bluuebunny/crossref_metadata_2025_split huggingface dataset:
WS15‐09Three‐dimensional ultrasound examination of fetal and placental vessels
Authors: Wisser J. 
Published: March 2003

ObjectiveSince August 1998 we used the integrated 3‐D software with the Siemens Elegra in order to evaluate fetoplacental vessels in the 3‐D mode. Aim of the evaluation was to examine the feasibility of the application and to demonstrated potential clinical advantages.MethodsIn our antenatal clinic we recruited pregnant women between 12 and 38 weeks of gestation to take part in a feasibility study in order to evaluate the free‐hand 3‐D application using the 5.0 MHz transducer for routine antenatal scanning. We examined vasculatore within the placenta, intrathoracoabdominal and intracranial fetal vessels with the integrated powermode. Acquisition time for a volume date set is between 3 and 20 s depending on the resolution selected.ResultsThree‐dimensional examination of the fetoplacental vessels is easily available using the Siemens Elegra, because no change in transducer is necessary. Our preliminary data show that we are able to demonstrate the complexity of intraplacental vasculature, which may be clinically helpful in the evaluation of twin placentas. Within the fetus the spatial arrangement of the vessels and their relation to each other can be depicted. This allows to study the fetal vascular tree and clearly discloses vascular anomalies.ConclusionsApplication of the integrated 3‐D software within the Siemens Elegra for the first time allows the examination of the complex fetoplacental vascular tree in vivo. This may be clinically helpful in the differential diagnosis of fetal anomalies.
WS16‐06Three‐dimensional ultrasound assessment of the first trimester fetus – a ‘one step’ approach
Authors: Hull A. D. , James G. , Nelson T. R. , Pretorius D. H. 
Published: March 2003

BackgroundThe optimal time at which to perform obstetric ultrasound remains controversial. Late first trimester imaging offers the possibility for early diagnosis of structural and genetic abnormalities. Three‐dimensional ultrasound (3DUS) allows the entire first trimester conceptus to be contained within one or two volumes of data. Subsequent processing of this data allows optimized views of the fetus, placenta and cord to be obtained.MethodLate first trimester (∼12 week) pregnancies were imaged with transvaginal 3DUS. A fetal structural survey was performed, standard biometry obtained and nuchal translucency thickness (NTT) measured. The time taken to perform and assess the scans was recorded.ResultsA comprehensive fetal survey was obtained, fetal measurements made and NTT measured in most fetuses with average scan times of less than one minute and average volume assessment times of less than 10 min in all cases. There were no abnormal findings in this series.Conclusion3DUS appears to be a useful tool in the ultrasound evaluation of the 12 week fetus. A detailed examination of the fetus may be performed with minimal scan time offering exciting possibilities for the use of transvaginal 3DUS as a ‘one step’ screening examination.
WS17‐02Utero‐ovarian arterial blood flow and hormonal profile in patients with polycystic ovaries
Authors: Vrtačnik‐Bokal E. 
Published: March 2003

BackgroundTo review the literature of utero‐ovarian arterial blood flow and serum hormonal profile in the patients with polycystic ovaries (PCO) compared to the patients with normal menstrual cycles undergoing in‐vitro fertilization treatment.MethodPertinent studies were identified through a computer MEDLINE search. References of selected articles were hand‐searched for additional citations.ResultsThe vascular impedance to uterine artery blood flow is higher during the luteal phase of PCO patients compared to the normally cycling patients and it does not show any dynamics throughout the menstrual cycle. In the normally cycling patients the active ovary shows dramatic hemodynamic changes during the cycle, therefore the vascular impedance to ovarian artery blood flow is almost constant throughout the menstrual cycle in the inactive ovary. In PCO patients the ovarian arterial blood flow in both ovaries is about the same as in inactive ovaries in the normally cycling patients. High vascular impedance to utero‐ovarian arterial blood flow is associated with typical low vascular impedance of stromal ovary vascularization in PCO patients. In stimulated cycles a strong negative correlation between the vascular impedance to the uterine artery blood flow and the serum E2 concentration is found on the day of HCG administration. Taking only anovulatory PCO cycles into consideration, the above correlation is not confirmed.ConclusionDoppler analysis can be a valuable method for the assessment of utero‐ovarian arterial blood flow in spontaneous and in stimulated cycles.
WS17‐03Relationship between ultrasound‐determined follicular size and DNA ploidy of human granulosa cells
Authors: Gersak K. , Lavrencak J. , Us‐Krasovec M. , Tomazevic T. 
Published: March 2003

BackgroundThe possibility that the hyperstimulatory effect of gonadotropins may be important etiologically in the genesis of some cases of ovarian cancer is still under discussion. Few flow and image cytometric studies report on DNA aneuploid granulosa cells in follicular fluid from women undergoing in vitro fertilization (IVF). The reports are very controversial. The aim of the study was to analyse relationship between ultrasound‐determined follicular size and DNA ploidy of granulosa cells from gonadotropin‐stimulated follicles.MethodThe granulosa‐luteal cells were obtained from women undergoing an IVF‐ET program at the University Department of obstetrics and Gynecology Ljubljana. Seventy aspirates of individual follicles (transvaginal determined size, range 15 mm – 30 mm in diameter) from gonadotropin‐stimulated cycles were analysed. Cytospins were prepared and fixed in delaunay fixative. All the slides were stained by the feulgen thionin method. Image DNA analyses was performed on automated high‐resolution image cytometer. The DNA index was calculated to define DNA ploidy.ResultsAll granulosa cell samples were found to be diploid.ConclusionRegardless of different ultrasound‐determined size of follicles, all analysed granulosa cells have diploid DNA content.AcknowledgementsSupported by grants from ministry of Research and technology republic of Slovenia (No. j3‐0428–032–98).
WS17‐09Doppler flow measurements and neuromotoric morbidity
Authors: Ertan A. K. , Schmidt W. 
Published: March 2003

BackgroundAbsent enddiastolic flow (AEDF) velocities are associated with fetal distress and adverse fetal outcome. The aim of this study was to evaluate perinatal findings of fetuses with an AEDF in fetal vessels and to investigate the neurological long‐term‐outcome.MethodThe analytical program ‘Munich functional developmental diagnostics’ (MFDD) was applied to the 90 children at different time intervals. The results of 40 children with an AEDF (Gr. I) and 20 children with pathological S/D‐Ratio (Gr. II) were compared to the group of 30 children with normal Doppler‐flow‐findings (Gr. III) with the same pregnancy weeks at birth.ResultsThe rate of C‐section (92% vs. 71% vs. 36%), birthweight (1140g vs. 1725g vs. 2570g), 5′min. APGAR‐Score (31% vs. 5% both) were significantly different in three groups. Brain sparing effect in the middle cerebral arteries was found in 81% in Gr. I, in 21% Gr. II and only 8% in Gr. III. At the time of neurological assessment the age of children was between 12 and 36 months. The developmental age for each functional category was evaluated and the difference between corrected age and developmental age was calculated. In 33% of all infants with a AEDF had a pathological neuromotoric development vs. 22% in Gr. II and only 15.3% in Gr. III.ConclusionsThe children with pathological Doppler‐flow‐measurements during pregnancy have not only very high risk of perinatal abnormality but also show a distinctly increased risk of impaired growth and neurodevelopmental disability comparing to the cases with a normal Doppler‐flow‐finding. Most of these fetuses showed brain‐sparing effect. These aspects are very important to be discussed with the parents before the definitive perinatal decision is made.
WS02‐03What can fetopathology add to the prenatal ultrasound diagnosis?
Authors: Papp Z. 
Published: March 2003

BackgroundMultiple malformation syndromes are generally heterogeneous diseases with inappropriate clinical delineation most cases. Geneticists are facing problems with lack of proper knowledge inspite of the overwhelming information available regarding a certain syndrome. Emphasis should be placed on the characteristic features of the suspected syndrome, or any major or detectable minor anomaly with significant effect on the course of the pregnancy.ConclusionDetailed ultrasonography by experienced personnel provides a valuable tool in diagnosing morphological alterations of the fetus in mid‐gestation. After termination of the pregnancy, the effected fetus must be examined thoroughly by an experienced fetopathologist. Careful and comprehensive examinations reveals all major and minor morphological alterations that might outline a certain syndrome or other multiple abnormality entity. Computer based syndromological programs are important in this process, for they help geneticists and fetopathologists by matching the most suitable syndrome to the given case. Genetic counseling can be completed only with the establishment of the most probable diagnosis. Declaration of recurrence rate and possible application of other prenatal diagnostic methods must be included in the counseling. Different types of multiple malformation syndromes of the fetus will be presented in the lecture.
WS02‐04Fetal tumours
Authors: González A. G. , Herrero F. L. , Alvarez E. CH. , Rodriguez R. R. 
Published: March 2003

Fetal oncology is a chapter of the Obstetrics non well known yet. Fortunately, the improvements in the ultrasonography has let us to obtain an intrauterine diagnosis and to follow its evolution in order to choose the most appropriated obstetrical way.A total of 1326 fetal abnormalities has been diagnosed in the last 10 years in the Hospital ‘La Paz’, Madrid, and we have found 54 cases of fetal tumours detected by ultrasonography (cyst and solid tumours included). This number of fetal tumours is estimated to be the 4.07% of all fetal abnormalities. Most frequent tumours include the fetal central nervous system, fetal lung, fetal heart, fetal genitourinary system, fetal gastrointestinal system.We have reviewed these fetal tumours histology, location and behaviour, trying to study the best obstetrical conduct and its chirurgical treatment. Ultrasonographic characteristic of each fetal tumour has been specified. Besides, we describe the possible differential diagnosis, maternal complications (preeclamptic status, mirror syndrome), obstetrical complications (polyhydramnios, preterm labour and delivery or placentomegaly) and fetal complications (cardiovascular failures, hydrops or death).Finally, we perform the indications for the spontaneous delivery or the preterm delivery induction depending on each case. Although we have not experience in intrauterine surgery, we believe that the best results are obtained in the neonatal surgery, always after an individual study and in agreement with the whole perinatal equipment.
WS03‐06Tubal patency as assessed by three‐dimensional power Doppler imaging (3D‐PDI) and hystero‐salpingo‐contrast sonography (HyCoSy)
Authors: Sladkevicius P. 
Published: March 2003

BackgroundThe purpose of the study was to evaluate the feasibility of three‐dimensional power Doppler imaging (3D‐PDI) in the assessment of the patency of the fallopian tubes during hystero‐salpingo‐contrast sonography (HyCoSy).MethodsHyCoSy using contrast medium echovist was done on 67 subfertile women. 3D‐PDI and two‐dimensional (2D) gray‐scale imaging were used to visualize the contrast medium in the tubes.ResultsContrast medium echovist produced prominent signals on the 3D‐PDI image. Free spill of the fallopian tubes which had had the proximal part visualized was demonstrated in 114 (91%) tubes using 3D‐PDI technique and in 58 (46%) tubes using conventional HyCoSy. The mean duration of imaging procedure was less than 3D‐PDI. A significantly lower volume of contrast medium (5.9 + 0.6 ml) was used for 3D‐PDI in comparison with volume (11.2 + 1.9 ml) used for conventional HyCoSy.ConclusionsThe 3D‐PDI method appeared to have advantages over the conventional HyCoSy technique, especially in terms of visualization of spill from the distal end of the tube which was achieved twice as often with the 3D technique. The shorter duration of the imaging and lower volume of the contrast medium used suggested that the 3D‐PDI technique may have a better side‐effect profile. The 3D‐PDI technique allowed better storage of the information for re‐analysis and archiving than 2D scanning.
WS04‐04Vascular impedance of uterine, inferior vesicle and ophthalmic arteries in postmenopausal women receiving hormonal replacement therapy: comparative Doppler study
Authors: Bekavac I. , Kupesic S. , Mihaljevic D. , Kurjak A. 
Published: March 2003

BackgroundTo investigate the effects of combined hormone replacement therapy (HRT) on the vascular impedance of the uterine, inferior vesicle and ophtalmic artery.MethodThirty‐five postmenopausal patients were analysed in basal condition and during a HRT phase at 1, 3 and 6 months. Patients were divided in two groups: 21 patients whose last menstrual bleeding was 1–5 years ago, and 14 patients with the duration of menopause > 6 years. Color Doppler analysis of the blood flow impedance was performed at the level of the uterine, inferior vesicle and ophtalmic artery. Estradiol plasma concentrations were assayed on the day of Doppler examinations.ResultsThe analysis of the uterine and inferior vesicle artery flow velocities demonstrated significant positive correlations between resistance index (RI) and years of menopause; higher impedance values were obtained in patients with longer interval from last menstrual bleeding (P < 0.05). The impedance in patients with > 6 years duration of menopause was 0.94 ± 0.03 vs., 0.89 ± 0.04, in the group of patients with 1–5 years duration of menopause for uterine artery, and for inferior vesicle artery (0.91 ± 0.04 vs. 0.98 ± 0.02). No significant correlation between baseline RI and time since menopause was noticed (0.72 vs. 0.73, respectively, P > 0.05) at the level of ophtalmic artery. After six months of HRT plasma estradiol levels inversely correlated with RI uterine (r = −0.2556; P = 0.021), inferior vesicle (R = −0.2653; P = 0.023) and opthalmic (r = −0.2211; P = 0.017) arteries.ConclusionDoppler studies of uterine, inferior vesicle, and ophtalmic artery can provide specific and precise pathophysiological information to assess blood flow variations in correlation with combined HRT administration.
WS05: Endometrial pathology WS05‐01Ultrasound in endometrial pathology
Authors: Haller H. 
Published: March 2003

BackgroundThis study was undertaken to evaluate the accuracy of transvaginal ultrasound combined with vaginal and endometrial cytology in detecting endometrial pathology in postmenopausal women.MethodIn all patients who underwent dilatation and curettage (D & C) for postmenopausal bleeding during four years endometrial thickness, vaginal and endometrial cytology were evaluated.ResultsAccuracy of endometrial thickness in detecting pathologic condition, like as polyp, hyperplasia and carcinoma was high sensitive but with low specificity. Combined use transvaginal ultrasound, vaginal and endometrial cytology show very high sensitivity and specificity for endometrial cancer. The combined use of three diagnostic methods show no benefit for other pathologic conditions.ConclusionCombination of transvaginal ultrasound, vaginal and endometrial cytology can not absolutely replace histologic findings obtained by D & C. However, in the cases with thin endometrium and negative cytology D & C could be avoided. Usefulness of these three methods has to be found in providing more information resulting in better understanding of endometrial condition.
WS07‐03Stage‐based treatment of twin–twin transfusion syndrome: preliminary study
Authors: Quintero R. A. , Bornick P. W. , Morales W. J. , Allen M. H. , Johnson P. K. 
Published: March 2003

BackgroundThe purpose of this study was to test the value of sonographic staging of twin–twin transfusion syndrome (TTTS) in predicting the outcome of patients treated with amniocentesis or selective laser photocoagulation of communicating vessels (SLPCV).MethodsTTTS was defined as a deep vertical pocket (DVP) in the recipient twin of > 8 cm and in the donor twin < 2 cm. TTTS was staged as follows: Stage I: bladder of donor visible; Stage II: bladder of donor not visible; Stage III: critically abnormal Dopplers; Stage IV: hydrops; Stage V: demise. Patients were treated with amniocentesis or SLPCV.ResultsThere were a statistically significant difference by stage for at least one survivor between the two techniques (Chi‐square = 2.63, p = 0.05), but analysis was limited by sample size (amniocentesis n = 9, SLPCV n = 70). In the amniocentesis group there was an 83% (n = 5) survival rate for two survivors in Stage I and no survivors (n = 3) in stages II or III. In the SLPCV group, at least one fetus survived 83% of the time, regardless of stage.ConclusionOur preliminary data suggests that analysis of survival data by in TTTS needs stratification by stage. Early stages may be amenable to treatment with amniocentesis, while later stages may not benefit. SLPCV is uniformly effective, regardless of stage, but may not be warranted in early stages of TTTS.
WS10‐02Nuchal translucency in multiple pregnancies
Authors: Monni G. 
Published: March 2003

BackgroundThe significance of an increased nuchal translucency measurement (NT) in relation to the fetal karyotype and pregnancy outcome has been evaluated in multiple pregnancies.Methods115 multiple pregnancies with 252 fetuses, including 100 pairs of twins (70 pairs with dichorionic placentas and 30 pairs with nonochorionic placenta), 9 sets of triplets, 5 sets of quadruplets, and one set of quintuplets, were considered.ResultsNT was greater than 95th centile in one fetus in 10 out of 70 cases of dichorionic twin pregnancies (14%), in two sets of quadruplets, in 7 out of 30 monochorionic twin pregnancies (23.3%). NT greater than 95th centile in both fetuses was found in one dichorionic twin pregnancy. Two cases of trisomy 21 and one 47, XXY were found. NT greater than 95th centile in 2/2 fetuses with trisomy 21 (one dichorionic twin pregnancy and one tetrachorionic pregnancy), and not enlarged in the 47, XXY (trichorionic triplet pregnancy). A case of skeletal dysplasia and one goldenhar syndrome were found among the 10 cases of increased NT in dichorionic pregnancies. Three intrauterine deaths of both fetuses, one congenital heart disease and a case of twin‐to‐twin transfusion occurred in 7 cases of increased NT in monochorionic pregnancies.ConclusionsAn enlarged NT in multiple pregnancies indicates fetuses at risk for chromosomal abnormalities and fetal malformation, as well as monochorionic twin pregnancies at higher risk for an adverse outcome.
F104Prenatal diagnosis and follow‐up of 38 cases of cleft lip – 5‐year experience of a Brazilian specialized center
Authors: Ruano R. , Hanaoka B. , Iglesias M. L. M. , Bunduki V. , Yamamoto R. M. , Miyadahira S. , Zugaib M. 
Published: March 2003

BackgroundSonographic aspects of prenatally diagnosed cleft‐lip were reviewed and compared with postnatal findings.Method38 cases of prenatally diagnosed fetal cleft lip were reviewed and the following was recorded: gestational age at diagnosis, maternal age, malformation history, associated palate clift, associated aneuploidies and malformations and postnatal follow‐up. Kariotyping was performed in all cases.ResultsMaternal age was 28.37 years and only one case had history of cleft lip. Gestational age at diagnosis was 28 weeks. Isolated cleft lip were observed in 7 cases (18.42%): 5 fetuses (71.43%) with left lesion and 2 (28.57%) with right lesion. One case (2.63%) was associated with cleft palate. Aneuploidy associated with structural malformations was identified in 9 cases (23.68%): trissomy 13 (n = 6); trissomy 18 (n = 2) and 47XXY (n = 1) In 66% of those cases associated cleft palate was found. Associated malformations with normal karyotype were found in 22 cases with associated cleft palate in 50% of those cases.ConclusionIn this series, fetal cleft lips were frequently associated with structural malformations and cromossomal, especially when cleft palate was associated. Cleft lip is an indication for fetal karyotyping and associated malformations must be discarded by level three ultra‐sound scan.
F106Prenatal diagnosis of syndromic and nonsyndromic craniosynotosis by ultrasound
Authors: Bernard J.P. , Delahaye S. , Senat M.V. , De Keersmaecker B. , Renier D. , Ville Y. 
Published: March 2003

BackgroundPrenatal diagnosis of cranyosynostosis are rare. Most of them are syndromic synsostosis (Apert, Crouzon.) and ultrasound diagnosis is done on associated lesions. Very few publications described nonsyndromic craniosynostosis and the diagnosis is made on skull deformation. Some animal experimentations have proven that synostosis have different sonographic features than normal sutures.MaterialFor 5 years we examined 32 fetuses, referred in our institution with a high risk of craniosynostosis. Some because of a family history of previous craniosynostosis, others because of an abnormality of the cephalic index or skull deformations.The diagnosis of craniosynostosis was only made when the sutures seemed abnormal.ResultsNine fetuses had a very high risk of craniosynostosis secondary to a previous autosomic craniosynostosis. In 5 of them, the sonographic appearance of the suture was abnormal and the newborn presented a recurrent craniosynostosis. In 4 of them, the sonographic appearance of the sutures was normal and the newborn were healthy.Twenty‐three fetuses had an increased risk of craniosynostotsis secondary to the appearance or biometry of the skull on the routine second trimester scan. In 20 of them, sutures were normal and newborns were healthy. Three fetuses presented abnormal sonographic features, two of them presented a craniosynostosis, however, one was a healthy newborn.ConclusionUltrasound seems to be a very good tool for the diagnosis of craniosynostosis even isolated in a very high risk population (risk of 1/2). In lower risk the negative predictive value can be used to rassure parents when the biometry or the appearance of the skull seems abnormal.