cases, and differentiate them from bicornuate uterus.17 patients with suspected uterine malformation were examined. 4 bicornuate, 6 septate, 6 arcuate, and 1 didelphic uterus were found. 3D US was concordant in 11 cases.
F72Visualization of anal sphincter disruptions with transperineal three‐dimensional ultrasound following vaginal delivery in primiparous women
Authors: Bader G. , Rozenberg P. , Ville Y. 
Published: March 2003

ObjectiveTo visualize the anal sphincter disruptions following vaginal delivery in primiparous women using 3D ultrasound to correlate damage to obstetrical factors.MethodsWe have studied prospectively 150 consecutive primiparous women. Axial and sagittal images of the anal sphincter were performed 48 h after vaginal delivery using a 7.5‐MHz convex transducer placed on the perineum (Voluson 530 D Kretz) and repeated in the 30 women with anal sphincter disruption at a median of six months post natally. Obstetrical characteristics were analysed in all cases.ResultsAnal sphincter defect and its location were detected in 30 women (20%). None of the 24 women (16%) who underwent cesarean section had a sphincter disruption even in the 10 women delivered by cesarean section in labor. Head circumference, birth weight, maternal age, the duration of each stage of labor and the duration of active pushing were not significantly related to anal sphincter disruptions after vaginal delivery. Instrumental delivery, epidural analgesia and posterolateral episiotomy were associated with a sphincter defect but the only single independent factor related to the development of sphincter defects was instrumental delivery. The 3D sonography revealed sphincter injuries in 70% of the cases in the forceps delivery group (7 of 10), 13.3% of the cases in the vacuum delivery group (2 of 15) and 9.9% of the cases in the normal vaginal delivery group (10 of 101). 12 women (8%) had anal incontinence of faecal urgency when studied two months after vaginal delivery. The anal function was not altered after cesarean section.ConclusionsTransperineal 3D ultrasound of the anal sphincter is a reliable method for evaluating the anal sphincter. It is quickly performed and well tolerated by patients. Besides forceps delivery, commonly measured delivery variables are not useful predictors of latent anal sphincter injury.
F77Application of ‘Live 3D’ ultrasound in the detection of fetal malformation of extremities
Authors: Lee A. , Pöhl M. , Bernaschek G. 
Published: March 2003

Background3D ultrasound can produce images comparable to photographs. However, they only represent about a second of the hole examination. Artifacts due to fetal movements can make interpretation difficult. Sequential rescanning, a technique which is also called ‘Live 3D’ may overcome these limitations.MethodPatients who underwent 3D ultrasound examination because of suspicious of fetal skeleton malformation were included into this study. Live 3D ultrasound was performed with a commercially available machine (Combison C530, Kretztechnik, Zipf, Austria)ResultsIn 32 out of a total from 70 patients malformation of the fetal extremities have been postulated in 2D ultrasound. Sufficient surface rendering of the region of interest could be achieved within 85% of all patients. Malformations of the fetal extremities could be visualized in 93%. Discrepancy between 2D and 3D findings could be found in only 2 cases.ConclusionLive 3D ultrasound can give confirmation and new diagnosis in cases of fetal malformation of extremities compared to 2D ultrasound examination.
F08Real‐time intraoperative ultrasound guidance; the transrectal approach
Authors: Bar‐Hava I. , Meizner I. , Rabinerson D. , Shalev I. , Mashiach R. , Orvieto R. , Ben‐Rafael Z. , Dekel A. 
Published: March 2003

BackgroundThe aim of this study was to assess the role of real‐time transrectal ultrasound (RT‐TRUS) guidance in complicated gynecological procedures.MethodDuring the study period RT‐TRUS was utilized to direct and assist the gynecological surgeon in two complicated gynecological procedures: Completing the evacuation of the uterine cavity after identification of uterine wall perforation during termination of pregnancy and drainage of posthysterectomy infected vault hematomas.ResultsIn all, 11 patients were treated by this fashion (6 abortions and 5 infected vault hematomas). All procedures were completed without any further complications and the patients were discharged the following day with uneventful follow‐up.ConclusionRT‐TRUS is an effective tool that can provide on‐line assistance to the gynecological surgeon in various pelvic procedures.
F80Three dimensional ultrasound reconstruction of monochorionic placental anastomoses
Authors: Welsh A. W. , Taylor M. J. , Fisk N. M. 
Published: March 2003

BackgroundFeto‐fetal transfusion syndrome is characterized by a paucity of bi‐directional superficial vascular anastomoses which protect against haemodynamic imbalance built up by deep unidirectional arterio‐venous (AVA) anastomoses. Vascular identification and ‘mapping’ is a necessary prerequisite to selective therapy for FFTS.MethodThe sites of arterio‐arterial (AAA) and an arterio‐venous anastomoses were identified by colour flow mapping and characteristic doppler waveforms (Acuson SequoiaTM5C2 MHz curvilinear probe). Having identified these sites, freehand 2D image storage to disk was performed, and images transferred to a personal computer. Purpose‐designed software (CQ Analysis, Kinetic Imaging Ltd, Liverpool, UK) was used to segment the colour information from these images and the resulting greyscale images were saved as TIFF image format files. These files were fed as a parallel data set into VoxBlast software (Vaytek Inc, Iowa, USA) for 3D rendering and rotational movie generation.ResultsThis technique allowed perfect reconstruction of 3D vascular and placental anatomy for both AAA and AVA. Dual rendering with original greyscale images allowed accurate visualisation of anastomotic location within the placenta.ConclusionsIt is now technically feasible to gain an understanding of monochorionic placental microvasculature in 3D. Prospective evaluation is underway to compare the predictive ability of 3D vs. 2D ultrasound placental mapping.AcknowledgementsAlec Welsh is supported by a Research Training Fellowship from RCOG/WellBeing.
Complications in pregnancy F86Mullerian anomalies: prospective follow‐up with transvaginal ultrasound of the cervix
Authors: Berghella V. , Talucci M. , Odibo A. , Chen J. 
Published: March 2003

IntroductionPatients with mullerian anomalies have higher rates of preterm delivery (PTD), but the true reason for PTD has not been elucidated. Transvaginal ultrasound (TVU) has proven an accurate test for the prediction of PTD, but has not been studied in this patient population.MethodsPatients with known mullerian anomalies were followed prospectively in pregnancy with TVU of the cervix between 14 and 24 weeks. The predictive value of TVU was evaluated using < 25 mm cervical length and/or > 25% funneling as definition for a short cervix. The primary outcome was PTD < 35 weeks.Results45 patients with mullerian anomalies were identified. 16 were excluded from analysis because of: prophylactic cerclage (6), twins (3), induced PTD (4), no follow‐up (1), still pregnant (2). Of the 29 pregnancies available for analysis, there were 8 with septate uterus (5 corrected), 7 with bicornuate uterus, 6 with didelphus uterus, and 5 with unicornuate uterus (3 were unknown type). 6 (21%) had a short cervix (3 of these received a therapeutic cerclage because of TVU short cervix), with 2 (33%) having PTD despite both receiving therapeutic cerclage. 23 (79%) did not have a short cervix, with 2 (9%) having PTD. Both of these patients had a didelphus uterus. The sensitivity, specificity, positive and negative predictive values for PTD were 50, 88, 40, 92%, respectively (RR 4.8, CI 0.9–26.5).DiscussionTVU seems to be predictive of PTD in patients with mullerian anomalies, with the possible exception of didelphus uterus. Therapeutic cerclage in patients with a mullerian anomalies with a short cervix on TVU may not prevent PTD.
F94Early ultrasonographic screening for malformation – how early is too early?
Authors: Gull I. , Wolman I. , Har‐Toov J. , Fait G. , Amster R. , Lessing J. B. , Jaffa A. J. 
Published: March 2003

BackgroundEarly ultrasonographic screening for malformation is performed between 14 and 17 weeks of gestation.AimsTo analyze the effect of the gestational age on the screening efficacy of specific organs and to assess the optimal date for screening.MethodsWe analyzed 427 ultrasound screening performed between 14 and 18 weeks of gestation. The efficacy of screening for each structure at certain week was calculated. Then, we analyzed the data to obtain the best date in which the need for repeated screening was minimal.ResultsThe lips, posterior fossa, heart and gall bladder were the main structures that could not be optimally visualized during the 14th week of gestation. The lips, Gall bladder and the VA valves and the great vessels were the structures that were not visualized optimally during 15–16 weeks of gestation. The ears and the fingers were the main structures that could not be optimally visualized during 17–18 week of gestation. The need for repeated screening at the 14th week of gestation was ∼65%, and at the first half of the 15th week ∼20%. The need for repeated screening from the end of the 15th week of gestation to the 17th week was ∼8% and rose to 11% at the 18th week.ConclusionThe optimal date for early screening for malformation is the end of the 15th week of gestation to the 17th week.