bluuebunny/crossref_metadata_2025_split huggingface dataset:
P47The functionality of renal kidneys. Can amniotic markers be used to diagnose renal pathologies?
Authors: Troyano J. M. , Clavijo M. T. , Feo C. M. , Marco Y. , Laynez E. 
Published: March 2003

Background and methodFetal urine was analysed for differences in renal functionality between physiological cases and pathological cases featuring dilatation of the excretory channels (hydronephrosis). Kidney samples were taken by means of aspirative nephrostomy under echographic monitoring, and 4 parameters were assessed in both amniotic fluid and urine, namely osmolarity, [Na+], [Cl−], [nag] and [β2 microglobuline].ResultsA total of 51 cases (healthy group) presented hypotonic urine, medium osmolarity (200 mosm), low levels of Na+(< 100 mEq/ml), Cl− (< 90 mEq/ml), nag (< 2 U/l) and β microglobuline (< 5 ml/l), and a healthy postnatal evolution. In contrast, the remaining 19 cases (pathological group) had hypertonic urine, nag and β2 microglobuline levels over 18 U/l and 26 ml/l, respectively, and evolved towards heavy renal disfunctionality after delivery. In the pathological group the concentration of nag and β2 microglobuline in the amniotic fluid was significantly larger than in the physiological group, but no differences in amniotic Na+, Cl− and osmolarity were observed between both groups.ConclusionThe concentration of liposomial proteins (nag and β2 microglobuline) from the amniotic fluid is a sound indicator of heavy proximal tubulopathy. Invasive techniques such as puncturing can thus be avoided to diagnose fetal disfunctionality.
P55Large yolk sac preceding increased nuchal translucency in skeletal malformations: report of two cases
Authors: Odeh M. , Kais M. , Wolfson M. , Ophir E. , Oettinger M. 
Published: March 2003

Case 1A 20‐year‐old secondegravida was screened at 20 weeks due to consanguinity. The fetus had extreme shortening of the limbs, cystic hygronia, hydrocephalus and tetralogy of fallout. The pregnancy was terminated. Missed abortion was diagnosed in her third pregnancy at 18 weeks. The fetus had extreme shortening of the limbs, spina bifida and cystic hygroma. In her fourth and fifth pregnancies she was first scanned at 7–8 weeks. A large yolk sac was detected (10 mm) and later the fetuses developed increased nuchal translucency short limbs and ascites. Both pregnancies were terminated. Twins were diagnosed in her sixth pregnancy. At 8 weeks one fetus had large yolk sac and this fetus developed the same features, including spina bifida and ascites and at 17 weeks heart activity was not detected. She delivered a healthy term female.Case 2A primigravida was scanned due to consanguinity at 22 weeks. The fetus had fixed extension of four limbs and bilateral club feet the parents refused termination and a newborn with congenital arthrogriposis died a few days after delivery. In her second pregnancy she was first seen at 9 weeks and a large yolk sac was found and 2 weeks later increased nuchal translucency developed. Deformities of the limbs were first detected at 16 weeks and this pregnancy was terminated. The third and fourth pregnancies were normal. In her fifth pregnancy the same features developed. The parents refused termination and the baby died a few days after delivery.
P07Fetal gender determination in the first trimester using the transverse view: the importance of the third point
Authors: Pedreira D. A. L. , Yamasaki A. , Czeresnia C. 
Published: March 2003

AimTo determine the accuracy of fetal gender determination between 11–13 weeks of pregnancy.Material and methodsRetrospective evaluation from October 1997 to July 1999. Transabdominal sonography using 3.5–5.0 MHz curvilinear probes. Fetal gender was evaluated at the transverse view of genital region. Male gender was considered when three hiperecogenic points, triangular in shape (probably corresponding to the escrotum (‘two points’) and falus (‘third point’) were visible. Female gender was considered when only two parallel white lines were observed (probably corresponding to the falus pointing to the caudal fetal region.Results166 singleton pregnancies had fetal sex determined after birth and/or after cytogenetic results. Total accuracy in determining fetal sex was 82.1%. The most frequent error was evaluating as female the male fetuses.

GA (weeks)
CRL (mm)
n
Correct

N
%

11–11 + 6
43.8–55.3
46
35
76.1

12–12 + 6
55.4–67.9
74
60
81.1

13–13 + 6
68.0–81.7
46
43
93.5

Total

166
134
80.7

ConclusionsRecent studies on fetal sex determination in the first trimester used mainly the longitudinal view of the fetus to this evaluation. In this study, we describe the presence of the ‘third point’ as an important sign in the characterization of fetal gender, in the transverse view, during the first trimester.
P88Cardiotocography predicting buffer base deficit (> 10 mM) at birth in pregnancies with absent or reversed end‐diastolic velocity in the umbilical artery Doppler studies
Authors: Yamamoto R. M. , Francisco R. P. V. , Okatani D. , Miyadahira S. , Zugaib M. 
Published: March 2003

BackgroundA study of cardiotocographic (CTG) variables and buffer base deficit at birth in fetuses with AREDV.MethodsThe last CTGs of 127 AREDV cases were correlated to buffer base deficits above 10 mM. The variables selected by the Logistic Regression model were: baseline, accelerations, variability (variab.), sinusoidal pattern, bradycardia, late and variable (var.) decelerations (mild, moderate and severe).ResultsThe maximum likelihood estimates are shown with the variables:

Variable
Parameter  estimate
Standard  error
P
Odds  ratio

Intercept
−0.4976
1.8374
0.7865

GA (weeks)
−0.0195
0.0590
0.7407
0.981

variab. 5–9 bpm
0.5330
0.4431
0.2290
1.704

Variab. < 5 bpm
2.5275
0.5804
0.0001
12.522

ConclusionThe analysis of cardiotocographic variables makes it possible to estimate the probability of a base deficit above 10 mM at birth, i.e. buffer base depletion. Low placental permeability to bicarbonate and buffer base is an advantage for studying these results, which are less influenced by acute events.
Gestational age in pregnancies conceived after in vitro fertilization: a comparison between age assessed from oocyte retrieval, crown‐rump length and biparietal diameter
Authors: Tunón K. , Eik‐Nes S.H. , Grøttum P. , Von Düring V. , Kahn J.A. 
Published: March 2003

Objective
To compare gestational age (GA) and day of delivery estimated from the time of in vitro fertilization (IVF) (oocyte retrieval + 14 days), the ultrasonic measurement of the crown–rump length (CRL) and the biparietal diameter (BPD) in pregnancies conceived in an IVF setting.
Design
Included were 208 singletons and 72 twin pregnancies conceived after IVF. GA estimated from the time of IVF was compared with the GA estimated from the ultrasonic measurement of the CRL in the first trimester and the BPD in the second trimester.
Results
In singletons the mean difference in gestational age was 0.9 days between IVF and CRL estimates and 2.1 days between IVF and BPD estimates. The gestational age as estimated from CRL or BPD was shorter than the GA estimated from IVF. There was no systematic variation in the mean differences in GA between the methods. In three pregnancies there was a difference of more than 7 days between the gestational age estimated from IVF and CRL and in 22 pregnancies between gestational age estimated from IVF and BPD. A difference of > 14 days for any of the estimates was not found in any case. In singletons there was a high correlation in the gestational age at birth assessed from the time of IVF and from CRL, from the time of IVF and from BPD.
Conclusion
Assessment of gestational age from the time of IVF, CRL and BPD in pregnancies conceived after IVF shows equally high agreement between the three methods. This supports the use of ultrasound as a reliable method for estimation of gestational age.
WS17‐05Placentation studied by three dimensional power Doppler sonography
Authors: Hafner T. 
Published: March 2003

ObjectiveThe aim of this study is to investigate processes of placentation by the use of three‐dimensional sonography.MethodsA group of 25 pregnant women in gestational age ranging six to 10 weeks underwent a detailed assessment. The ultrasound device was Voluson 530D MT, by Kretztechnik, Zipf, Austria. Measurements in three‐dimensional B‐mode were gestational sac volume, chorion volume, and embryonic volume. Volumes were measured by the use of an integrated software. Structures were outlined manually in multiple parallel sections. The machine integrated and calculated the volume. The hemodynamical changes correlated to the process of placentation were assessed by the use of three‐dimensional power Doppler (angio mode). Three‐dimensional imaging of vascular changes was expressed and quantified by the use of volume flow index (VFI). The analysis of the results included correlation of morphological and hemodynamical parameters obtained by measurements.ResultsThe volume of gestational sac, chorion and embryo increases during the weeks of gestation under investigation. The amount of vascular spaces in the chorion and surrounding myometrium increase with gestational age and correlates with the gestational sac and chorion volume.Conclusion3D power Doppler sonography is a valuable tool for assessment and quantification of hemodynamic changes involved in placentation.
WS03‐02Doppler assessment of the ovarian blood flow
Authors: Mercé L. T. 
Published: March 2003

BackgroundThe aim of this study was to evaluate arterial and venous intraovarian blood flow in infertile patients.MethodsSeventy‐six FSH stimulated cycles in 39 patients participating in a timed intercourse or iui program were studied. Transvaginal color and pulsed Doppler measurement of the dominant follicle and corpus luteum resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), maximum venous velocity (MVV) and serum p levels during mesoluteal phase were recorded. Velocimetric parameters were established and then used to classify ovarian function in normal ovulatory cycle (NOV; n = 52), luteal phase defect (LPD; n = 15) and luteinized unruptured follicle (LUF; n = 9).ResultsThe luteal PSV and MVV in the nov and LPD cycles were significantly higher (NOV: 24.3 ± 12.2 vs. 13.1 ± 6.5 and 8.1 ± 3.30 vs. 3.6 ± 1.1; LPD: 29.8 ± 10.3 vs. 14.4 ± 4.8 and 5.7 ± 1.5 vs. 4.3 ± 1.2) and luteal RI and PI were significantly lower (NOV: 0.45 ± 0.06 vs. 0.55 ± 0.08 and 0.62 ± 0.15 vs. 0.83 ± 0.22; LPD: 0.46 ± 0.05 vs. 0.54 ± 0.06 and 0.62 ± 0.10 vs. 0.81 ± 0.15) than follicular ones. LUF cycles did not show significant changes during the ovarian cycle (follicular vs. luteal PSV; MVV; RI and PI: 14.4 ± 4.8 vs. 14.9 ± 7.3; 4.3 ± 1.2 vs. 4.2 ± 2.1; 0.47 ± 0.07 vs. 0.58 ± 0.12 and 0.66 ± 0.12 vs. 0.89 ± 0.29) and no ‘luteal conversion’ of the Doppler signal was identified. There was significant correlation between luteal MVV and serum p (r = 0.36).ConclusionsArterial and venous intraovarian blood flow remain unaltered during LUF cycles and P levels correlate with luteal MVV. This makes Doppler an effective noninvasive test to assess ovulation and luteal function.
WS03‐03Three‐dimensional digital imaging for assessing oogenesis and follicular development as well as live 3D follicle aspirations
Authors: Feichtinger W. 
Published: March 2003

The purpose of the first study was to evaluate whether number and size of antral follicles can predict the outcome of IVF‐ET. A total of 113 patients was prospectively included into this study. After 19 days of downregulation number and size of follicles were determined by using recent three dimensional transvaginal ultrasound (3‐D) technology. We demonstrated that patients with a higher number of follicles between 5 and 10 mm showed a significantly higher pregnancy rate (PR), whereas patients with antral follicles > 11 mm have a higher cancellation rate due to ovarian low‐response.Ultrasound visualization of the cumulus has been demonstrated years ago as an occasional finding during follicle scanning. It has never been proven, however, that cumulus‐like intrafollicular structures as seen on ultrasound correlated with the recovery of mature oocytes. It was therefore our aim to investigate this possibility by using recent three‐dimensional ultrasound (3‐D) technology: Cumulus visualization by 3D ultrasound seems to be an indicator for mature oocytes and the fertilization rate. Follicles without visualization of the cumulus in all three planes are unlikely to contain mature, fertilizable oocytes.In the third part we wanted to evaluate the possibility of puncturing procedures under three‐dimensional ultrasound control in close to real time using a new commercially available system, and to describe the technique.It will be demonstrated for follicle punctures that recent technology enables the carrying out of three‐dimensional puncture procedures in real time; but this will be of more importance in other fields, e.g. in fetal medicine, oncology, and surgery.
WS03‐04Three‐dimentional‐ultrasound in IVF cycles
Authors: Schild R. L. , Knobloch C. , Van Der Ven H. , Hansmann M. 
Published: March 2003

AimTo investigate the role of 3D‐ultrasound in estimating the likelihood of conception in an IVF programme.Materials and methodsWe studied a total of 152 women during their stimulation cycle. Apart from conventional 2D‐parameters we assessed endometrial and uterine volume (sub‐)endometrial blood flow (sub‐)endometrial vessel density and ovarian volume by 3D‐ultrasound.ResultsWith regard to subendometrial blood flow on day 1 of the stimulation cycle, all 3D‐indices were significantly lower in the conception vs. non‐conception group. On the day of oocyte retrieval, any difference between the two groups failed to reach statistical significance. The same applied to endometrial volumes. The latter showed a significant corrrelation with uterine size. Ovarian volumes ≤ 3 mm (1 SD below the mean) on day 1 of the stimulation cycle were associated with a nonsignificant lower conception rate.ConclusionQuantitative assessment of spiral artery blood flow and vessel density may be an early predictor of IVF success.
WS03‐08Diagnosis and treatment of PCO syndrome – what is the place of ultrasound
Authors: Šimunic V. 
Published: March 2003

Ultrasound characterization of ovarian morphology and vascularisation has become an important part of gynaecological endocrinology. PCO syndrome is the most prevalent endocrinological problem in women during reproductive period of life. The us diagnostic accuracy has advanced from recognition of ovarian size (volume), characteristic follicular distribution and volume of dense ovarian stroma, to blood flow changes in the uterine and ovarian stromal vessels. Improvement has been made by using innovations such as 3D US, colour and pulsed Doppler US, which allows US quantitative analysis of the ovarian stroma. In the PCOS the ovarian stroma is the source of hyperandrogenemia.One hundred and thirty‐two patients with PCOS, diagnosed by us and endocrinological findings, underwent further clinical, US and endocrine evolution during various kinds of therapy (metformine, ovarian drilling, oral contraception, flutamide and finasteride treatment). Mean age of the PCO patients was 25.5 years (range 15–48), 59.3% were obese (BMI = 28), 75.6% had signs of hirsutism, 43.02% presented with acne and 88.5% have had irregular menstrual cycle. Ultrasound findings (TVUS, colour and pulsed Doppler, 3D US) and hormonal evaluation (FSH, LH Androstendion, DHEA‐a, T, Free T, SHBG, 3 α diol) were performed prior, during and at the end of the therapy.Comparison has been made between these five groups of patients.
WS03‐10Vasoactive substances and infertility
Authors: Battaglia C. , Regnani G. , Volpe A. 
Published: March 2003

The regulation and significance of ovarian and uterine haemodynamics in human reproductive pathophysiology has been largely studied. In women, ovarian vascularization seems to be responsible for the selection and maturation of follicles both in spontaneous and stimulated IVF cycles while endometrial receptivity is related to uterine blood flow and implicated in the achievement of pregnancy. In patients who underwent to IVF cycles, the PI of both uterine and spiral arteries is significantly lower in patients who became pregnant in comparison with nonpregnant and is associated with significantly lower endometrial cell thromboxane concentrations than non pregnant patients. In poor responders women it has been demonstrated the role of l‐arginine in improving uterine and follicular Doppler flow and in increasing ovarian response to gonadotrophin. Recently, in a total of 41 patients undergoing to assisted reproduction, an higher number of oocytes collected and embryos transferred was observed in normo‐responders than in poor‐responders patients. Furthermore follicular vascular endothelial growth factor (VEGF) resulted inversely correlated with retrieved oocytes (r = −0.942; p = 0.0017). In addition significant higher uterine and perifollicular Doppler flow resistances were observed in poor‐responders women. The pregnancy rate/cycle was significantly higher in normo‐responders (26%) than poor‐responders (6%; p = 0.037) patients.In conclusion, vasoactive substances improve ovarian response to gonadotrophin and allow a better management of ovarian stimulation in infertile patients.
WS04‐02Should all unilocular ovarian cysts be removed in postmenopausal women?
Authors: Granberg S. , Ekerhovd E. , Wienerroith H. , Staudach A. 
Published: March 2003

ObjectivesOur purpose was to evaluate the risks of malignancy in surgically removed ovarian cysts that preoperatively were characterized as unilocular by transvaginal sonography.Study designThis prospective analysis included 1307 women operated at two European university Hospitals between January 1992 and December 1997. Based on ultrasonographic findings the cysts were characterized either as echo‐free, without solid parts or papillary formations (group I) or cysts with solid parts/papillary formations or echogenic cyst content (group II). Ultrasonographic and macroscopic appearance of the cysts were compared with histopathological diagnosis.ResultsIn group I seven of 670 (1.1%) proved to be borderline or malignant, and all measured ≥ 75 mm in diameter. The corresponding figures for cysts in group II were 24 of 634 (3.8%). The frequency of borderline/malignant cysts increased significantly with the size of the cysts.ConclusionUnilocular, echo‐free cysts (group I) with a mean diameter above 50 mm and all unilocular cysts with solid parts/papillary formations should be removed surgically. Serial ultrasound follow‐up should be the standard procedure of unilocular, echo‐free cysts less than 50 mm.
WS01‐03The posterior fossa: a useful landmark in the evaluation of the fetal ventriculomegaly
Authors: D′addario V. , Pinto V. , Di Naro E. , Di Cagno L. 
Published: March 2003

ObjectiveThe objective of this study was to obtain a nomogram of the clivus‐suvraocciput angle as a basis for the diagnosis of Chiari II malformation in fetuses with ventriculomegaly.DesignA cross‐sectional study was undertaken on 310 normal pregnant women of 16–34 weeks' gestation. A mid‐sagittal section of the fetal skull was obtained and the angle between the clivus and the supraocciput was measured. 44 fetuses with ventriculomegaly due to different causes (13 Chiari II malformation, 12 dysgenesis of the corpus callosum, 7 aqueductal stenosis, 6 borderline ventriculomegaly, 3 Dandy‐Walker malformation, 2 porencephaly, 1 schizencephaly) were also included into the study and the values of the angle found in the pathological cases were compared with that found in the normal population.ResultsThe clivus‐supraocciput angle did not change during gestation and was almost constant with an average value of 79,3° ± 6°. All cases of Chiari II malformation showed a value below the 10th centile of our nomogram; all the remaining cases of ventriculomegaly showed normal values of the angle.ConclusionsThe evaluation of the posterior fossa and particularly the measurement of the clivus‐supraocciput angle is a useful parameter to differentiate the various causes of fetal ventriculomegaly and particularly to recognize Chiari II malformation. The measurement of the angle could be also useful to screen for spina bifida which is almost constantely associated to Chiari II malformation.
WS05‐05A role of ultrasound in follow‐up of tamoxifen patients
Authors: Predanic M 
Published: March 2003

Recently suggested role of tamoxifen as a preventive agent in women at high risk of breast cancer has a potential to increase significantly the number of women treated with tamoxifen agent. By the fact that tamoxifen is beneficial in taming the breast cancer, but detrimental to the uterus by increasing the risk of endometrial carcinoma, hyperplasia, and development of endometrial polyps, surveillance of endometrial changes in patients on tamoxifen is needed. However, no cost‐effective method has been found for screening for the rare occurrence of endometrial carcinoma. Therefore, the ACOG does not recommend routine endometrial screening of tamoxifen‐treated breast cancer patients. Regardless of aforementioned recommendation, ultrasound (US) is very helpful as a first line for diagnosis of endometrial pathology in symptomatic or asymptomatic patients with previous endometrial pathology. Endometrial thickness < 5 mm is reassuring, > 5–8 mm calls for further investigation such as sonohysterography to rule out polyps. If it fails to demonstrate polyps, but cystic structures still present and letter on endometrial biopsy (or D & C) shows atrophic changes of the endometrium or material is insufficient for analysis, likely diagnosis is Cystic Endometrial Atrophy. Additionally, Color Doppler flow measurement helps in differentiation between atrophic cystic endometria and polyps, hyperplasia or even cancer in terms that atrophic endometrial are mainly avascular, whereas endometrial polyps and carcinomas are richly vascularized within the endometrium as well as in surrounding myometrial tissue.How and how often endometrial surveillance should be done?1. Recommend us or endometrial biopsy evaluation prior to tamoxifen treatment;2. Follow up with endometrial biopsy/D & C if symptomatic; or3. If asymptomatic but patient at high risk (history of previous endometrial disorders, obesity, long duration of tamoxifen treatment), recommend us 6 months.US findings1. If endometrial thickness > 5–8 mm, exclude endometrial polyps by sonohysterography; and add color doppler to evaluate vascularity pattern;2. If no polyps with thick endometrium on sonohysterography and avascular pattern present, perform blind or hysteroscopic guided endometrial biopsy;3. If findings are atrophic endometrium or insufficient material for diagnosis, assume atrophic (± cystic) endometrial changes and continue annual/semiannual endometrial evaluation (± US);4. If (+) simple hyperplasia, consider progestin and/or D & C treatment;5. Consider hysterectomy as final option if endometrial pathology persists.