bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrated first and second trimester screening for Down syndrome
Authors: Lam Y. H. , Lee C. P. , Sin S. Y. , Tang R. , Wong H. S. , Wong S. F. , Tang M. H. Y. , Woo H. H. N. 
Published: March 2003

Purposes:  It is uncertain whether first trimester nuchal translucency is more effective than the well established second trimester serum screening for fetal Down syndrome or whether their combination works best. We report our data on a large multicenter non‐interventional trial in which all subjects underwent both first and second trimester screening to assess their relative efficacy.Methods:  All women who attended the obstetric clinic before 15 weeks were recruited. An ultrasound examination was performed at 10–14 weeks to measure the nuchal translucency. The nuchal measurements were not acted upon unless the fetus showed gross features of hydrops fetalis. All women had serum alpha‐fetoprotein and human chorionic gonadotrophin assay at 15–20 weeks. The Down syndrome risk assigned by serum screening was disclosed and amniocentesis was offered if this assigned risk was at or >1:250 or if the women were 35 years and older. Efficacy of different combinations of screening were compared.Results:  Between January 1997 and August 2000, 17590 women were recruited (19% was 35 years and older). After excluding subjects who miscarried, defaulted the serum test and other reasons, 16237 pregnancies were included in the final analysis. Of these, 35 pregnancies were affected by Down syndrome (2.2 cases per 1000 pregnancies). At a false‐positive rate of 5%, the detection rate of Down syndrome by nuchal translucency alone; nuchal translucency + age; serum human chorionic gonadotrophin, alpha‐fetoprotein + age and nuchal translucency + human chorionic gonadotrophin + alpha‐fetoprotein + age were 61, 69, 73 and 86%, respectively. Comparison of areas under the receiver‐operating characteristic curves showed statistically significant differences between these methods of screening.Conclusions:  Integration of nuchal translucency and second trimester serum alpha‐fetoprotein and human chorionic gonadotrophin assay yielded the best screening efficacy for Down syndrome.
Effects of US on maternal–fetal bonding: 2D vs. 3D
Authors: Pretorius D. H. , Uyan K. M. , Newton R. , Hull A. , James G. , Nelson T. 
Published: March 2003

Objective:  To compare the effects of two‐dimensional ultrasound (2DUS) vs. three‐dimensional ultrasound (3DUS) imaging on the maternal–fetal bonding process.Methods:  A total of 100 normal pregnant subjects were randomly selected retrospectively. Ultrasounds were performed between 1998 and 2000. Fifty mothers who had 2DUS and 50 who had 3DUS were randomly selected to screen. We designed a postpartum survey consisting of 10 questions regarding parental–fetal bonding for telephonic interview.Results:  A randomized sampling of data was performed to equalize cells for some study questions. Mothers who received 3DUS shared their ultrasound photographs with significantly more number of people (mean, 31.72) than did mothers receiving 2DUS (mean, 16.02) (t = − 2.810, d.f. 1, 46, P = 0.007). Subjects screened with 3DUS had a greater tendency to form a mental image of the baby post‐screening (82%) than 2DUS subjects (39%). The 3DUS parents were more likely to receive comments on similarities/differences with the actual baby than parents having 2DUS studies (x = 4.109 d.f. 1, P = 0.043). Further, 70% of the mothers receiving 3DUS felt they ‘knew’ the baby right after birth because of the images they saw compared to only 56% of 2DUS moms.Conclusion:  The 3DUS images appears to have a more positive influence on the perceptions of mothers compared to 2DUS images. Specifically, mothers who had 3DUS showed their images to twice as many people as those having 2DUS studies. 3DUS may have the potential benefit to strengthen the support system for families expecting their newborns.
Three‐dimensional obstetric ultrasound (3DUS) is perceived by lay non‐pregnant adults to be more valuable than two‐dimensional ultrasound (2DUS)
Authors: Hull A. D. , Pretorius D. H. , Newton R. , Asfoor S. A. , James G. 
Published: March 2003

Purpose:  To determine the impact of 3DUS on non‐pregnant lay adults.Methods:  A 15‐minute audiovisual presentation on 3DUS and 2DUS was shown to 120 students It included a brief explanation of the technology and both 2D and 3D images of a normal fetus at 30 weeks gestation. A number of 87 subjects (64 female, 23 male, age 21 ± 0.2 years) completed a self‐administered questionnaire after the presentation.Results:  Ninety percent of the subjects had never heard of 3DUS prior to the presentation. All were able to appreciate the difference between 2DUS and 3DUS. Seventy‐eight percent said that they would request 3DUS in a future pregnancy. The commonest reasons given for this choice were better detection of fetal anomalies and visualization of greater anatomical detail compared to 2DUS. Ninety‐four percent of subjects believed that 3DUS was likely to be a significant tool for medical use. Seventy‐five percent of women and 61% of men felt that 3DUS would affect parental fetal attachment.Conclusion:  Lay subjects readily appreciate the differences between 2D and 3DUS. Most believed that 3DUS was superior to 2DUS in assessing the fetus, afforded a diagnostic advantage to physicians and would have beneficial effects on parental attachment. These findings have important implications when considering consumer demand for new imaging modalities in obstetrics.
Transvaginal sonography of the uterine cervix prior to labor induction
Authors: Gabriel R. , Darnaud T. , Chalot F. , Gonzalez N. , Leymarie F. , Quereux C. 
Published: March 2003

AbstractObjectivesTo compare the Bishop score and transvaginal sonographic measurement of cervical length for predicting the mode of delivery following medically indicated induction of labor in term patients.MethodsThe study was conducted prospectively in 179 women who required medically indicated induction of labor. Inclusion criteria were singleton pregnancy, gestational age >37 weeks of amenorrhea, cephalic presentation and intact fetal membranes. Cervical length was measured upon arrival in the labor room but was not considered when choosing the induction procedure. Two receiver‐operating characteristic curves were plotted to calculate the best threshold value for the Bishop score and for cervical length for predicting the risk of Cesarean section.ResultsFifty‐three women (29.6%) had a Cesarean section. The Bishop score was not predictive of the delivery mode, although Cesarean section for failure to progress was more frequent when the Bishop score was ≤5. Among the women with a Bishop score >5, the cervical length was not predictive of the induction outcome. However, among the women with a Bishop score ≤5, a cervical length <26 mm was associated with a lower Cesarean section rate (20.6 vs. 42.9%; P = 0.006). Furthermore, the interval between the beginning of cervical ripening and delivery was shorter in the case of a short cervix (11.01 ± 6.7 vs. 18.55 ± 7.07 h; P < 10−5).ConclusionThe length of the uterine cervix, measured by transvaginal sonography, is a better predictor of the risk of Cesarean section than the Bishop score after induction of labor for medical reasons. In women with an unfavorable Bishop score, a cervical length of <26 mm is associated with a lower risk of Cesarean section and a shorter duration of labor. Copyright © 2002 ISUOG
Short‐term safety of celocentesis for the mother and the fetus
Authors: Makrydimas G. , Kaponis A. , Skentou C. , Lolis D. 
Published: March 2003

AbstractObjectiveCelocentesis offers the potential for prenatal diagnosis from as early as 6 weeks of gestation. The aim of this study was to examine the short‐term safety of celocentesis.MethodsEligible for the study were pregnant women with single live fetuses at 6–10 weeks of gestation, requesting pregnancy termination for social indications. At presentation, the patients were asked if they were willing to undergo celocentesis and in those women who agreed the procedure was performed at the time of the initial scan. A second scan was carried out just before termination to measure fetal crown–rump length and heart rate.ResultsFour hundred and forty‐seven women requested termination of pregnancy and 108 of these agreed to have celocentesis. There were no significant differences between the groups in maternal age, prevalence of primigravidas, cigarette smokers, existence of uterine fibroids, the median fetal crown–rump length or the interval between the initial scan (or celocentesis) at presentation and the pregnancy termination. At the time of termination, ultrasound examination demonstrated fetal death in five (4.7%) of the celocentesis group and nine (2.7%) of the controls (odds ratio, 1.804; 95% confidence interval, 0.5912–5.504). In all other cases, there was normal fetal growth and there were no significant differences between the groups in fetal crown–rump length.ConclusionsThe procedure related fetal loss associated with celocentesis may be approximately 2%. Copyright © 2002 ISUOG
Uterine and fetal cerebral Doppler predict the outcome of third‐trimester small‐for‐gestational age fetuses with normal umbilical artery Doppler
Authors: Severi F. M. , Bocchi C. , Visentin A. , Falco P. , Cobellis L. , Florio P. , Zagonari S. , Pilu G. 
Published: March 2003

AbstractObjectiveTo assess the value of different admission tests in predicting the outcome of small‐for‐gestational age (SGA) fetuses with normal Doppler waveforms in the umbilical artery.MethodsCriteria for admission into this retrospective study included: singleton pregnancy with a birth weight <10th centile; absence of severe maternal complications; no evidence of fetal anomalies on the sonogram; normal umbilical artery Doppler; and availability of complete follow‐up. At the first antenatal sonogram classifying the fetus as SGA, Doppler analysis of the uterine and middle cerebral arteries was performed and amniotic fluid volume was assessed. Outcome variables included adverse perinatal outcome (perinatal death, severe morbidity) and emergency Cesarean section for fetal distress.ResultsTwo hundred and thirty‐one pregnancies were included in the study. The mean ± standard deriation birth weight and gestational age at delivery were 2222 ± 502 g and 37.3 ± 2.9 weeks, respectively. In 37 cases (16%), an emergency Cesarean section was performed. There was one intrauterine death and three fetuses delivered by emergency Cesarean section developed severe morbidity. Logistic regression demonstrated that abnormal velocimetry of the uterine arteries and fetal middle cerebral artery were independently correlated with the occurrence of Cesarean section.ConclusionsSGA fetuses with normal umbilical artery Doppler waveforms and abnormal uterine arteries and fetal middle cerebral artery waveforms have an increased risk of developing distress and being delivered by emergency Cesarean section. Particularly when both uterine and fetal cerebral waveforms are altered at the same time, the risk is exceedingly high (86%) and delivery as soon as fetal maturity is achieved seems advisable. On the other hand, when both vessels have normal waveforms, the chances of fetal distress are small (4%) and expectant management is the most reasonable choice. Copyright © 2002 ISUOG
Ultrasonographic evaluation of cervical length in pregnancies complicated by preterm premature rupture of membranes
Authors: Gire C. , Faggianelli P. , Nicaise C. , Shojai R. , Fiori A. , Chau C. , Boubli L. , D'Ercole C. 
Published: March 2003

AbstractObjectiveTo evaluate the usefulness of transvaginal ultrasonography in the determination of the risk of preterm delivery and chorioamnionitis in pregnancies affected by preterm premature rupture of membranes preterm premature rupture of membranes.DesignOne hundred and one singleton pregnancies with preterm premature rupture of membranes were included in this prospective study over a 3‐year period. Patients underwent cervical length measurement by transvaginal ultrasonography at admission and thereafter, in the absence of chorioamnionitis, were managed expectantly.ResultsThe median time interval between admission and delivery (latency period) was 48 h. A cervical length of less than 20 mm was associated with a significant risk of early delivery (mean latency period was 59.44 ± 159.93 h vs. 240.94 ± 364.67; P < 0.05). There was no relation between cervical length and occurrence of chorioamnionitis or neonatal sepsis.ConclusionsThese data suggest that the use of transvaginal ultrasonography for cervical length measurement during preterm premature rupture of membranes may predict an early delivery but cannot anticipate the risk of chorioamnionitis or neonatal sepsis. Copyright © 2002 ISUOG
Umbilical venous volume flow in the normally developing and growth‐restricted human fetus
Authors: Boito S. , Struijk P. C. , Ursem N. T. C. , Stijnen Th. , Wladimiroff J. W. 
Published: March 2003

AbstractObjectiveTo determine the reproducibility of measurement of umbilical venous volume flow components and to calculate umbilical venous volume flow in normal and growth‐restricted (small‐for‐gestational age) fetuses in a cross‐sectional study.MethodUsing Labview and Imaq‐vision software, the cross‐sectional inner area of the umbilical vein was traced. Vessel area (mm2) and Doppler‐derived time‐averaged flow velocity (mm/s) were multiplied to calculate volume flow (mL/min) including flow per kg fetal weight. The coefficient of variation for vessel area and flow velocity scans and tracings were determined (n = 13; 26–35 weeks). Normal charts for components and volume flow were constructed (n = 100; 20–36 weeks) and related to data from growth restricted fetuses (birth weight <5th centile) (n = 33; 22–36 weeks). In growth‐restricted fetuses the umbilical artery pulsatility index was also obtained.ResultsReproducibility: The coefficient of variation was 5.4% (vessel area) and 7.3% (time‐averaged velocity) for scans and 6.6% and 10.5% for measurements, resulting in a coefficient of variation of 8.1% (scans) and 11.9% (measurements) for volume flow. A gestational age‐related increase exists for vessel area, time‐averaged flow velocity and umbilical venous volume flow from 33.2 (SD, 15.2) mL/min at 20 weeks to 221.0 (SD, 32.8) mL/min at 36 weeks of gestation, but there is a reduction from 117.5 (SD, 33.6) mL/min to 78.3 (SD, 12.4) mL/min for volume flow per kg fetal weight. In small‐for‐gestational age fetuses, the values were below the normal range in 31 of 33 cases for volume flow and in 21 of 33 cases for volume flow per kg fetal weight. Umbilical artery pulsatility index was significantly different between the subsets with normal and those with reduced volume flow per kg fetal weight.ConclusionsMeasurements of umbilical venous vessel area and time‐averaged velocity resulted in acceptable reproducibility of volume flow calculations, which show a seven‐fold increase at 20–36 weeks of gestation. In growth‐restricted fetuses, volume flow is significantly reduced. When calculated per kg/fetus, the values were reduced in 21 (63.6%) out of 33 cases. Copyright © 2002 ISUOG
Uterine artery Doppler patterns in abdominal pregnancy
Authors: Acácio G. L. 
Published: March 2003

AbstractChanges in the uterine artery blood flow waveform during pregnancy have been the subject of several studies and are frequently attributed to trophoblastic invasion of the myometrium. We report on a case of a third‐trimester abdominal pregnancy in which we performed Doppler velocimetry of the uterine arteries and observed low‐resistance flow and absence of notching bilaterally. During the 29th week of gestation, there was an increase in umbilical artery resistance and a decrease in the middle cerebral artery resistance, so we chose to deliver the baby at that stage. The patient was discharged from hospital 7 days following delivery and the child was discharged having gained the necessary weight. Our findings suggest that modification of the uterine artery waveform may occur independently of trophoblast invasion of the spiral arteries. Other theories that may explain the changes in the uterine artery waveform during pregnancy are discussed. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Outcome of antenatally diagnosed talipes equinovarus in an unselected obstetric population
Authors: Bakalis S. , Sairam S. , Homfray T. , Harrington K. , Nicolaides K. , Thilaganathan B. 
Published: March 2003

AbstractObjectiveTo investigate the natural history and outcome of fetal talipes diagnosed by routine ultrasound scanning at 18–23 weeks' gestation.Patients and methodsThis was a retrospective study of 103 228 pregnancies undergoing routine ultrasound scanning at 18–23 weeks' gestation. A computer search was made to identify all cases of fetal talipes and the records of these patients were examined to determine the incidence of other defects and pregnancy outcome.ResultsThe incidence of fetal talipes following routine ultrasound examination was 0.10% (107/103 228) and was bilateral in 64 (59.8%) and unilateral in 43 (40.2%) cases. In 52 (48.6%) cases, talipes was of complex etiology, as it was associated with other defects, while, in 55 (51.4%) cases, it was classified as idiopathic. In 19% of cases, an initial diagnosis of idiopathic talipes was changed to complex, because of the subsequent development of associated features. Perinatal death and long‐term neurodevelopmental or musculoskeletal problems were significantly more common when the talipes was complex rather than idiopathic (odds ratio, 150; 95% confidence interval, 34–665). Adverse outcomes were also seen more frequently with bilateral compared to unilateral talipes (odds ratio, 3.44; 95% confidence interval, 1.50–7.90).ConclusionThe outcome of antenatally detected talipes is mainly dependent on the presence or absence of other defects. A significant proportion of cases, thought to be idiopathic at presentation, will develop associated complex features when reassessed on subsequent scans or postnatally. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
First‐trimester diagnosis of fetal arachnoid cyst: prenatal implication
Authors: Bretelle F. , Senat M.‐V. , Bernard J.‐P. , Hillion Y. , Ville Y. 
Published: March 2003

AbstractWe report a case of the early diagnosis of an arachnoid cyst. Transvaginal ultrasound examination of the fetal brain at 13 weeks' gestation revealed the presence of an anechoic mass above the posterior fossa. After extensive counseling and because of the uncertain prognosis of a first‐trimester diagnosis of an arachnoid cyst, the parents opted for termination of pregnancy. The diagnosis was confirmed by postmortem examination. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Evolution of neural crest and placodes: amphioxus as a model for the ancestral vertebrate?
Authors: HOLLAND LINDA Z. , HOLLAND NICHOLAS D. 
Published: March 2003

abstractRecent studies of protochordates (ascidian tunicates and amphioxus) have given insights into possible ancestors of 2 of the characteristic features of the vertebrate head: neural crest and placodes. The neural crest probably evolved from cells on either side of the neural plate–epidermis boundary in a protochordate ancestral to the vertebrates. In amphioxus, homologues of several vertebrate neural crest marker genes (BMP2/4, Pax3/7, Msx, Dll and Snail) are expressed at the edges of the neural plate and/or adjacent nonneural ectoderm. Some of these markers are also similarly expressed in tunicates. In protochordates, however, these cells, unlike vertebrate neural crest, neither migrate as individuals through embryonic tissues nor differentiate into a wide spectrum of cell types. Therefore, while the protochordate ancestor of the vertebrates probably had the beginnings of a genetic programme for neural crest formation, this programme was augmented in the earliest vertebrates to attain definitive neural crest. Clear homologues of vertebrate placodes are lacking in protochordates. However, both amphioxus and tunicates have ectodermal sensory cells. In tunicates these are all primary neurons, sending axons to the central nervous system, while in amphioxus, the ectodermal sensory cells include both primary neurons and secondary neurons lacking axons. Comparisons of developmental gene expression data suggest that the anterior ectoderm in amphioxus may be homologous to the vertebrate olfactory placode, the only vertebrate placode with primary, not secondary, neurons. Similarly, biochemical, morphological and gene expression suggest that amphioxus and tunicates also have homologues of the adenohypophysis, one of the few vertebrate structures derived from nonneurogenic placodes. In contrast, the origin of the other vertebrate placodes is very uncertain.
The function of the Periaxin gene during nerve repair in a model of CMT4F*
Authors: Williams Anna C. , Brophy Peter J. 
Published: March 2003

AbstractMutations in the Periaxin (PRX) gene are known to cause autosomal recessive demyelinating Charcot‐Marie‐Tooth (CMT4F) and Dejerine‐Sottas disease. The pathogenesis of these diseases is not fully understood. However, progress is being made by studying both the periaxin‐null mouse, a mouse model of the disease, and the protein–protein interactions of periaxin. L‐periaxin is a constituent of the dystroglycan–dystrophin‐related protein‐2 complex linking the Schwann cell cytoskeleton to the extracellular matrix. Although periaxin‐null mice myelinate normally, they develop a demyelinating peripheral neuropathy later in life. This suggests that periaxin is required for the stable maintenance of a normal myelin sheath. We carried out sciatic nerve crushes in 6‐week‐old periaxin‐null mice, and, 6 weeks later, found that although the number of myelinated axons had returned to normal, the axon diameters remained smaller than in the contralateral uncrushed nerve. Not only do periaxin‐null mice have more hypermyelinated axons than their wild‐type counterparts but they also recapitulate this hypermyelination during regeneration. Therefore, periaxin‐null mice can undergo peripheral nerve remyelination, but the regulation of peripheral myelin thickness is disrupted.