bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal heart screening in low‐risk pregnancies
Authors: Rustico M. A. , Benettoni A. , D'Ottavio G. , Maieron A. , Fischer‐Tamaro I. , Conoscenti G. , Meir Y. , Montesano M. , Cattaneo A. , Mandruzzato G. 
Published: March 2003

AbstractThe aim of this study was to assess whether a screening program for fetal cardiac malformations is justified in a low‐risk population, and which factors influence its accuracy. The fetal heart was evaluated in 7024 pregnant women at 20–22 weeks, and evaluation was repeated at a more advanced gestational age in 9% of cases. Cardiological follow‐up was continued postnatally until 2 years of age. The overall prevalence of cardiac anomaly was 0.93% The incidences of major and minor defects were 0.44% and 0.48%, respectively. There were 23 true positives (0.33%). in 20 cases, the diagnosis was made in the second trimester, and 13 women (6.5%) chose termination of pregnancy. Seventeen of the 20 cases identified in the second trimester were serious malformations. There were 42 false negatives (0.60%). Of these, 12 had signs of cardiac dysfunction at birth or within the 1st month of life, and three of them died as a result of their cardiac anomaly. There were eight false positives (0.11%), all of a minor type. Six abnormal karyotypes, out of a total of 21 performed in the true‐positive group (28.5%) were found. In addition five of 42 newborns in the false‐negative group had trisomy 21. The overall sensitivity was 35.4% and 61.3% for major defects. The accuracy in two distinct periods was estimated because the level of experience of the operators was different: sensitivity was 45.2% in period 1 (1986–88) (77.8% for major defects) and 26.5% in period 2 (1989–92) (52.9% for major defects). We conclude that a fetal heart screening program in the obstetrics population is justified. It defines a high‐risk group for karyotyping, allows planning of delivery in a tertiary center or the choice of terminating the pregnancy for the parents and appears to have a positive cost‐benefit ratio. A crucial factor is the level of training and experience of the operators, who need specific teaching support. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Screening for chromosomal abnormalities in an unselected population by fetal nuchal translucency
Authors: Hafner E. , Schuchter K. , Philipp K. 
Published: March 2003

AbstractThe aim of this prospective study was to examine the value of nuchal translucency measurement for the detection of fetal aneuploidies in an unselected population of an Austrian National Health Service hospital. A total of 1972 women with singleton pregnancies who attended at 10–13 weeks for the initiation of routine antenatal care at our hospital were examined. Chromosomal abnormalities were found in 11 fetuses, four of them with Down's syndrome. Eight of the 11 chromosomally abnormal fetuses, including two of the four with Down's syndrome, were detected by a nuchal translucency thickness of ≥ 2.5 mm. Three of the fetuses with abnormal karyotype had a nuchal translucency thickness of < 2.5 mm. Two of these were fetuses with Down's syndrome, one of which was identified by karyotyping for maternal age, the second one by positive biochemistry testing (triple test). The additional chromosomal abnormality was identified by karyotyping for maternal age. These data suggest that nuchal translucency screening for aneuploidies is efficient even in an unselected population. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Cerebral hemodynamics in pre‐eclampsia/eclampsia syndrome
Authors: Zunker P. , Ley‐Pozo J. , Louwen F. , Schuierer G. , Holzgreve W. , Ringelstein E. B. 
Published: March 2003

AbstractPre‐eclampsia and eclampsia represent a syndrome with progressive pregnancy‐induced hypertension. They are associated with considerable morbidity and mortality. The pre‐eclampsia/eclampsia syndrome has been hypothesized to reflect a subtype of hypertensive encephalopathy. Additionally, an endothelial dysfunction with impaired cerebral autoregulation has been proposed. Neurological symptoms in hypertensive encephalopathy have been attributed to marked vasospasm or forced vasodilatation. This study was undertaken to evaluate the changes in cerebral hemodynamics due to this syndrome.Twelve patients with pre‐eclampsia/eclampsia syndrome, five of them with a concomitant syndrome involving hemolysis, elevated liver enzymes and low platelets (HELLP syndrome), were investigated. Mean blood flow velocities of the middle, anterior and posterior cerebral arteries were assessed bilaterally by means of a 2‐MHZ, pulsed Doppler ultrasound device. After the initial diagnosis, follow‐up examinations were performed twice a week until delivery, and then weekly over a 4‐week period postpartum.Intracranial arterial blood flow velocities were elevated in ten out of 12 patients. Values of up to twice the normal flow velocities were observed in individual cases. Flow velocities correlated with the systemic arterial blood pressure (r = 0.75, p = 0.008). Eight patients showed pathologically increased flow velocities despite a mean arterial blood pressure below 150 mmHg.Our preliminary findings suggest that a forced vasodilatation, probably due to passive overdistension of cerebral arterioles and vasogenic edema rather than vasospasm, is responsible for the observed high cerebral flow velocities. We hypothesize that endothelial dysfunction plays a crucial role in the altered cerebral hemodynamics in the pre‐eclampsia/ eclampsia syndrome. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Demonstration of fetal coronary blood flow by color‐coded and pulsed wave Doppler sonography: a possible indicator of severe compromise and impending demise in intrauterine growth retardation
Authors: Gembruch U. , Baschat A. A. 
Published: March 2003

AbstractWe report four cases of uteroplacental insufficiency with severe intrauterine growth retardation in which coronary blood flow was demonstrated by means of color‐coded and pulsed wave Doppler sonography. Intrauterine fetal compromise was indicated by pathological uterine and umbilical flow indices and decreased impedance in the cerebral vasculature. Later, this was followed by normalization of middle cerebral artery Doppler indices in one case. The latter change was associated with abnormal atrial systolic reverse blood flow initially in the inferior vena cava, then in the ductus venosus and finally resulting in pulsatile flow in the umbilical vein. In the late stage of fetal deterioration pulsatile flow in the umbilical vein was replaced by a biphasic flow pattern. In two cases coronary flow was visualized preceding intrauterine fetal death. In the two other cases a severely growth retarded newborn was delivered by Cesarean section. The postnatal course was complicated by a prolonged period of circulatory insufficiency and renal failure and in one case by a persistent ductus arteriosus.Visualization of fetal coronary blood flow in severe uteroplacental insufficiency could be a preterminal event when urgent delivery may be warranted. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Acute appendicitis: diagnosis by transvaginal sonography
Authors: Caspi B. , Weissman A. , Pfefferman R. , Appleman Z. 
Published: March 2003

AbstractWe present a case of a female patient with right lower quadrant abdominal pain, in whom transvaginal ultrasound facilitated the diagnosis of acute appendicitis. The insertion of the appendix into the cecum was demonstrated with direct continuity between the cecal lumen and the appendix. The inflamed appendix was in close proximity to the right ovary and was distinguished by a thick edematous wall and fluid in the lumen. This combination of findings may comprise a new sonographic sign for the diagnosis of acute appendicitis, particularly when performed by transvaginal sonography. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Prognostic significance of antenatally detected fetal pyelectasis
Authors: Ouzounian J. G. , Castro M. A. , Fresquez M. , Al‐Sulyman O. M. , Kovacs B. W. 
Published: March 2003

AbstractIn order to evaluate the prognostic significance of ultra‐sonographically detected fetal pyelectasis, a retrospective review was performed of patients evaluated for fetal pyelectasis over a 24‐month period.From 84 patients a total of 98 fetal kidneys with pyelectasis were identified. Fetal pyelectasis was more common in the left kidney and in males. Postpartum evaluation revealed 48 (57.1%) neonates with hydronephrosis. Among these, mean (SD; range) values of antenatal fetal pyelectasis were 17.0 mm (8.4; 5–26) before 33 weeks and 16.9 mm (8.5; 5–34) after 33 weeks in the left kidney and 15.4 mm (3.3; 10–24) and 17.1 mm (5.1; 5–36), respectively, in the right kidney. Thirteen infants (15.4%) with hydronephrosis required surgical pyeloplasties (mean age 6 months; range 3–18 months). It was found, from a receiver‐operating characteristic curve, that fetal pyelectasis of 8 mm was 91% sensitive and 72% specific in predicting subsequent hydronephrosis. Use of a threshold of 5 mm yielded a sensitivity of 100% and a specificity of 24%. On the basis of these findings, we recommend that women with ultrasonographically detected antenatal fetal pyelectasis of ≥ 5 mm at any gestational age have follow‐up ultra‐sound examinations and detailed postnatal evaluation. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Adrenal artery velocity waveforms in the appropriate and small‐for‐gestational‐age fetus
Authors: Mari G. , Uerpairojkit B. , Abuhamad A. Z. , Copel J. A. 
Published: March 2003

AbstractThe purpose of this study was to compare adrenal artery flow velocity waveforms in the appropriately grown and the small‐for‐gestational‐age fetus.Adrenal artery flow velocity waveforms were prospectively obtained from 131 appropriate‐ and 21 small‐for‐gestational‐age fetuses with pulsed Doppler ultrasonography. The success rate in recording the adrenal artery was 84% (131/155) and 100% in the appropriate‐ and small‐for‐gestational‐age fetuses, respectively. The pulsatility index (PI) was used to quantify the waveforms.The PI in the appropriate‐for‐gestational‐age fetuses decreased linearly with gestational age (PI = 1.7 − 0.016 × gestational age). In ten small‐for‐gestational‐age fetuses the adrenal artery PI was below the 95% confidence interval. Small‐for‐gestational‐age fetuses with abnormal adrenal artery PI had a significantly higher incidence of fetal heart rate decelerations, preterm delivery and Cesarean sections when compared to small‐for‐gestational‐age fetuses with normal adrenal artery PI.Our data indicate that the PI of the adrenal artery in the normal fetus decreases with advancing gestation, and they suggest that in the small‐for‐gestational‐age fetus there is an increased blood flow to the adrenal gland. We postulate that management of the small‐for‐gestational‐age fetus may be aided by the study of the adrenal artery flow velocity waveforms. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Demonstration of fetal coronary blood flow by Doppler ultrasound in relation to arterial and venous flow velocity waveforms and perinatal outcome – the ‘heart‐sparing effect’
Authors: Baschat A. A. , Gembruch U. , Reiss I. , Gortner L. , Diedrich K. 
Published: March 2003

AbstractThis longitudinal observational study evaluates the stage at which coronary flow can be visualized by color‐coded and pulsed wave Doppler sonography in fetuses with normal cardiac anatomy. Fetal biometry, echocardiography and Doppler examination of the umbilical and middle cerebral arteries, ductus venosus, inferior vena cava and umbilical vein were performed in 109 cases. Fetuses were divided into five groups based on the Doppler examination of the umbilical artery, birth weight and the ability to visualize coronary blood flow. Coronary blood flow was identified in six of 55 fetuses with normal growth who had normal Doppler studies and perinatal outcome. In these, visualization of coronary blood flow was possible after 31 weeks' gestation at a median gestational age of 37 weeks. Coronary blood flow was also visualized in ten of 54 fetuses with severe intrauterine growth retardation and highly pathological flow velocity waveforms in all vessels soon after a significant increase of venous indices in the inferior vena cava and ductus venosus. In these cases, coronary blood flow was identified at a significantly earlier gestational age (median 27 weeks). These fetuses had a poor perinatal outcome (average birth weight less than 3rd centile, mortality rate 50%, significantly lower umbilical artery blood pH and Apgar scores after 1 and 5 min). Intrauterine fetal death occurred in five fetuses after a median of 3.5 days following visualization of coronary blood flow. Median coronary peak blood flow velocities in the right coronary artery were higher in intrauterine growth‐retarded than appropriate‐for‐gestational‐age fetuses. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Differential diagnosis and outcome of fetal intracranial hypoechoic lesions: report of 21 cases
Authors: Pilu G. , Falco P. , Perolo A. , Sandri F. , Cocchi G. , Ancora G. , Bovicelli L. 
Published: March 2003

AbstractOur objective was to evaluate the diagnostic and prognostic value of sonography in fetal intracranial hypoechoic lesions. A retrospective study revealed a total of 21 cases diagnosed over a period of 10 years. Most of the diagnoses were made in the third trimester. The presence of fluid‐filled lesions within the brain matter always predicted porencephaly and a poor outcome. In most of these cases (nine out of ten), the lesions were seen to communicate with the cavity of the lateral ventricles. Among the 11 cases of hypoechoic lesions that were external to the brain matter, Doppler ultrasound was always able to distinguish between arachnoid cysts (seven cases) and vein of Galen aneurysms (four cases). Arachnoid cysts were associated with a good outcome in four out of five pregnancies that delivered at term. Three of the four cases of vein of Galen aneurysm were associated with distortion of the cerebral architecture and/or hydrops: one pregnancy was terminated and two resulted in early postnatal death. One pregnancy with vein of Galen aneurysm and normal cerebral structures, without signs of hydrops, had a good outcome. It is concluded that current antenatal ultrasound has the capability of accurate differentiation between different clinical entities resulting in fetal intracranial hypoechoic lesions, and that the sonographic findings have practical clinical implications. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Effect on fetal circulation of low‐dose aspirin for prevention and treatment of pre‐eclampsia and intrauterine growth restriction: Doppler flow study
Authors: Bar J. , Hod M. , Pardo J. , Fisch B. , Rabinerson D. , Kaplan B. , Meizner I. 
Published: March 2003

AbstractThe use of low‐dose aspirin for the prevention and treatment of pre‐eclampsia and intrauterine growth restriction has been studied extensively during the last 10 years. The large clinical trials do not support routine prophylaxis or therapeutic administration of low‐dose aspirin in high‐risk pregnant patients.We report on 87 Israeli women who were recruited for the CLASP study (a collaborative trial for the prevention and treatment of pre‐eclampsia and intrauterine growth restriction). Of these women, 41 were treated with 60 mg aspirin daily, and 46 with placebo. The fetal circulation was evaluated by repeated Doppler flow waveform measurements of the umbilical artery and descending aorta from 20 to 34 weeks of gestation. The peak‐systolic/lowest‐diastolic velocity ratio, pulsatility index and resistance index were calculated.No significant differences in Doppler measurements were observed for any of the indices between the aspirin and placebo groups. There were no statistically significant changes in the flow parameters during the course of pregnancy in any of the women studied, nor was there a correlation between waveform analysis and pregnancy outcome. Thus, based on the present results, it appears that low‐dose aspirin does not improve fetal circulation parameters. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Increased fetal nuchal translucency: possible involvement of early cardiac failure
Authors: Montenegro N. , Matias A. , Areias J. C. , Castedo S. , Barre H. 
Published: March 2003

AbstractThe ultrasonographic measurement of nuchal translucency thickness at 10–23 weeks of gestation is accepted as an efficient method of screening for chromosomal abnormalities. However, the underlying mechanism producing increased nuchal translucency thickness is still poorly understood. The purpose of this study was to investigate the possible contribution of impaired cardiac function to such an increase, by studying the venous return in the ductus venosus, using Doppler ultrasound.In a total of 6.5 fetuses, nuchal translucency thickness was measured at 10–13 weeks of gestation by means of a transvaginal probe. Color‐coded and pulsed Doppler ultra‐sound were also used to evaluate different hemodynamic parameters in the ductus venosus: maximum systolic and diastolic velocities, pulsatility index, lowest forward velocity during atria1 contraction and fetal heart rate.Fetal nuchal translucency thickness of ≥ 3 mm was found in 17 cases; in five of them there were chromosomal anomalies: four trisomy 21 and one trisomy 18. Of interest is the finding that in the five chromosomally abnormal fetuses with increased nuchal translucency thickness, the forward velocity during atria1 contraction was consistently less than 2 cm/s (p < 0.001).This impairment of atria1 contraction may well implicate cardiac failure and/or heart defects in the pathogenesis of increased nuchal translucency thickness in the first trimester of pregnancy. Furthermore, nuchal translucency may prove to be a sensitive marker of the early identification of fetal cardiac anomalies. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of 22q11 microdeletion in a fetus with a conotruncal heart defect
Authors: Paladini D. , Pacileo G. , Palmieri S. , Russo M.G. , Conti A. , Piccola B.D. , Martinelli P. 
Published: March 2003

AbstractA case of prenatal diagnosis of 22q11 microdeletion in a fetus with a conotruncal heart defect is described. This type of chromosomal aberration has been shown to be present in up to 30% of isolated conotruncal anomalies and in most cases of DiGeorge and velocardiofacial syndromes. The implications of such a diagnosis on prenatal counselling are discussed. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
The effect of a nitric oxide donor on Doppler flow velocity waveforms in the uterine artery during the first trimester of pregnancy
Authors: Amit A. , Thaler I. , Paz Y. , Itskovitz‐Eldor J. 
Published: March 2003

AbstractOur objectives were to study the effect of a nitric oxide donor on uterine blood flow velocity waveforms and maternal heart rate and blood pressure during the first trimester of pregnancy. Eleven women were examined at 8–12 weeks' gestation, prior to elective termination of pregnancy. Each woman was randomly given a sublingual tablet containing 5 mg of isosorbide dinitrate or placebo, on two consecutive days. Measurements of maternal blood pressure, heart rate and Doppler flow velocity waveforms of the ascending branch of the main uterine artery were obtained before, and every 2 min (for 20 min) after taking the drug or placebo.Following administration of isosorbide dinitrate, the mean arterial blood pressure fell from a control value of 82.5 ± 5.6 mmHg to a nadir of 73 ± 4.1 mmHg at 16 min (p < 0.0001). The mean maternal heart rate increased from a control value of 80.9 ± 2.8 beats/min to a peak of 90.4 ± 4.6 beats/min at 10 min (p < 0.001). The mean resistance index in the uterine artery fell from a control value of 0.80 ± 0.02 to a nadir of 0.73 ± 0.03 at 10 min (p < 0.0001). Analysis of covariance was employed to compensate for the effect of heart rate on the resistance index. The drug had a significant effect on the resistance index in the uterine artery, independent of maternal heart rate. These results suggest that drugs such as isosorbide dinitrate may have a potential benefit under such conditions where the production of nitric oxide (i.e. endothelium‐derived relaxing factor) is decreased. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of congenital granular cell epulis
Authors: Pellicano M. , Zullo F. , Catizone C. , Guida F. , Catizone F. , Nappi C. 
Published: March 2003

AbstractCongenital granular epulis is a benign tumor that has rarely been diagnosed prenatally, although there have been numerous reports on its postnatal diagnosis. We report a case of large granular epulis diagnosed at 31 weeks' gestation in a woman whose previous anomaly scan had been normal. The lesion was 2.5 cm in diameter, pedunculated, and arose from the maxilla. It was completely surgically removed following preterm vaginal birth and histologically examined. The tumor did not prevent deglutition of the amniotic fluid and did not interfere with feeding or respiration, but prevented complete closure of the lips. We discuss the fetal management and the theories of histogenesis, and highlight the importance of early diagnosis and treatment. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of ductus venosus agenesis: a report of two cases and review of the literature
Authors: Gembruch U. , Baschat A. A. , Caliebe A. , Gortner L. 
Published: March 2003

AbstractAnomalies of venous return due to absence of the ductus venosus have been described in the literature. This is a report of the prenatal diagnosis of two cases of isolated ductus venosus agenesis occurring at 20 and 37 weeks' gestation, confirmed postnatally by color‐coded Doppler sonography. In both cases the hepatic veins assumed the function of the ductus venosus without compromising fetal hemodynamics or causing hydrops. In the first case, a healthy female infant was delivered at term. In the second case, a 46,XY,dup(8) (q21.1q22)[35]/47,idem,+r(8)[15] karyotype was diagnosed by amniocentesis. The male newborn showed facial anomalies, a bell‐shaped thorax and increased intermamillary distance. There was muscular hypotonia, delayed psychomotor development and an inspiratory stridor leading to obstructive nocturnal dyspnea.On the basis of our observations in these two cases and previous reports from animal studies, we conclude that absence of the ductus venosus may be compatible with normal fetal development without relevant disturbance of circulation and oxygenation. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of testicular torsion
Authors: Devesa R. , Muñoz A. , Torrents M. , Comas C. , Carrera J. M. 
Published: March 2003

AbstractA case of the prenatal diagnosis of testicular torsion at 39 weeks' gestation is presented. The affected testicle was observed as a small rounded area of hypoechogenicity with a peripheral echogenic ring without hydrocele. The appearance was suggestive of the chronic phase of testicular torsion. The neonatal genital exploration confirmed the diagnosis. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology