bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy in women with Marfan syndrome
Authors: García C. G. , Lagos N. P. , Benavides C. E. , Hoffmann I. F. , Castillo G. A. , Astorga M. A. , Melgarejo X. , Ferres I. 
Published: March 2003

Background:  The Marfan syndrome is inherited as an autosomal dominant trait, and the fetus has a 50% risk of inheriting the mutant gene. It is caused by an abnormal fibrin gene located on chromosome 15q. The prevalence of the syndrome is 7–17/100 000. The symptoms and complications usually affect ocular, skeletal and cardiovascular systems. Pregnancy in the Marfan syndrome is associated with major problems: the first are maternal catastrophic cardiovascular complications which include aortic dissection, aortic rupture, or cardiac failure, due to mitral and aortic valve regurgitation. These conditions are responsible for 90% of the maternal deaths. The second problem is the risk of having a child with the syndrome (50%).Case report:  An 18‐year‐old patient with a Marfan syndrome and with mental retardation. She had long limbs, slenderness of hands and feet, marked hyperextensible joints, kyphoscoliosis, narrow chest with pectum excavatum, an high arched palate with malocclusion. On first evaluation by US, she was 18 weeks pregnant. A maternal echocardiography was done, showing that all four chambers, and the valvular structures were normal, and the aortic root measured 26 mm, which was normal. The echocardiography was repeated at weeks 29 and 36, and showed no change in the aortic root or in the rest of the parameters. Study of the fetus showed normal anatomy, without morphotype of Marfan in utero. Fetal echocardiography was normal. There was moderate IUGR. At 39th week, there was a vaginal delivery, without complications, of a male newborn, 2910 g, 49 cm, Apgar 9–9, on a normal physical examination.Conclusions:  Maternal and fetal outcomes were monitored with systematic echocardiography, which is the best and safest method available for the follow up of the severe cardiovascular complications. Patients with Marfan syndrome with aortic root of <40 mm, usually tolerate pregnancy well and can undergo vaginal delivery with epidural anesthesia, with favorable maternal and fetal outcomes.
Diagnosis and prognostic value Doppler flow velocity waveform in high risk pregnancies
Authors: Ghoneim M. R. , Megahed H. , Habba M. , El‐Biely M. M. , Lotfy G. L. 
Published: March 2003

Objective:  To determine whether Doppler umbilical artery flow velocity waveforms (FVW) would improve the clinical management and reduce the prenatal morbidity or not, in cases of high risk pregnancies.Methods:  A total of 160 pregnant women of 28 weeks or more gestational age were included in this study. The age of the cases were from 20‐ to 30‐year‐old and their gravidity ranged from gravida 1 to 5. The cases were classified into two groups. Low risk group, not associated with medical or obstetric complications and includes 70 cases. High risk groups include, the other 90 cases, such as the following: mild pre‐eclampsia (20), severe pre‐eclampsia (15), diabetes mellitus (10), postdated pregnancy (15), previous one or more cesarean section (15), rheumatic heart (4), decreased perception of fetal movement (3), bronchial asthma (2), Rh incompatibility (2) and previous IUFD. All of them were subjected to thorough general and obstetric examination, investigations, ultrasonic examination, biophysical profile scoring and Doppler umbilical artery FVW study. The cases of low risk group were examined every 2 weeks, while high risk ones, were examined every week or twice weekly according to the results of the previous examination.Results:  There is a highly significant difference between values of umbilical artery FVW indices in low and high risk group. Doppler has specificity 92.8% in cases of low risk group while has sensitivity 52.8% and specificity 55.6% in cases of high risk group and it is more sensitive than biophysical profile. Doppler of umbilical artery is very beneficial in cases of pre‐eclampsia, where its sensitivity 78.5% and its specificity 52%.Conclusion:  There is a strong association between abnormal FVW and adverse fetal outcome. The Doppler will identify a group of fetuses truly at risk, where intensive fetal monitoring or delivery will be required.
Doppler assessment of the uterine circulation in the second trimester in twin pregnancies: prediction of hypertensive disorders, small‐for‐gestational age and weight discordance
Authors: Geipel A. , Berg C. , Germer U. , Gröger S. , Krapp M. , Katalinic A. , Gembruch U. 
Published: March 2003

Objective:  To compare singleton nomograms of the uterine circulation with previously established twin nomograms in the prediction of hypertensive disorders, small‐for‐gestational age (SGA) and birth weight discordance >20%.Methods:  This was an analysis of maternal and perinatal data obtained from 256 diamniotic–dichorionic twin pregnancies. The uterine artery resistance and pulsatility index were calculated as a mean from both sides and the presence and absence of notching was recorded. Cut‐off levels for abnormal flow parameters were the 95th centile of reference ranges using singleton and twin nomograms.Results:  As mean uterine artery indices are lower in twin gestation, a higher number of patients (n = 73; 28.5%) was screen positive according to twin reference values when compared to those of singletons (n = 51; 19.9%). However, singleton reference ranges or recording of notches only proved to be more efficient than twin reference ranges to correctly predict SGA (17.6, 19, 13.7%), birth weight discordance >20% (30.6, 37.5, 23.9%), and hypertensive disorders (23.5, 21.4, 16.4%), respectively. Compared to singleton nomograms of uterine artery Doppler, twin nomograms had higher sensitivities, lower specific and positive predictive values, but equal negative predictive value to comprise adverse pregnancy outcomes.Conclusion:  For routine clinical practice, it seems justified to use singleton nomograms to assess uterine circulation in twin gestation. However, as the negative predictive value of uterine Doppler studies is slightly lower when compared to singletons, maternal and fetal complications might occur despite normal uterine waveforms.
Three‐dimensional volumetry in fetal weight estimation, cerebral ventricle measurements, and cardiac function
Authors: Yagel S. 
Published: March 2003

Objectives:  To examine the applicability and efficacy of 3‐D volumetry in three discrete areas: fetal weight estimation, cerebral ventricle measurements, and 3‐D echocardiographic studies of fetal cardiac function.Materials and methods:  Group 1: fetal weight estimation: 250 gravidae with uncomplicated singleton gestations and first‐trimester confirmation of gestational age were examined up to 48 h before delivery using both standard 2‐D fetal weight estimation and 3‐D volumetry. Group 2: fetal cerebral ventricle measurements: 40 gravidae with first‐trimester confirmation of dates were examined at 15–25 weeks gestation. Fetal lateral ventricles were measured by 3‐D volumetry. Group 3: 3‐D echocardiography: 40 gravidae with 1st‐trimester confirmation of dates were examined at 15–25 weeks gestation. End‐systolic and ‐diastolic ventricular volumes were studied to evaluate fetal cardiac function.Results:  In these preliminary groups 3‐D volumetry for fetal weight estimation was shown to have a considerable advantage over standard 2‐D methods. Three‐dimensional volumetry of the fetal cerebral lateral ventricles is a simple method of measuring the fetal brain, and may prove to be a more intelligent method of evaluating cerebral ventricular volume. Three‐dimensional echocardiographic volumetry of the end‐systolic and ‐diastolic ventricular volumes is a new method for evaluating fetal cardiac function, and has considerable potential in heart scanning in cases of suspected fetal heart failure.Conclusions:  Three‐dimensional ultrasonography shows great potential in the evaluation and volumetric measurement of many fetal organ systems.
Evaluation of the effects of cervical properties
Authors: Kepkep K. , Gurpinar H. , Kar E. 
Published: March 2003

Introduction:  Preterm delivery has been faced in all delivery with a 7–11% and it keeps its importance by causing perinatal mortality and morbidity. Therefore it is important to define preterm delivery risk during the earlier period of the delivery.Objective:  The aim of our work is evaluating the influence of the cervical length and funneling which are measured by transvaginal ultrasonography (TVUSG) in the asymptotic singleton pregnant women, to predefine preterm delivery.Material and methods:  The cervical length at 16th, 20th, 24th, 28th, 32nd and 36th week of the pregnancy has been measured by TVUSG within a sample of 60 pregnant women who do not have any risk about the preterm delivery or who have already had a preterm delivery or an abortus case before. Also, the funneling has been observed within the same sample. The relation of a cervical length less than or equal 30 mm and the existence of the funneling with a preterm delivery risk before the 37th week of the delivery has been evaluated statistically.Results:  We have observed the preterm delivery in the seven of the 60 pregnant women which were controlled until the delivery (11.7%). In this group, the relation between the preterm delivery and a cervix which is less than or equal 30 mm has been found to be statistically reasonable with the cervical length value at the 28th and 32nd week (P = 0.0001; P = 0.00001). A cervical funneling has been found in one patient and it has been not defined as meaningful with regard to the preterm delivery risk (P > 0.05).Conclusions:  In order to define the risk of the preterm delivery, it is more meaningful if the cervical length is less than 30 mm and measured at the 28th and 32nd week of the delivery. On the other hand, funneling could not been determined during the earlier period of the delivery; therefore it is not used as a criteria to predefine the preterm delivery.
Choroid plexus cyst revisited – the KK Hospital experience
Authors: Tan J. V. K. , Woo B. H. , Yeo G. S. H. 
Published: March 2003

Objective:  To study the clinical outcome of cases of choroid plexus cysts (CPC), the prognostic factors that increase the risk of aneuploidy and to formulate a counseling strategy for CPC.Study design:  Cases of CPC detected at screening ultrasonography (between 18 and 24 weeks gestation) from 1 October 1996 to 30 September 2000 in low risk antenatal patients at KK Women's & Children's Hospital, Singapore, were studied. The risk of aneuploidy and postnatal cranial ultrasonography of the cases were analyzed. Data was stratified according to maternal age, size of CPC, unilaterality or bilaterality and presence of concomitant structural abnormalities and/or ultrasound markers (non‐isolated).Results:  There were 485 cases with CPC among 56 746 patients (incidence 0.08%). Overall risk of aneuploidy was 6.2%. There were 30 cases of chromosomal abnormalities including 23 cases of trisomy 18; five cases of trisomy 21; one case of monosomy X and one case of Klinefelter syndrome. Cases of non‐isolated CPC were at significantly higher risk for aneuploidy (56.8%) compared to isolated CPC (1.4%), P < 0.001. No significant difference in risk was detected between unilateral and bilateral isolated CPC (P = 0.4), and with increasing size of isolated CPC. A near significant increase in risk was found between the under‐30 age group (0.37%) and the above‐30 age group. (2.3%) (P = 0.07). In non‐isolated CPC, the risk of aneuploidy ranged from 14.3% at age 20–24 and 100% at age 41–45. Likelihood ratio for trisomy 18 was 7.2 for isolated CPC, 1276 for non‐isolated CPC and 0.54 for absent CPC in the whole scanned population.Conclusion and recommendations:  Our results support the need for a thorough ultrasound anatomic survey for all cases of diagnosed CPC. Karyotyping should be offered to all cases of non‐isolated CPC. In isolated CPC, there may be benefit from offering karyotyping when maternal age exceeds 30.
Prenatal sonographic appearance of Beare–Stevenson cutis gyrata syndrome
Authors: Tsai C.‐C. , Hsu T.‐Y. , Chang S.‐Y. , Wang T.‐J. , Ou C.‐Y. , Chen Z.‐H. , Hsu P.‐U. 
Published: March 2003

Background:  Beare first described a 2‐year‐old boy who had abnormal physical feature including hypertelorism, cutis gyratum, acanthosis nigrican, cleft palate, functional pyloric obstruction and abnormal genitalia. Ten cases of Beare–Stevenson cutis gyrata syndrome have been reported. Here, we present, the first case of antenatal ultrasound image of this rare syndrome. A 31‐year‐old Taiwanese, gravida 2, para 1, was referred for fetal evaluation at 32 weeks gestation because of polyhydramnios and fetal head anomaly. Conventional sonography revealed a single fetus with amniotic index of 27.3 cm, cover leaf skull, and a skin fold‐like umbilical cord. Three‐dimensional sonography of the face of the fetus showed, high wide forehead, ocular proptosis, and depressed nasal bridge. The patient delivered a male infant weighing 2980 g at 39 weeks gestation. Physical examination of the infant showed furrows of corrugated appearance of the skin, craniofacial anomalies, particularly craniosynosis, displaced ears, prominent umbilical stump and hypospadia. Computer tomography and magnetic resonance image were performed and revealed fronto‐ethmoid‐nasal, cephalocele, pansynostosis and frontal base defect.Conclusion:  A total of 10 cases of Beare–Stevenson cutis gyrata syndrome have been previously reported. All of the previously reported cases of the syndrome were diagnosed postnatally. Our patient presented with ocular hypertelorism, low‐set and creased ears, ocular proptosis, choanal atresia, cloverleaf skull, craniosynosis, cutis gyrata, acanthosis nirican, prominent umbilical stump and bifida scrotum. Here we present the first case of antenatal ultrasound image of this rare syndrome.
Fetal renal blood flow assessment by three‐dimensional power Doppler ultrasound: preliminary results of a three‐dimensional histogram study
Authors: Chang F.‐M. , Chang C.‐H. , Yu C.‐H. , Liao T.‐P. , Ko H.‐C. J. 
Published: March 2003

Purpose:  To assess the fetal renal blood flow in normal gestation using three‐dimensional (3D) power Doppler ultrasound.Methods:  The study was under a prospective, consecutive and cross‐sectional design. Normal pregnancies that attended the prenatal clinic were included. We used a three‐dimensional power ultrasound scanner, Voluson 530D MT (Kretz, Zipf, Austria) to assess the total blood flow of fetal kidney. First, we used the 3D transabdominal probe to scan the whole fetal kidney under the 3D power Doppler mode at a fixed condition. Second, we used the VOCAL software (Kretz, Zipf, Austria) to calculate the histogram indices of fetal renal blood flow obtained from the 3D power Doppler scanning. The histogram indices included vascularization index (VI), flow index (FI) and vascularization‐flow index (VFI).Results:  In total, 81 fetuses ranging from 20 to 39 weeks of gestation were included for final analysis. Our results showed that VI had a high correlation with gestational age (r = 0.90, n= 81, P < 0.001). In addition, FI was positively correlated with gestational age (r = 0.35, n= 81, P < 0.05), and VFI also presented a high correlation with gestational age (r = 0.88, n= 81, P < 0.001). Furthermore, the VI, FI, and VFI of fetal kidney in the third trimester were all higher than those indices of fetal kidney in the second trimester (all P < 0.01).Conclusion:  The 3D power Doppler ultrasound can assess the total blood flow of fetal kidney, which is superior to the previous methods of blood flow assessment. Our study indicates that fetal renal flow increases with the advancement of gestational age, and our data may be a useful reference for further studies of fetal renal flow in abnormal conditions.
Cervical ectopic pregnancy: a case report and literature review
Authors: Gun M. , Mavrogiorgis M. 
Published: March 2003

AbstractWe report a case of cervical ectopic pregnancy that was diagnosed using transabdominal ultrasound. Conservative management with methotrexate administration was undertaken and, following a period of heavy bleeding, bilateral uterine artery embolization was performed. Two weeks after presentation, the gestational sac was shown to have reduced in size. We describe the ultrasound findings in this case and discuss those reported in the literature along with the available management options. Copyright © 2002 ISUOG
Prenatal diagnosis of an infratentorial subdural hemorrhage: case report
Authors: Batukan C. , Holzgreve W. , Bubl R. , Visca E. , Radü E. W. , Tercanli S. 
Published: March 2003

AbstractWe report a case of a prenatally diagnosed infratentorial subdural hemorrhage. The hematoma located in the posterior cerebral fossa was detected by conventional ultrasound at 24 weeks of gestation. Intrauterine magnetic resonance imaging confirmed the diagnosis. Autopsy of the fetus revealed a well‐circumscribed subdural hematoma. The prenatal findings of intracranial bleeding located in the posterior fossa and the prognosis of such cases are discussed. Copyright © 2002 ISUOG
Fetal pulmonary venous flow pattern is determined by left atrial pressure: report of two cases of left heart hypoplasia, one with patent and the other with closed interatrial communication
Authors: Lenz F. , Machlitt A. , Hartung J. , Bollmann R. , Chaoui R. 
Published: March 2003

AbstractWe report two cases of fetal left heart hypoplasia with extremes of size of interatrial communication, i.e. a closed foramen ovale and an atrial septal defect. Doppler examinations of the pulmonary veins showed almost to and fro flow in the fetus with the closed foramen ovale and, in contrast, a normal flow velocity waveform in the fetus with the atrial septal defect, despite mitral atresia. Our observations support the importance of left atrial pressure in the creation of a pulmonary venous flow pattern in the fetus. Copyright © 2002 ISUOG
Harlequin fetus: three‐dimensional sonographic findings and new diagnostic approach
Authors: Bongain A. , Benoit B. , Ejnes L. , Lambert J. C. , Gillet J. Y. 
Published: March 2003

AbstractCongenital ichthyosis, otherwise known as harlequin fetus, is a severe, generally lethal, anomaly. Prenatal diagnosis is usually possible in families at risk but requires invasive fetoscopy for skin biopsy. The application of three‐dimensional ultrasound enables a greatly improved analysis of the facial morphology and thus provides an important contribution to prenatal diagnosis. Although such three‐dimensional diagnostic procedures are performed in specialized centers, sonographers should be aware of the signs observed at routine two‐dimensional ultrasound examination in order to ensure appropriate referral for diagnosis. We describe two consecutive pregnancies of the same parents in which two‐ and three‐dimensional ultrasound were used in the prenatal diagnosis of harlequin fetus. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasound evaluation of aortic valve anatomy in the fetus
Authors: Paladini D. , Russo M. G. , Vassallo M. , Tartaglione A. , Pacileo G. , Martinelli P. , Calabrò R. 
Published: March 2003

AbstractObjectiveTo assess the feasibility of ultrasound identification of aortic valve anatomy in the fetus, with particular emphasis on the detection of bicuspid aortic valve.MethodsThis study was a prospective analysis of 21 fetuses with prenatally diagnosed congenital left heart obstructive lesions and 45 normal fetuses undergoing routine ultrasound evaluated at a tertiary referral center. These fetuses underwent detailed echocardiography, including the study of the aortic valve on a targeted short‐axis view of the right ventricle. Necropsies or postnatal echocardiograms were available for confirmation of the diagnosis in all cases.ResultsAortic cusps and commissures were satisfactorily visualized in 38/45 (84%) normal fetuses and in 18/21 (86%) fetuses with congenital heart disease. The aortic valve was correctly defined as bicuspid in one normal fetus and in six fetuses with congenital heart disease. In two fetuses with a positive family history, the bicuspid aortic valve was isolated. There was one incorrect diagnosis (a unicuspid unicommissural valve diagnosed prenatally as a bicuspid aortic valve in a fetus with severe aortic stenosis) and one false‐positive diagnosis in a fetus diagnosed with a coarctation and a bicuspid aortic valve late in the third trimester of pregnancy and in which both anomalies were not confirmed at neonatal echocardiography.ConclusionsThis study demonstrated that aortic valve anatomy can be satisfactorily assessed in fetuses with and without left heart obstructive lesions. We believe that a detailed search for a bicuspid aortic valve should be attempted in all patients referred for a positive family history of congenital heart disease, in general, and of left ventricle outflow tract obstruction or bicuspid aortic valve, in particular. In fact, the presence of an asymptomatic bicuspid aortic valve has been demonstrated to represent an important factor predisposing to the development of bacterial endocarditis and dissecting aortic aneurysm late in adult life. Therefore, an early detection of such an anomaly may contribute to ensure a longer symptom‐free lifespan of individuals with the most common cardiac anomaly at birth. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Cardiomyocyte differentiation of mouse and human embryonic stem cells*
Authors: Mummery C. , Ward D. , Van Den Brink C. E. , Bird S. D. , Doevendans P. A. , Opthof T. , De La Riviere A. Brutel , Tertoolen L. , Van Der Heyden M. , Pera M. 
Published: March 2003

AbstractIschaemic heart disease is the leading cause of morbidity and mortality in the western world. Cardiac ischaemia caused by oxygen deprivation and subsequent oxygen reperfusion initiates irreversible cell damage, eventually leading to widespread cell death and loss of function. Strategies to regenerate damaged cardiac tissue by cardiomyocyte transplantation may prevent or limit post‐infarction cardiac failure. We are searching for methods for inducing pluripotent stem cells to differentiate into transplantable cardiomyocytes. We have already shown that an endoderm‐like cell line induced the differentiation of embryonal carcinoma cells into immature cardiomyoctyes. Preliminary results show that human and mouse embryonic stem cells respond in a similar manner. This study presents initial characterization of these cardiomyocytes and the mouse myocardial infarction model in which we will test their ability to restore cardiac function.
Tendon morphogenesis in the developing avian limb: plasticity of fetal tendon fibroblasts
Authors: Oldfield Sarah F. , Evans Darrell J. R. 
Published: March 2003

AbstractThe differentiation and patterning of tendon fibroblasts is at present a poorly understood aspect of musculoskeletal development in the vertebrate limb. Precursors of tendon fibroblasts originate in the somatic mesoderm adjacent to the early limb bud and gradually become incorporated into the limb mesenchyme as development proceeds. It is unclear whether these progenitor cells are committed to the tendon lineage at this early stage, or whether cells become committed only as they are incorporated into a developing tendon. Following a review of our current knowledge of early tendon development, we present recent results from our preliminary studies looking at tendon cell commitment. Using a lacZ encoding replication‐deficient retrovirus, we have mapped regions of the early limb bud that contain presumptive tendon progenitor cells, and later used these sites for implanting labelled fetal tendon fibroblasts into developing limbs. Following implantation, we found that these cells successfully re‐incorporated into developing proximal and distal tendons, but also surprisingly contributed to other tissue lineages within the limb. Our results suggest that fetal tendon fibroblasts may not be irreversibly committed to a tendon cell fate in the limb and may be somewhat plastic in their ability to integrate into other tissue lineages during development.