bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificial neural network models for the preoperative discrimination between malignant and benign adnexal masses
Authors: Timmerman D. , Verrelst H. , Bourne T. H. , De Moor B. , Collins W. P. , Vergote I. , Vandewalle J. 
Published: March 2003

AbstractObjectiveThe aim of this study was to generate and evaluate artificial neural network (ANN) models from simple clinical and ultrasound‐derived criteria to predict whether or not an adnexal mass will have histological evidence of malignancy.DesignThe data were collected prospectively from 173 consecutive patients who were scheduled to undergo surgical investigations at the University Hospitals, Leuven, between August 1994 and August 1996. The outcome measure was the histological classification of excised tissues as malignant (including borderline) or benign.MethodsAge, menopausal status and serum CA 125 levels and sonographic features of the adnexal mass were encoded as variables. The ANNs were trained on a randomly selected set of 116 patient records and tested on the remainder (n = 57). The performance of each model was evaluated using receiver operating characteristic (ROC) curves and compared with corresponding data from an established risk of malignancy index (RMI) and a logistic regression model.ResultsThere were 124 benign masses, five of borderline malignancy and 44 invasive cancers (of which 29% were metastatic); 37% of patients with a malignant or border‐line tumor had stage I disease. The best ANN gave an area under the ROC curve of 0.979 for the whole dataset, a sensitivity of 95.9% and specificity of 93.5%. The corresponding values for the RMI were 0.882, 67.3% and 91.1%, and for the logistic regression model 0.956, 95.9% and 85.5%, respectively.ConclusionAn ANN can be trained to provide clinically accurate information, on whether or not an adnexal mass is malignant, from the patient's menopausal status, serum CA 125 levels, and some simple ultrasonographic criteria. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Focal aneurysmal dilatation of subchorionic vessels simulating chorioangioma
Authors: Reinhart R. D. , Wells W. A. , Harris R. D. 
Published: March 2003

AbstractSubchorionic vascular aneurysms of the placenta are rare lesions and may present confusion with chorioangioma or focal mesenchymal dysplasia on sonography. To our knowledge, the findings of placental aneurysms have not been reported in the ultrasound literature. We present a case with detailed sonographic evaluation, including spectral and color Doppler and pathological analysis, that was mistaken for chorioangioma prenatally. Knowledge of this benign entity may allow the sonologist to recommend conservative management in similar cases. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Characteristics of blood flow in intrauterine growth‐restricted fetuses with hypercoiled cord
Authors: Nishio J. , Nakai Y. , Mine M. , Imanaka M. , Ogita S. 
Published: March 2003

AbstractObjectiveTo clarify the characteristics of fetoplacental blood flow of growth‐restricted fetuses with hypercoiled umbilical cord.SubjectsEight growth‐restricted fetuses with hypercoiled cord.MethodsFlow velocity waveforms of the umbilical cord artery and vein, fetal abdominal aorta and fetal inferior vena cava were analyzed.ResultsThe resistance index in the umbilical artery in the hypercoiled cases was lower than that in normal fetuses. Early‐diastolic reversed flow was observed in the abdominal aorta in some cases. In all cases, umbilical venous pulsation was observed in the entire cord until delivery. In one case, fetal heart failure occurred, resulting in pre‐mature delivery. An atrophic type of single umbilical artery was observed in four cases.ConclusionFetal blood flow disturbance caused by a hypercoiled umbilical cord may be a cause of growth restriction. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Johanson–Blizzard syndrome: a prenatal ultrasonographic diagnosis
Authors: Auslander R. , Nevo O. , Diukman R. , Morrad E. , Bardicef M. , Abramovici H. 
Published: March 2003

AbstractJohanson–Blizzard syndrome is a rare autosomal recessive disorder characterized by aplasia of alae nasi, pancreatic insufficiency, aplasia cutis, anorectal anomalies and postnatal growth restriction.In this case report, we describe the prenatal sonographic findings of Johanson–Blizzard syndrome in a 21‐week pregnancy of a consanguineous couple. Sonographic findings of aplastic alae nasi (beak‐like nose) and dilated sigmoid colon led to the prenatal diagnosis. This is the first report of the prenatal sonographic diagnosis of Johanson–Blizzard syndrome. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Tetralogy of Fallot in the fetus: findings at targeted sonography
Authors: Yoo S.‐J. , Lee Y.‐H. , Kim E. S. , Ryu H. M. , Kim M. Y. , Yang J. H. , Chun Y. K. , Hong S. R. 
Published: March 2003

AbstractObjectivesTo evaluate the findings of tetralogy of Fallot in various fetal sonographic views.MethodsWe reviewed the fetal sonograms and medical records of 20 fetuses with prenatal diagnosis of tetralogy of Fallot. We analyzed the indications for targeted sonography, the abnormalities seen in various sonographic views, the postnatal echocardiographic and angiographic findings and autopsy findings.ResultsThe most common indication for targeted sonography was an abnormal (n = 12) or inadequate (n = 3) finding on sonographic screening in which the abnormality was most frequently found on the three‐vessel view (n = 9). The key pathological features of tetralogy of Fallot were uniformly demonstrated in the ventricular outflow tract, three‐vessel and short‐axis views. The ductus arteriosus was small in 70% of cases and not identifiable in the remaining fetuses. In three of six fetuses with no identifiable ductus, the ductus was shown to be absent at autopsy. The direction of ductal flow was variable.ConclusionThe key features of tetralogy of Fallot were always demonstrable in the ventricular outflow tract, three‐vessel and short‐axis views. The most common reason for referral was the abnormal three‐vessel view. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Comparison of the non‐stress test with the evaluation of centralization of blood flow for the prediction of neonatal compromise
Authors: Ott W. J. 
Published: March 2003

AbstractObjectiveTo determine whether the middle cerebral to umbilical artery systolic/diastolic velocity waveform ratio (MC/UA) was a more sensitive indicator of fetal compromise than the non‐stress test (NST).Study design An outcome study of high‐risk patients undergoing NST testing and MC/UA studies within 10 days of delivery. Patients were divided into four groups based on their test results, and neonatal outcome parameters were compared.ResultsThere were significant differences between all four test result groups with respect to length of stay in the neonatal intensive care unit (NICU). Patients in whom both the NST and MC/UA ratio were normal had significantly lower utilization of Cesarean section for delivery, admission and length of stay in the NICU and occurrence of significant neonatal complications. Logistic regression analysis indicated that the combination of the NST and MC/UA ratio was an excellent predictor of perinatal outcome.ConclusionsThe MC/UA ratio improves the sensitivity for the prediction of poor perinatal outcome when it is combined with the NST. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Perinatal management of fetal hemolytic disease due to Rh incompatibility combined with fetal alloimmune thrombocytopenia due to HPA‐5b incompatibility
Authors: Schild R. L. , Hoch J. , Plath H. , Geißen C. , Fahnenstich H. , Dame C. , Hansmann M. 
Published: March 2003

AbstractWe report our experience in the perinatal management of a complex case of fetal hemolytic disease primarily due to Rhesus incompatibility combined with fetal alloimmune thrombocytopenia. The lowest fetal hemoglobin and platelet levels were 2.6 g/dl and 13 000/µl, respectively. Intrauterine treatment consisted of six transfusions of packed red cells into the umbilical vein and one transfusion of platelets. The neonate required four transfusions of packed red cells to correct her hyporegenerative erythropoiesis. Postnatal management also included one platelet transfusion, intravenous immunoglobulins and erythropoietin. Although some degree of fetal thrombocytopenia may invariably be found in fetal red cell incompatibility, other rare causes need to be excluded. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Comparative study of transvaginal ultrasonography and CA 125 in the preoperative evaluation of myometrial invasion in endometrial carcinoma
Authors: Alcázar J. L. , Jurado M. , López‐García G. 
Published: March 2003

AbstractObjectiveTo compare the ability of transvaginal sonography and serum CA 125 levels to predict myometrial invasion in patients with endometrial carcinoma.Design and methods Prospective study in 50 consecutive patients (mean age 60 years, SD 10.5, range 29–77 years) diagnosed as having endometrial cancer and scheduled for surgical staging. All patients were evaluated by transvaginal ultrasonography. Endometrial thickness was measured in all cases and myometrial invasion was estimated as < 50% or ≥50%. Serum CA 125 level was determined in each patient. A cut‐off level of ≥35 IU/ml was considered to predict myometrial invasion of ≥50%. All patients underwent surgical staging, and definitive histopathological findings regarding myometrial invasion were used as the ‘gold standard’. Sensitivity, specificity and positive predictive value (PPV) and negative predictive value (NPV) were calculated for transvaginal ultrasonography and CA 125 and compared.ResultsOn histopathological analysis, myometrial invasion was found to be < 50% in 35 (70%) cases and ≥?50% in 15 cases (30%). Mean endometrial thickness in patients with superficial invasion was significantly lower than in those with deep invasion (13.4 mm (95% CI 11.2–15.7) vs. 18.7 mm (95% CI 15.0–22.3), respectively; p = 0.014). Median CA 125 was significantly higher in patients with deep invasion than in those with superficial invasion (30 IU/ml, interquartile range (IQR) 46.0 vs. 16.9 IU/ml, IQR 13.9, respectively; p = 0.002). The sensitivity, specificity, PPV and NPV for transvaginal ultrasonography were 86.7% (95% CI 59.5–98.3), 94.3% (95% CI 80.8–99.3), 86.7% (95% CI 59.5–98.3) and 94.3% (95% CI 80.8–99.3), respectively. The sensitivity, specificity, PPV and NPV for CA 125 were 40% (95% CI 16.3–67.7), 91.4% (95% CI 76.9–98.2), 66.7% (95% CI 29.9–92.5) and 78% (95% CI 63.4–89.5), respectively. The sensitivity of transvaginal ultrasonography was significantly higher than that of CA 125 (p = 0.008). No differences were found in terms of specificity, PPV or NPV.ConclusionOur results indicate that transvaginal ultrasonography is more sensitive than CA 125 in predicting myometrial invasion in endometrial cancer. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
The expectant management of women with early pregnancy of unknown location
Authors: Banerjee S. , Aslam N. , Zosmer N. , Woelfer B. , Jurkovic D. 
Published: March 2003

AbstractObjectiveTo assess the results of expectant management in women with pregnancy of unknown location and to identify diagnostic parameters that are predictive of spontaneous pregnancy resolution.DesignProspective, observational study.SubjectsWomen with a positive pregnancy test and suspected early pregnancy complications who were referred for ultrasound assessment.MethodsWomen were first examined by transvaginal ultrasound to establish the location and viability of pregnancy. All women with pregnancies that could not be located on the scan had a blood sample taken to quantify the serum human chorionic gonadotropin (hCG) and progesterone levels. Management was expectant until the pregnancy was identified, the condition resolved spontaneously or an intervention was required because clinical symptoms deteriorated or hCG levels did not decline. For each woman, age, clinical symptoms (pain and bleeding), menstrual dates, past gynecological history, endometrial thickness and levels of serum hCG and progesterone were recorded. All parameters were tested by univariate analysis and then analyzed in a stepwise procedure to form a logistic regression model for predicting spontaneous resolution of pregnancy.ResultsA total of 1625 women were included in the study. In 135 cases (8%) the location of pregnancy was unknown. Complete data sets were obtained in 127 cases. These included 34 (27%) normal intrauterine pregnancies, 11 (9%) miscarriages and 18 (14%) ectopic pregnancies. A total of 64 (50%) pregnancies resolved spontaneously. Stepwise analysis showed that four diagnostic parameters – vaginal bleeding, endometrial thickness, serum hCG level and progesterone level – contributed significantly to the predictive power of the logistic model. With the use of this model, spontaneous pregnancy resolution could be predicted at the initial visit with a sensitivity and specificity of 92%.ConclusionsThe majority of pregnancies of unknown location are abnormal; many resolve spontaneously when managed expectantly. A logistic model may be used at the initial visit to identify those cases in which the pregnancy is likely to resolve without the need for intervention. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
P101Doppler flow velocimetry in fetal and maternal circulation in relation to blood serum and amniotic fluid erythropoietin levels
Authors: We¸grzynowski J. , Ronin‐Walknowska E. 
Published: March 2003

ObjectiveTo correlate arterial Doppler flow velocimetry with amniotic fluid and umbilical cord erythropoietin levels and umbilical cord gasometry.Material and methodsThe study compromised 80 pregnant woman who delivered in cesarean section without prior uterine contractions. The AB, PI and RI indexes of fetal umbilical, cerebral arteries as well as uterine arcuate arteries was assessed max. 24 h before delivery. Amniotic fluid was collected during the cesarean section before the uterine incision and umbilical cord blood was retrieved after the delivery, 1 min after the cord was clamped.ResultsThe correlation was found between umbilical arteries AB ratio and amniotic erythropoietin levels, fetal serum erythropoietin levels as well as umbilical artery pO2 and apgar score 5 min after delivery. The correlation was also found between fetal blood and amniotic fluid erythropoietin levels.ConclusionsDoppler flow velocimetry of umbilical artery reflects the fetal and newborn well being. Umbilical cord and amniotic fluid erythropoietin levels reflect fetal oxygenation. Erthropoietin levels may be checked in amniotic fluid beceause amniocentesis is related to lower incidence of complications in comparisone with cordocentesis.
P117Echocardiographic findings in fetuses with trisomy 18
Authors: Holan M. , Ferianec V. , Pohlodek K. , Kaldararova M. , Benedekova M. 
Published: March 2003

The aim of this study was to present our 4 cases of trisomy 18, with a congenital heart defect detected during the last 6 months.ResultsTwo complex congenital heart defects (CHD) with a very similar anatomy were found during a prenatal ultrasonographic examination – Double outlet right ventricle (DORV) with complete atrioventricular septal defect (AVSDC) – in the 20th and 38th week of gestation and in other two cases – in the 19th and 21st week of gestation – an isolated muscular ventricular septal defect (VSD) was proved. In All fetuses also noncardiac (central nervous, gastro‐intestinal and uropoetical) congenital malformations were present.ConclusionTrisomy 18 (Edwards sy) occurs approximately in 1:7000 live births. 95–100% of these newborns have some form of CHD. Because of a very poor prognosis a surgical correction is usually not considered. Left to their natural course, death occurs at the age of one hour to 18 months, the median life expectance is 5–48 days, according to the presence of severe CHD and associated anomalies.
P127Assessment of fetal anatomy in the first trimester using two and three dimensional ultrasound
Authors: Michailidis G. D. , Papageorgiou P. , Economides D. L. 
Published: March 2003

ObjectivesTo study if a complete anatomical survey of the fetus at 12–13 weeks gestation can be achieved using stored volumes acquired by a 3D scanner.Subjects/methodsOne hundred and twenty‐two consecutive women at 12–13 weeks gestation who had a scan in our unit. A complete survey of the fetal anatomy was attempted by transabdominal and if needed transvaginal 2D scanning. Then using the 3D transvaginal probe (Kretz 530D) two volumes containing the fetus were acquired. A complete anatomical survey was attempted using the data from these volumes (excluding the anatomy of the heart).ResultsA complete anatomical survey was achieved in 93% (113/122) of cases with the 2D scanning comparing to 71% (86/122) with the 3D volumes (statistically significant difference, P < 0.01). The nuchal translucency was measured in 97.5% of cases with 2D scanning and in 82% with the 3D volumes. The mean time to perform the 2D scan was 15 min (SD: 4 min) while the time to examine the stored volumes was 6.6 min (SD: 2.66). Using the stored volumes we obtained the required views in 8 of the 9 cases in which the survey was incomplete by the 2D scan.DiscussionReal time 2D scanning is still the best way to examine the fetal anatomy in the first trimester. However, 3D scanning can be a useful addition to clinical practice providing views not easily obtained by conventional 2D scanning. It can potentially minimise the actual scanning time and provides an excellent way to store scanned data.
P128Impact of patient initiated three‐dimensional ultrasound examination
Authors: Pretorius D. H. , Hull A. D. , Newton R. , Nelson T. R. , James G. 
Published: March 2003

BackgroundNews media and the internet have a significant impact on raising patient awareness of new care. Visualization of the fetal face made possible by 3‐dimensional ultrasound (3DUS) is one such area that has encouraged many pregnant patients to initiate requests for these studies. The purpose of this project was to identify indications, reactions and benefits for these studies.Method3DUS examinations were performed on 35 consecutive patients requesting studies from our service. We require a physician to order the 3DUS exam in conjunction with conventional 2DUS. Patients had a targeted 3DUS to the area of interest as well as the fetal face. Comments by the parents were recorded at the time of the study and after delivery.ResultsMedical indications for 3DUS studies were: patient reassurance (19), patients with prior anomalies (8), hospice patients carrying fetuses with fatal anomalies (2), patient with family history of anomaly (1), infertility (1), patient carrying a fetus with abnormal karyotype (1). Although most parents found the 3DUS to be a positive, reassuring experience (28), (7) found it to be extremely beneficial (previous children with anomalies or demise, fetuses with fatal anomalies, and infertile couples).ConclusionPatient initiated 3DUS studies had a positive impact and reassured all families and were extremely beneficial to 6/35 families.
P129The sonographic appearance of fetal micrognathia using a novel three‐dimensional ultrasound system
Authors: Malinger G. , Lerman‐Sagie T. , Gomel A. , Glezerman M. 
Published: March 2003

BackgroundFetal micrognathia is difficult to diagnose using conventional ultrasound and three‐dimensional surface rendering may provide additional information when available. We present two fetuses with micrognathia in whom this technique helped in the diagnosis.MethodThree‐dimensional ultrasound examination was performed with an add‐on unit that fits any existing conventional ultrasound machine. The system contains a unique positional sensor and extremely powerful segmentation feature that allows to remove obscuring objects from the region of interest (BabyFace, Biomedicom, Jerusalem, Israel).In both fetuses the diagnosis was suspected during conventional ultrasound examination.ResultsGood three‐dimensional images of both fetuses were obtained at the first acquisition intent and provided additional information about the severity of the anomaly.ConclusionWe present a novel 3D ultrasound system, which is user friendly and cost‐efficient. Its compatibility as an add‐on to existing us equipment allows for immediate upgrades and increases diagnostic options in fetal imaging.
P13The impact of transvaginal obstetric ultrasound scan in high risk pregnancy
Authors: Benute G. R. G. , Wojciechowski V. , Dias T. V. , Cianciarullo P. , Quayle J. , Burlachini  , Bunduki V. , Yamamoto R. , Miyadahira S. , De Lucia M. C. s , Zugaib  
Published: March 2003

BackgroundThe acceptance of transvaginal ultrasound among Brazilian pregnant women is not yet established.ObjectiveTo evaluate the level of acceptance of transvaginal ultrasound (US) among high risk pregnant women.MethodPsychological semi structured interview with 50 pregnant patients scheduled to undergo ultrasound exam.Results94% of the patients arrive without knowing they are going to undergo a transvaginal US and 80% believe they are going to undergo a regular abdominal US. Asked about the utility of transvaginal US, 46% didn't know; 70% didn't have any preferences about the sex of the ultrasonographist. After the exam, 76% of the patients referred no particular discomfort, but 46% would prefer to have an abdominal US scan if they could choose, but all emphasized they would undergo the exam again if the doctor said it was necessary. As far as sexuality, 12% mentioned some difficulty with the partner and 40% referred that it is hard for women to discuss subjects related to sex.ConclusionThe discomfort eventually associated to transvaginal US is not related to the sex of the examiner but to his attitude. Patients' fantasies play an important role in the emotional discomfort elicited by the situation where cultural aspects are deeply imbricated.
P132Three‐dimensional ultrasound: A new diagnostic option monitoring cervical incompetence in higher order multiple gestation
Authors: Strauss A. , Heer I. , Fuchshuber S. 
Published: March 2003

BackgroundPreterm birth is the greatest threat to the infants of a multiple pregnancy. Incompetent cervix is still a diagnostic and therapeutic dilemma. Is three dimensional volumetry of the cervix uteri the key to predict preterm birth in higher order multiples?MethodFrom May 1999 to May 2000 we prospectively compared conventional measurements of cervical length to 3D‐volumetry in 10 triplet pregnancies.Results29 volume scans as well as conventional length measurements of the cervix in 10 triplet pregnancies were analyzed. 2.9 examinations per patient (1–5) were done on a weekly basis. The mean cervical length was 27 mm (4–50). The mean cervical volume decreased with gestational age parallel to the two dimensional data. In three women length‐assessment could not be obtained as the presenting part of the leading triplet obstructed a longitudinal scan of the cervix. In contrast, these anatomic difficulties did not present an obstacle in (transverse) 3D‐scans which were possible in all patients.ConclusionTransabdominal 3D‐volumetry as compared to 2D cervical length measurements represents an exact and potentially superior method to monitor cervical incompetence. We believe it a valuable parameter to predict preterm birth.