bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lethal congenital arthrogryposis presents with increased nuchal translucency at 10–14 weeks of gestation
Authors: Hyett J. , Noble P. , Sebire N. J. , Snijders R. , Nicolaides K. H. 
Published: March 2003

AbstractThis study examines the ultrasonographic features of congenital lethal arthrogryposis. In 27 cases of arthrogryposis diagnosed in the second and third trimesters there was severe bilateral talipes, fixed flexion deformities of the wrists and elbows and either fixed flexion or extension of the knees. In seven (26%) of the cases there was nuchal edema. In two fetuses with arthrogryposis that were examined at 13 weeks of gestation the nuchal translucency thickness was above the 99th centile of the normal range for crown‐rump length. In three other women with previously affected pregnancies, ultrasound examination at 10–14 weeks demonstrated normal fetal nuchal translucency thickness and none of these fetuses were subsequently found to have arthrogryposis. These findings suggest that lethal arthrogryposis, which is usually diagnosed by the demonstration of multiple joint contractures during the second or third trimester of pregnancy, may present as increased nuchal translucency thickness at 10–14 weeks of gestation. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Pulmonary venous blood flow in the human fetus
Authors: Paladini D. , Palmieri S. , Celentano E. , Guida F. , Salviati M. , Morra T. , Martinelli P. 
Published: March 2003

AbstractThe objective of this study was to assess the feasibility of recording pulmonary venous blood flow in the human fetus, and to evaluate its relationship with gestational age.We studied 152 singleton pregnancies between the 19th and 40th weeks of gestation. One hundred and one cases were studied cross‐sectionally to gather data on color flow visualization, and 51 were studied longitudinally. The upper right pulmonary vein was interrogated by pulsed wave Doppler to assess pulmonary venous blood flow.On color Doppler, the upper right pulmonary vein could be imaged in 89.6% of cases in the peri‐atria1 tract and in 75% of cases within the lung. The upper left pulmonary vein could only be imaged in 8% of cases close to the atrium and in 41% of cases within the lung. Reliable velocity waveforms were obtained in 91% of cases. The mean systolic peak velocity was 22.19 ± 6.39 cm/s and the mean diastolic peak velocity was 22.1 ± 6.35 cm/s. Both increased significantly with gestational age. Reversed end‐diastolic blood flow was present in 18% of cases, regardless of gestational age and fetal heart rate. Expressed as a percentage of the forward flow velocity time integral, its value was 7.65 ± 5.2 %.Our data seem to confirm the presence of pulsatile pulmonary venous blood flow in the second‐ and third‐trimester fetus. Normative data have been established for the second and third trimesters of pregnancy. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Fetal anomalies: what is the diagnosis when the chromosomes are normal?
Authors: Gagnon A. L. , Wilson R. D. 
Published: March 2003

AbstractA retrospective study of cases of fetal anomalies associated with a normal karyotype was conducted (1) to evaluate the accuracy of prenatal diagnosis; and (2) to assess two different tools to assist in determining the correct diagnosis.A total of 201 charts were reviewed. The accuracy of the prenatal diagnosis was assessed subjectively by one physician. The London Dysmorphology Database and a locally developed non‐computerized tool (Appendix) were assessed retrospectively using 36 test cases.The population studied presented a spectrum of 97 different groups of single (67%) or multiple (33 %) anomalies. The prenatal diagnosis was accurate in 57% of the cases. The two proposed tools generated an average of 146 and 15 different diagnoses, respectively and the correct one in 26 and 22 of the 36 test cases.The two studied tools have the potential to generate a differential diagnosis in the presence of a fetal anomaly prior to and following normal karyotype analysis. The non‐computerized tool presents the advantages of listing antenatal features and creating a shorter differential diagnosis list with a minimal decrease in the identification rate of the correct diagnosis. Its use should be studied prospectively. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of otocephaly using two‐dimensional and three‐dimensional ultrasonography
Authors: Lin H.‐H. , Liang R.‐I. , Chang F.‐M. , Chang C.‐H. , Yu C.‐H. , Yang H.‐B. 
Published: March 2003

AbstractWe report a case of the prenatal diagnosis of a very rare anomaly, namely isolated otocephaly, using two‐dimensional and three‐dimensional ultrasound at 24 weeks of gestation. Two‐dimensional ultrasound revealed poly‐hydramnios, absence of a stomach shadow, hypotelorism and a proboscis‐like mass. Three‐dimensional ultrasound gave a precise demonstration of the striking craniofacial features of otocephaly including agnathia, synotia, microstomia and protuberance of the nose‐mouth fusion. The use of three‐dimensional ultrasound provided a whole view of the very rare lethal malformation in utero and contributed significantly to prenatal diagnosis. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Outcome of fetuses with isolated borderline unilateral ventriculomegaly diagnosed at mid‐gestation
Authors: Lipitz S. , Yagel S. , Malinger G. , Meizner I. , Zalel Y. , Achiron R. 
Published: March 2003

AbstractObjectiveTo evaluate the outcome of fetuses with isolated borderline, unilateral ventriculomegaly.DesignA retrospective survey was conducted at four perinatal centers in Israel.Subjects and methodsOnly fetuses with one ventricular width of ≥ 11 mm and the other < 10 mm were included in the study. In all cases, the difference of the ventricular width between the two ventricles was > 2.4 mm (two standard deviations). Fetuses with other malformations, chromosomal abnormalities, or those with evidence of in utero infection, were not included in the study.ResultsUnilateral ventriculomegaly was found in 27 subjects (after excluding one case with unilateral ventriculomegaly and Down's syndrome). The mean width of the enlarged ventricle was 11.7 ± 0.9 mm, while the other normal ventricle was 7.2 ± 0.9 mm. The mean gestational age at diagnosis of the unilateral ventriculomegaly was 23.6 ± 2.7 weeks. In one case, pregnancy was terminated, and pathological examination of the fetal brain failed to detect any structural abnormality. Twenty‐five patients delivered at term and only one at 34 weeks' gestation. The neurological development in all 25 fetuses was normal, and one fetus had petit mal seizures.ConclusionFetuses with isolated, borderline unilateral ventriculomegaly, but without other abnormalities, have a good neurological outcome. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Acute effects of a transdermal nitric oxide donor on perifollicular and intrauterine blood flow
Authors: Zackrisson U. , Brännström M. , Granberg S. , Janson P. O. , Collins W. P. , Bourne T. H. 
Published: March 2003

AbstractBackgroundNitric oxide is a potent vasodilator and is involved in several physiological events during the female reproductive cycle.ObjectiveThe aim of this study was to determine the acute effects of a nitric oxide donor on ultrasound‐derived indices of blood flow in the intact human uterus and ovaries during the follicular phase of the normal menstrual cycle.Study designThe plan was to perform an observational study of six healthy volunteers, recruited during days 9–12 from day 1 of the last menstruation. Subjects were scanned transvaginally, with B‐mode and color Doppler imaging around 12.00, and 2 h after the application of a transdermal glyceryl trinitrate (GTN) patch 10 mg/24 h. The patch was then removed and the subjects were rescanned 2 h later.End‐pointsThe main outcome measures were the peak systolic velocity (PSV), time‐averaged maximum velocity (TAMV) and the pulsatility index (PI) derived from flow velocity waveforms, in the left and right main uterine arteries, a radial artery and subendometrial vessels, and from vessels at the rim of the dominant ovarian follicle.ResultsOne woman was scanned on day 9, two on day 10 and three on day 12 of the cycle. The median pretreatment values for endometrial thickness and follicular volumes were 7.2 mm (range 6.0–10.0 mm) and 3.1 ml (range 0.3–6.8 ml), respectively. GTN induced a significant (p < 0.05) increase in the PSV and TAMV in the subendometrial vessels in all subjects. There was a corresponding decrease in the PI in four cases. Changes in blood flow were reversible (50% of the changes in PSV, TAMV and PI were essentially reversed 2 h after the patch had been removed). In the uterine arteries, PSV and TAMV were significantly (p < 0.01) and progressively decreased with a concomitant significant (p < 0.01) increase in PI. There was also a tendency for the mean PI to decrease progressively in the vessels at the rim of the dominant follicle with decreased post‐treatment values in four out of six subjects.ConclusionsGTN induces a reversible increase in subendometrial blood flow velocity during days 9–12 of the menstrual cycle. The expected circadian decrease in uterine artery blood flow seemed to be partly interrupted by GTN treatment.ImplicationsThese data justify the implementation of randomized controlled studies to determine the potential beneficial effects of transdermal GTN on ovarian and uterine blood flow and function. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Three‐dimensional ultrasonographic assessment of fetal hands and feet
Authors: Hata T. , Aoki S. , Akiyama M. , Yanagihara T. , Miyazaki K. 
Published: March 2003

AbstractObjectiveThe aim of this study was to describe fetal hands and feet using three‐dimensional ultrasonography.DesignThis was a randomized prospective study.MethodsNinety‐seven fetuses from 12 to 40 weeks' gestation were studied with a specially developed transabdominal three‐dimensional transducer (3.5 MHz). The imaging system used in this study can provide conventional two‐dimensional ultrasound images and can also generate, within seconds, high‐quality three‐dimensional images in the surface and transparent modes with no need for an external workstation. The rate of visualization of the hands/fingers and feet/toes at each gestational‐age interval was calculated using two‐dimensional and three‐dimensional ultrasonography.ResultsThe ability to visualize fetal hands/fingers and feet/toes was better with three‐dimensional than with two‐dimensional ultrasonography in the late first trimester (detection rates were 65% and 41% by three‐dimensional ultrasonography for hands and feet, respectively, and 41% and 12%, respectively, by two‐dimensional ultrasonography). For the early second trimester, detection rates were 82% for hands and 72% for feet by three‐dimensional ultrasonography, and 54% for hands and 45% for feet by two‐dimensional ultrasonography. Optimal visualization of the fetal fingers using three‐dimensional ultrasonography was achieved between 28 and 35 weeks of gestation, although at this stage there were no significant differences in detection rates for hands and feet between two‐ and three‐dimensional imaging. During this period it was possible with three‐dimensional ultrasonography adequately to depict at least one hand in 93% of the fetuses at 28–31 weeks and in 88% at 32–35 weeks. The percentage of visualization of at least one fetal foot between 16 and 35 weeks using three‐dimensional ultrasonography ranged from 50 to 85%. Before 15 weeks or after 36 weeks, the respective percentages decreased.ConclusionsThree‐dimensional ultrasonography provides a novel means of visualizing fetal fingers and toes. Our observations suggest that three‐dimensional ultrasonography may enhance the diagnostic potential of two‐dimensional ultrasonography and might be useful in identifying fetal malformations and anatomical markers of chromosomal abnormalities prenatally in high‐risk pregnancies. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Functional pulmonary valve regurgitation in the fetus
Authors: Smrcek J. M. , Germer U. , Gembruch U. 
Published: March 2003

AbstractObjectiveThe purpose of this study was to determine the prevalence and the characteristics of functional pulmonary valve regurgitation in normally grown fetuses.DesignA prospective cross‐sectional study.SubjectsA total of 1115 singleton fetuses between 18 and 41 weeks of gestation and who had normal heart anatomy, normal estimated weight for gestational age and normal flow velocity waveforms in the umbilical and middle cerebral arteries and umbilical vein were examined. Cases with agenesis, constriction or other abnormalities of the ductus arteriosus were excluded.MethodsExamination of the pulmonary valve was performed by color Doppler echocardiography, pulsed wave Doppler and, if necessary, continuous wave Doppler in the short‐axis view at the level of the origin of the great arteries and/or in a subcostal view of the right ventricular outflow tract and pulmonary trunk. If pulmonary valve regurgitation was detected by color Doppler flow imaging and confirmed by pulsed wave Doppler echocardiography, the maximum velocity of the regurgitant jets as well as their maximum lengths were measured.ResultsThe prevalence of functional pulmonary valve regurgitation was 0.54% (n = 6). Pulmonary valve regurgitation was part diastolic in four cases and holodiastolic in two cases, with maximum velocity of ≤ 2.05 m/s and maximum length of 3–8 mm. Prenatal re‐examination of five of the six fetuses with pulmonary valve regurgitation showed that pulmonary valve regurgitation was a transient phenomenon in four cases. The fetal outcome in the presence of transient pulmonary valve regurgitation was normal; pediatric echocardiographic examination in these six fetuses with transient pulmonary valve regurgitation showed no regurgitations or other cardiac anomalies.ConclusionsPulmonary valve regurgitation was functional in all six fetuses. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Clinical interpretation of ultrasound biometry for dating and for assessment of fetal growth using a wheel and chart: is it sufficiently accurate?
Authors: Hutchon D. J. R. , Kearney C. 
Published: March 2003

AbstractObjectivesTo investigate how accurately practicing obstetricians (experts) can apply dating rules and compare the interpretation of gestation‐sensitive ultrasound data with those of a computer system.SubjectsSeventeen practicing obstetricians, Members of the Royal College of Obstetricians and Gynaecologists, from 14 different units throughout the UK.DesignSix cases with menstrual and ultrasound data together with identical ultrasound charts and obstetric wheels.Main outcome measures Concordance between the calculated estimated date of delivery (EDD) and growth assessment provided by the experts and the computer system.ResultsThe calculation of the EDD by the experts was imprecise (59% within 3 days overall). Concordance with the computer calculation was poorest when the ultrasound measurements lay close to the upper or lower centile lines (average 7% within 3 days of the computer). Interpretation of growth showed good concordance with the computer when gestation was not critical to the interpretation (94%), but very poor when gestation was critical (7%).ConclusionsCalculation of EDD by means of an obstetric wheel and charts is not precise. Compared with the computer system, these errors have a significant effect on the subsequent interpretation of growth scans when the data are borderline. A computer system provides the more accurate method for interpreting gestation‐sensitive ultrasound biometry. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
The development of the fetal sternum: a cross‐sectional sonographic study
Authors: Zalel Y. , Lipitz S. , Soriano D. , Achiron R. 
Published: March 2003

AbstractObjectiveTo assess the relationship between gestational age and sonographic appearance of the various sternal components and establish growth during human gestation.DesignA prospective cross‐sectional study.MethodsThe study was performed on 252 consecutive normal singleton pregnancies from 19 weeks of gestation until term, using transabdominal high‐resolution ultra‐sound techniques. The sternal length, as well as the number of ossification centers at each gestational age, were recorded.ResultsThe first occasion at which a fetal human sternum could be visualized with two to three ossification centers was at 19 weeks' gestational age. The fifth ossification center was first visualized at 29 weeks' gestation. The mean ± SE of sternal length varied from 15 ± 0.98 mm (95% confidence interval (CI) 12.79–17.21) at 19–20 weeks, to 36.50 ± 0.29 mm (95% CI 35.58–37.42) at 37–38 weeks' gestation. Sternal length as a function of gestational age was expressed by the regression equation: sternal length (mm) = −11.06 + 1.39 × gestational age (weeks). The correlation coefficient, r = 0.924 for sternal length, was found to be highly statistically significant (p < 0.0001).ConclusionsThe presented data offer normative measurements of the fetal sternum which may be helpful in the prenatal diagnosis of congenital syndromes that include, among other manifestations, abnormalities of sternal development. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Cardiac changes in fetuses secondary to immune hemolytic anemia and their relation to hemoglobin and catecholamine concentrations in fetal blood
Authors: Oberhoffer R. , Grab D. , Keckstein J. , Högel J. , Terinde R. , Lang D. 
Published: March 2003

AbstractObjectivesImmune hemolytic anemia in the fetus may cause cardiac decompensation and intrauterine death. Postnatally, norepinephrine (noradrenaline) is released in chronic heart failure, and may lead to myocardial hypertrophy. The aim of this study was to determine fetal cardiac changes associated with immune hemolytic anemia by means of echocardiography, and to relate them to fetal hemoglobin and norepinephrine levels.DesignThirty anemic fetuses underwent a total of 76 umbilical venous transfusions. Before the procedure, fetal echocardiography was performed, and end‐diastolic myocardial wall thicknesses and ventricular dimensions together with Doppler flow patterns at the atrioventricular and semilunar valves were measured. Fetal hemoglobin, epinephrine and norepinephrine concentrations were determined before the transfusion. Statistical analysis of this prospective study comprised descriptive statistics including linear regression and correlation analyses. Two samples of measurements were compared by the Mann–Whitney U test.ResultsThe mean hemoglobin concentration before the first tranfusion was 6.9 g% at a mean gestational age of 26.8 weeks. Norepinephrine values were elevated in comparison to a reference range, and were higher than epinephrine values. The most striking echocardiographic finding was myocardial hypertrophy of all ventricular walls. Mean blood flow velocities were increased; at the left ventricle, they were negatively related to the hemoglobin concentrations, and positively to the norepinephrine values.ConclusionsFetal myocardial hypertrophy in anemia may be the result of an augmented cardiac workload, indicated by the increased left ventricular mean velocities. This reaction reflects the redistribution of blood flow that may depend on hemoglobin and norepinephrine concentrations. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Nitric oxide donors in pregnancy: fetomaternal hemodynamic effects induced in mild pre‐eclampsia and threatened preterm labor
Authors: Luzi G. , Caserta G. , Iammarino G. , Clerici G. , Di Renzo G. C. 
Published: March 2003

AbstractObjectiveThe present study was performed to determine whether there are significant differences in the effects of the nitric oxide donor, glyceryl trinitrate, administration in pregnancies complicated by mild pre‐eclampsia compared to the effects in pregnancies which are uncomplicated by this pathology. Glyceryl trinitrate is able to release nitric oxide (NO); deficiency of NO has been hypothesized in the pathogenesis of pre‐eclamptic disorders.MethodsIn this prospective study, ten patients with threatened preterm labor and ten patients with mild pre‐eclampsia were studied at around 30 weeks of pregnancy. The maternal blood pressure, maternal heart rate, fetal heart rate and flow velocity waveforms of the placental uterine artery, umbilical artery and fetal middle cerebral artery, evaluated by means of color Doppler and pulsed Doppler, were recorded before and 10, 20 and 30 min after the sublingual administration of 0.3 mg of glyceryl trinitrate or placebo. The pulsatility index (PI) was calculated. The percentage change from the control period (Δ%) was calculated for each parameter at 10, 20 and 30 min. Ten normal pregnant women at the same gestational age were used as controls and were administered a placebo.ResultsThe maternal blood pressure recorded as systolic and diastolic values, demonstrated a significant decrease in the pre‐eclampsia group after glyceryl trinitrate administration; the Δ% at any time considered was significantly higher in the pre‐eclampsia group than in the threatened preterm labor group. The PI of the placental uterine artery showed a significant decrease in both groups after 20 and 30 min from drug administration; the Δ at 20 and 30 min was significantly higher in the pre‐eclampsia group than in the threatened preterm labor group. The PI of the umbilical artery showed a significant decrease after 30 min from the glyceryl trinitrate administration. The fetal heart rate showed no significant variations during the study in either group. The PI of the fetal middle cerebral artery showed no significant variations during the study in either group. No parameter was changed in the control group.ConclusionGlyceryl trinitrate administration was followed by a greater reduction of the resistance to blood flow in the fetoplacental circulation of the pregnancies affected by mild pre‐eclampsia compared to pregnancies uncomplicated by this pathology. This effect can be attributed to the NO released by the drug which offsets the decreased production of NO, postulated to contribute to the pathogenesis of pre‐eclampsia. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology