bluuebunny/crossref_metadata_2025_split huggingface dataset:
P106Persistent right umbilical vein: incidence and significance in a low risk population
Authors: Wolman I. , Gull I. , Amster R. , Hartoov J. , Fait G. , Lessing J. B. , Jaffa A. J. 
Published: March 2003

ObjectivesOur purpose was to conduct the first prospective evaluation of the incidence and neonatal outcome of fetuses with persistent right umbilical vein (PRUV). This condition had traditionally been considered to be extremely rare and to forebode grave consequences for the babies, but later evidence raised some doubt upon the veracity of these contentions.MethodsBetween August 1995 and November 1998, 8950 low‐risk patients were prospectively evaluated at two medical centers. The ultrasonographic diagnosis of a persistent right umbilical vein was made in a transverse section of the fetal abdomen when the portal vein was curved toward the stomach and the fetal gallbladder was located medially to the umbilical vein.ResultsSeventeen cases of fetuses with PRUV were detected during the study period among the 8950 study participants. Four of them had additional malformations of which three had been detected antenatally.ConclusionsWe established that the incidence of PRUV in a low risk population is 1:526. We believe that the sonographic finding of this anomaly is an indication for conducting targeted fetal sonography and fetal echocardiography. When the PRUV is connected to the portal system and after other anomalies are ruled out, the prognosis can generally be expected to be favorable.
P115First trimester diagnosis of the Pentalogy of Cantrell
Authors: Yamasaki A. , Pedreira D. A. L. , Muller R. , Machado M. V. , Schultz R. , Cha S. C. 
Published: March 2003

Case reportCATO, 31‐year‐old, 2G 0P 1 missed abortion (6 weeks). Ultrasound at 13 weeks gestation showed an opened fetal thoraco‐abdominal wall, with ectopia cordis and a large omphalocele, severe scoliosis was noticed, suggesting the diagnosis of Pentalogy of Cantrell. Nucal translucency measured 1.5 mm and Doppler velocimetry of the venous ductus showed a reverse A wave. At 15 weeks, a transabdominal echocardiography showed a complete ectopia cordis and a ventricular septal defect with mild dilatation of right atrial and ventricular cavities. Kariotype obtained by cvs at 14 weeks showed a normal male (46,XY). Spontaneous fetal death occurred at 18 weeks and after 4 days induced labor resulted in an uneventful vaginal delivery. The anatomopathologic study confirmed the diagnosis of Pentalogy of Cantrel: ectopia cordis, cardiac anomalies (IAC, IVC, truncus arteriosus), sternal agenesis, diaphragmatic defect and gastrosquisis.DiscussionEctopia cordis is present in the Pentalogy of Cantrell, which is one of the thoraco‐abdominal malformation syndromes. It is a rare disease with a relatively good prognosis in neonatal series. Nevertheless, during pregnancy, few cases have been reported making fetal counselling difficult. This anomaly seems to be a X‐linked dominant inheritance, suggesting that male fetus can have worse prognosis.
P119Usefulness fetal echocardiography in the prenatal diagnosis of Down Syndrome (analysis of the 40 cases)
Authors: Krasoń A. , Kaczmarek P. , Janiak K. , Piotrowicz M. , Nowicki G. , Respondek‐Liberska M. 
Published: March 2003

BackgroundThe aim of our study was retrospective analysis of 40 cases fetuses with down syndrome (T21) who had detailed sonography and echocardiography.MethodVideo tape analysis of 40 fetuses with T21 who had completed ultrasound and echocardiography examinations and completed neonatal follow‐up in the same center.ResultsIn our study the majority of cases 26 (65%) were low risk pregnancies. High risk pregnancies were in 14 (35%) cases. Congenital heart defect (72%) (AV‐canal in 13/18 cases) was the most common anomaly diagnosed prenataly in fetuses with T21. Functional cardiac anomalies with normal heart anatomy were recorded also such as: dyspoportion and hypertrophy in 4/12 cases, tricuspid valve regurgitation, bright spot and pericardial effusion in 3/12 cases. Extracardiac malformations (25%) were diagnosed in fetuses with T21 such as: dudenal atresia, femur length shortening, pyelectasis bilateralis, face anomalies, sceletal malformations, hydrops fetalis.Conclusions1. Congenital heart defect (72%) (AV‐canal in 13/18 cases) was the most common anomaly diagnosed in fetuses with T21. 2. The most common extracardiac malformation was duodenal atresia 13/40 = 32.5% cases. 3. Fetal echocardiography can be usefull to identify in the group of low risk pregnancies, the potential patients for cytogenetic examinations of trisomy 21.
P147Preoperative evaluation of endometriosis with transvaginal ultrasound
Authors: Kopjar M. , Alvir I. 
Published: March 2003

ObjectiveTo show the use of transvaginal ultrasound in the diagnosis of endometriosis, and based on that in the decision on the choice of treatment.Patients and methodsUltrasound finding of round shaped adnexal mass with thick wall and homogeneous, low level echo pattern was considered suspected for endometriosis. From 1995 to 1999 in women with chronic pelvic pain and palpable mass, transvaginal ultrasound confirmed the endometriosis, according to the above criteria in IS patients. Eleven patients were treated preoperatively with GnRH agonists (goserelin depot 3.6 mg) for 6 months. After the treatment operative laparoscopy was performed. In 7 patients laparoscopy was performed immediately, and patients received medicated treatment after the operations, also GnRH agonists for 6 months.ResultsDuring the preoperative treatment with GnRH most patients reported a reduction of pain after 3 months of treatment, and with patients operated immediately reduction of pain was reported 2 weeks following operation. Operation was shorter in patients with preoperative treatment with GnRH.ConclusionDisadvantages of preoperative treatment of endometriosis include changes in appearance of endometriosis, price of the medication, side‐effects, dilate of accurate diagnosis, and dilate in eventual pregnancy. For some patients it can be useful to start the preoperative medicated treatment to suppress ovulatory activity, so functional cysts would not be misdiagnosed for endometriosis. Patients with chronic pelvic pain should be evaluated laparoscopically to diagnose mild endometriosis adequately.
P15Cervical cerclage: comparison of two techniques by transvaginal ultrasound
Authors: Rozenberg P. , Gillet A. , Ville Y. 
Published: March 2003

BackgroundCervical cerclage can be performed using either the MacDonald technique or following an anterior colpotomy (Shirodkar technique). A randomized study comparing the two techniques would be impossible to run since 1900 patients would have to be included in each arm.ObjectiveTo evaluate the benefit of performing a colpotomy prior to putting a cervical suture, by measuring the distance between the stitch and the external os.Design and methodsRetrospective case‐control study (January 1997–January 1999). All patients having had cervical cerclage after anterior colpotomy and giving birth in our Institution were the study group. Each case was matched with the next patient giving birth in our Institution after having had a MacDonald cerclage. The indication was left to the surgeon's decision and each surgeon used only one technique. Obstetrical characteristics were recorded and ultrasound measurement of the cervix was performed within 8 days following the procedure.ResultsDuring the study period, there were 15 cases in each group. There was no significant difference between the two groups in the obstetrical outcome. Cervical length was 36.6 mm and 35.4 mm, and the distance between the stitch and the external os was 16.1 mm and 13.5 mm in the Shirodkar and the MacDonald groups, respectively.ConclusionAnterior colpotomy did increase the distance between the stitch and the external os by only 2.6 mm and does not seem to offer any clinical benefit.
P156Teaching in ultrasound – new methods in training
Authors: Heer I. , Fuchshuber S. , Strauss A. 
Published: March 2003

IntroductionThe purpose of this study was to evaluate a new training system for transvaginal ultrasound.MethodsWe used a software‐based 3D‐ultrasound which allows offline re‐evaluation of structures recorded in a 3D‐voxelcube during an actual exam. The software assigns a specific plane to each possible position of the transducer within the 3D‐cube. This allows virtual ‘re‐scanning’ of recorded exams. In the teaching model, an vaginal ultrasound transducer is used to examine a life‐size model pelvis. The transducer is linked to a computer which displays the virtual ultrasound scan. We tested the system on 30 Munich‐University 3rd year medical students. None had previous ultrasound experience. All were shown an 8 minute teaching video. Each student was allowed a 1 minute practice period, then asked to find a proper plane and measure the endometrial thickness.ResultsAll students were able to find a proper plane for measurement within 30 s. The results of measurments varried between 5 and 9 mm (actual thickness 8 mm). All rated the session as an excellent theoretical introduction into the field of transvaginal ultrasound, and as extremely valuable skill‐training.ConclusionIn this software based re‐evaluation model, we believe to have found an optimal new training tool for transvaginal ultrasonound. As a consequence, we intend to establish a case‐library for the future basic training of younger doctors.
P16Office ultrasonography in obstetrics: an eight year experience
Authors: Assimakopoulos E. A. 
Published: March 2003

BackgroundWe present an eighth year experience (1991–98) of ultrasonography in a private office, using a portable ultrasound unit, Aloca SSD‐500.MethodEach pregnant woman underwent transvaginal ultrasound examination 7–8w in order to date pregnancy, to confirm fetal viability and the number of fetuses. At 17 weeks, a second trimester screening for Down syndrome was ordered by using BPD, maternal age and maternal serum AFP and free β‐HCG. Later, at 20–22w a detailed scan was performed to all pregnant women in order to exclude fetal anomalies.ResultsIn 1019 consecutive pregnant women, 22 could not recall the date of their LMP and 59 had irregular cycles. By measuring the CRL, the expected date of delivery was accurately calculated. One hundred and seventy‐six women underwent amniocentesis with no complications, and from these, there was only 1 case with trisomy 18. All pregnant women had level II scan. There were 5 cases with abnormalities (1 cystic hygroma, 1 diaphragmatic hernia, 1 with talipes, 1 anencephalic and two with hydrops). We couldn't diagnose prenataly 1 case with coarctation of the aorta, 1 anorectal atresia, 1 microcephaly and 3 with Down Syndrome. All the other women delivered babies with normal anatomy. As far as the cost is concerned, there was no extra charge for ultrasound examinations.ConclusionOffice ultrasonography is feasible after long‐term training and experience.AcknowledgementsW. R. Lees and J. C. Hobbins.
P23Ultrasonographic weight estimation of the macrosomic fetus: the benefit of two examiners
Authors: Gull I. , Wolman I. , Har‐Toov J. , Fait G. , Amster R. , Lessing J. B. , Jaffa A. J. 
Published: March 2003

BackgroundUsing two examiners to obtain more accurate estimation of fetal weight (EFW) in suspected macrosomy is commonly accepted. However, the real benefit of such routine has not been validated.AimTo validate and calculate the benefit of using two examiners for increasing the accuracy and decreasing errors of more than 10% in EFW of macrosomic fetuses.MethodsFifty term fetuses suspected for macrosomy were examined by two examiners. The accuracy and the number of errors of EFW of more than 10% were calculated for each examiner, and compared to an average estimation of both examiners.ResultsThe average birth weight was 4140gr. The estimation accuracy of the examiners was 5.83% and 6.18% (N.S.). Using an average estimation of both examiners the accuracy increased to 5.75% (N.S.). However, using two examiners decrease the number of errors of more than 10%. Twelve fetuses were estimated erroneously by at least one examiner. Only 6 fetuses were estimated erroneously when the EFW was based upon the average of the two examiners.ConclusionAlthough the use of two examiners for EFW in macrosomic fetus doesn't increase the accuracy, it decreases errors of more than 10%.
P27Unusual fetal infection leading to early IUGR and hydrocephaly: case report
Authors: Pedreira D. A. L. , Jasinowodolinsk D. , Rocha A. J. , Schultz R. , Zerbini M. C. N. , Cha S. C. 
Published: March 2003

LRK, 34 years‐old, primigravida, had first scan done at 10 weeks 1 day with CRL compatible with 9 weeks + 5 days. At 12 weeks 2 days, nucal translucency measured 1.0 mm, Doppler velocimetry of ductus venosus (positive A wave) showed posite A wave and CRL measured 46 mm (11 weeks 4 days). At 21 weeks + 6 days the anomaly scan revealed dilatation of cerebral ventricles, asymmetric IUGR (measurement compatible for 17w + 6d), oligohydramnios and severe placentomegaly. Amniocentesis showed normal karyotipe (46XX). MRI was performed at 22 weeks, using T2 sequence and single shot fast spin echo (SSFSE) without maternal or fetal sedation. Global dilatation of cerebral ventricles, without signs of obstruction or other CNS malformations. Delivery was induced after spontaneous fetal death at 23 weeks, a female stillborn weighting 240g showed no other malformation then those described in CNS. Anatomo pathologic evaluation of the brain revealed encephalitis and periventriculitis and placenta showed severe vilositis. Immuno‐histochemistry of the brain/placenta was negative for herpesvirus and CMV, but adenovirus was positive in both tissues. Maternal serology from the begining of pregnancy showed no antibodies against toxoplasmosis, HIV or syphilis and acquired antibodies to rubella, CMV, Hepatitis B. At delivery all this serologies were repeated and results remained the same. Maternal serology for adenovirus in a stored sample collected at 18 weeks showed a 1/8 titre.DiscussionBesides the usual torch infection, other infections can severely affect otherwise normal pregnancies. The identification of other possible infection agents may help to elucidate the so‐called ‘idiophatic’ causes of spontaneous fetal death. We suggest the inclusion of adenovirus in the infection screening of such cases.
P35Duodenal atresia: prenatal diagnosis and perinatal outcome of 27 fetuses
Authors: Has R. , Batukan C. E. M. , Ermiş H. , Başaran S. , Yüksel A. , Ibrahimoglu  
Published: March 2003

ObjectiveTo discuss the prenatal diagnosis, obstetrical management, and perinatal outcome of duodenal atresia, and investigate the incidence of associated malformations and chromosomal anomalies.Materials and methodsThe data about 27 fetuses with duodenal atresia which were diagnosed on prenatal sonographic evaluation, and confirmed postnatally, among 20401 high risk pregnancies who were referred to Prenatal Diagnosis Unit of Obstetrics and Gynecology Department of Istanbul Medical Faculty between 1988 and 1999, are analyzed. Presence of polihydramnios, gestational week at diagnosis, associated malformations and chromosomal abnormalities, and perinatal outcomes were evaluated. Fisher's exact test is used for statistical analysis.ResultsDuodenal atresia was diagnosed in 43 fetuses, but postnatal outcomes of 38 fetuses could be obtained. Ten of the fetuses had additional abnormalities in 27 cases whom diagnosis was confirmed. Nine chromosomal abnormalities (33.3%) including seven trisomy 21 (29.6%), one deletion, one translocation anomaly detected. The perinatal mortality of duodenal atresia is found 44.4% with 12 pre and postnatal deaths. Fifteen infants discharged in a healthy condition after operations.ConclusionDuodenal atresia, especially in the presence of associated abnormalities has a high perinatal mortality. Establishment of diagnosis in prenatal period, even in the late stages of gestation, may contribute the obstetrical and neonatal management.
P36Prenatally diagnosed duodenal obstruction: a report of 16 cases
Authors: Galindo A. , Arbues J. , Puente J. M. , Villar O. , Cano I. , Grañeras A. , De La Fuente P. 
Published: March 2003

AimTo evaluate main ultrasound findings, associated anomalies and perinatal outcome of fetuses with duodenal obstruction (DO).MethodsRetrospective review from January 1990 to October 1998 of 16 fetuses with DO.ResultsThe incidence was 1 in 2771 deliveries. DO accounted for 53% (16/30) of all the small bowel obstructions. Sensitivity was 76%. Mean gestational age at diagnosis was 32.6 weeks. Associated anomalies were diagnosed prenatally in 5 cases (31.3%) and postnatally in 3 more cases, so associated anomalies were present in 50%. DO was an isolated finding in 11 cases (68.7%) and no chromosomal anomalies were observed in this group. These were diagnosed in 4 out of the 5 cases with associated anomalies. Polyhydramnios was quite common (93.7%). Taking into account also cases postnatally diagnosed, chromosomal defects rate was 33.3% (trisomy 21 represents 86% of all). Mean gestational age at delivery was 35.1 weeks. Mean weight at birth was 2315 g. Perinatal mortality rate for prenatally diagnosed DO cases was 31.2%, but this rate rose up to 62.5% in those cases with associated anomalies. No deaths were seen in isolated cases. DO resulted from atresia in 6 cases (37.5%), from web in 5 (31.2%) and from annular pancreas in 5 (31.2%).ConclusionDO is most prevalent type of small bowel obstruction. Associated anomalies and chromosomal defects (Tr.21) are common and should always be ruled out. While isolated cases have good prognosis, outcome is worse with associated anomalies, the latter being the major prognostic factor.
P39Recurrent non inmune hydrops fetalis in parents with shared HLA DR and DQ
Authors: Pérez Fernández R. , De León J. A. , Pintado P. , Orera M. , Carbone J. , Ortiz L. 
Published: March 2003

IntroductionNon immune hydrops fetalis (NIHF) is defined as the extra cellular accumulation of fluid in tissues and serous cavities, without evidence of circulating antibodies against red blood cell antigens. NIHF is the result of a heterogeneous group of conditions including cardiovascular, pulmonary, chromosomal, haematology, infectious disorders and deposit disease.A 34‐year‐old pregnant woman with obstetrical history of two prior perinatal deaths between 29th and 30th weeks of gestation, all associated with foetal hydrops. In the prior pregnancy we made a exhaustive study of the foetal blood, obtained by cordocentesis, and the parents' blood. This study included haematology, infectious serology, hormonal and immune disorders and it was detected a shared HLA DR and DQ. In the current pregnancy, the foetus has developed hydrops at the 20th week of gestation which has been diagnosticated by ultrasound. Once again the results of the research has been normal and we have tried to correct the hypoproteinemia with albumen infusion by cordocentesis. The following up has showed the increase of the hydrops concluding with cardiovascular failure and foetal death.DiscussionThe mortality rate of recurrent NIHF is over the 80% of the cases and depends on the ethiology. The epidemiological studies had demonstrated the association between abortions and parents who shared HLA DR and DQ but the association with recurrent NIHF is not a proved fact.The diagnosis of hydrop fetalis is by ultrasound on detection of skin thickness greater than 5 mm with fluid accumulation in at least one of the serous cavities. It is also necessary to obtain a detailed ultrasound scan for structural defects, echocardiography and Doppler blood flow studies of mayor foetal vessels. Ultrasound is an important tool used in the following up of NIHF and it makes possible the use of the cordocentesis therapy in some cases.
P42Hydrops fetalis and hepatosplenomegaly in the second half of pregnancy as a sign of myeloproliferative disorder in fetuses with trisomy 21
Authors: Smrcek J. , Germer U. , Baschat A. , Gembruch U. 
Published: March 2003

BackgroundFetal hydrops and/or hepatosplenomegaly in the second half of pregnancy may be a sign of myeloproliferative disorder in fetuses with trisomy 21.MethodsIn order to search for fetuses with myeloproliferative disorder a retrospective study was performed in fetuses with trisomy 21 and hydrops diagnosed in our prenatal unit. Three of these fetuses presented hepatosplenomegaly and myeloproliferative disorder. In addition, one fetus with sonographic signs of trisomy 21, where karyotyping was unfortunately unsuccessful, presented with hepatosplenomegaly, hydrops and myeloproliferative disorder.ResultsThe four fetuses reported presented with fetal hepatosplenomegaly and hydrops in the second and third trimester. Infectious serology was negative. The characteristics of blast cells in the peripheral blood smear revealed a myeloproliferative disorder. The diagnosis was confirmed by postmortem examination, since all four cases ended up in fetal demise.ConclusionFetal hydrops and/or hepatosplenomegaly in the second half of pregnancy, although suggestive of infectious aetiology, may be a sign of myeloproliferative disorder in fetuses with trisomy 21 or mosaic trisomy 21. It seems to be possible, that a myeloproliferative disorder is the most common cause of hydrops in cases of trisomy 21, at least during late second and third trimester. Furthermore, the incidence of myeloproliferative disorder in utero may be more frequent than realized.
P46Differential diagnosis in fetal obstructive uropathy
Authors: Paternoster D. M. , Stella A. 
Published: March 2003

Case reportA healthy 24‐year‐old secundigravida presented for a routine ultrasound examination at the 11th week of gestation. The scan showed a singleton pregnancy and the crown‐rump length (43.8 mm) was compatible with the gestation calculated from the last menstrual period. The foetal abdomen was distended by the presence of one only cyst (12 × 7.4 mm), compatible with distension of the bladder. There was no other evident abnormality. Amniotic fluid volume was normal for the first trimester despite total urethral obstruction. At 14 weeks still birth was found and the patient delivered three days later. Diagnosis was confirmed at autopsy. Post mortem examination confirmed a phenotypically normal male foetus consistent with 14 weeks gestation and weighing 70 gr. The abdomen was distended and the abdominal wall was thin. Internal examination confirmed the presence of an enlarged bladder. There was urethral atresia, with associated dilatation of the bladder but the ureter and kidneys were normal. Internal genitals were male with normal testicles and penis. Chromosome analysis was performed on foetal skin and karyotype was 46, XY.DiscussionCloacal dysgenesis sequence (CDS) is a rare cause of fetal obstructive uropathy (FOU). The prenatal differentition of CDS from other FOU is important because CDS is not amenable to in utero surgical intervention in the form of vescicoamniotic shounts. Differential diagnosis must be made with pathologies capable of determining cystic lesions localised in the inferior foetal abdomen, such as ovarian cysts, intestinal duplications, Hirschsprung disease, colic dilatation, imperforate hymen with hydrometracolps and megacystes–microcolon syndrome. Accurate prenatal diagnosis can be difficult and requires prolonged serial observations. The above‐mentioned pathologies have characteristics of relative ‘fixity’, while typical imaging of cloaca undegoes variations due to sequential filling in, or repletion, of the liquid contained in the urinary, genital and digestive components of the malformation. Moreover, intestinal obstruction is generally associated with polyhydramnios. In the first trimester diagnosis of cloaca anomalies are very difficult because there are no great changes in amniotic fluid volume and ascites rarely is present; serial examinations are required for enable definition of diagnosis.