bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early fetal megacystis between 11 and 15 weeks of gestation
Authors: Favre R. , Kohler M. , Gasser B. , Muller F. , Nisand I. 
Published: March 2003

AbstractObjectiveThe purpose of this study was to evaluate the prognostic criteria of early fetal megacystis. Design A prospective, transvaginal ultrasound, cross‐sectional study at 11–15 weeks of gestation at a tertiary referral fetal medicine unit. Subjects and methods Sixteen pregnancies out of a total of 5240 were identified with early fetal megacystis. Fetal biometry, morphology, amniotic fluid, bladder size and volume were also evaluated. The karyotype was available in 15 cases. Vesicocentesis was performed in six fetuses and three had concomitant cystoscopies.ResultsIn six fetuses, the megacystis was isolated. In the remaining ten, we detected associated hygroma (n = 5), nuchal translucency (n = 3), omphalocele (n = 1), mild pyelectasis (n = 1) and bilateral talipes (n = 1). In three cases the fetuses demonstrated renal hyperechogenicity with cysts, and in two cases oligohydramnios was found; four cases (25%) had chromosomal abnormalities; 47,XY + 13 (two cases), 47,XY + 18 and 47,XY + 21. Only one fetus from this study survived. In the remaining 13 cases, termination was proposed after counselling of the patients on the poor prognosis. The mean gestational age at termination was 15.5 ± 2.4 weeks (range 12–20). Three fetal trans‐abdominal cystoscopies did not allow us to view the valves; one urethral atresia was suspected, and confirmed postnatally.ConclusionsWe found a high rate of associated malformations, especially intestinal malformations. The systematic evaluation of the intestinal enzymes in the amniotic fluid and urine samples might be an important aid in the diagnosis of multiple malformations, such as cloacal dysgenesis. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
A prospective management study of slow‐release aspirin in the palliation of uteroplacental insufficiency predicted by uterine artery Doppler at 20 weeks
Authors: Harrington K. , Kurdi W. , Aquilina J. , England P. , Campbell S. 
Published: March 2003

Objective
To investigate the effect of low‐dose, slow‐release aspirin in reducing the incidence and/or severity of pregnancy complications in women identified as high risk of developing problems associated with uteroplacental insufficiency, namely pre‐eclampsia or delivering a small‐for‐gestational age (SGA) baby.
Design
A prospective, randomized management study. One thousand and twenty‐two women of mixed parity underwent color flow/pulsed Doppler (CFPD) imaging of the uterine arteries at the time of the 17–23 week (mean 19.9) anomaly scan. Women who were screen positive were randomized to a control or treatment group. The treatment group was given 100‐mg slow‐release aspirin (Disprin CV) daily and followed up at regular intervals. Women in the routine group received routine antenatal care. Main outcome measures were pre‐eclampsia and SGA < 3rd centile. Secondary outcome measures were: SGA < 10th centile, pre‐eclampsia requiring delivery before 34 weeks, placental abruption, an Apgar score < 7 at 5 min, admission to neonatal intensive care unit or a pregnancy that resulted in a stillbirth or neonatal death. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for severe and any complications.
Results
Two hundred and sixteen women were screen positive according to the defined criteria. One hundred and three women were assigned to the treatment group and 113 to the control group. The difference in the incidence of pre‐eclampsia and SGA < 3rd centile between the control and treatment groups did not reach statistical significance. There was a statistically significant reduction in any (OR 0.41 (CI 0.35–0.45), P < 0.01) and severe pregnancy complications (OR 0.43 (CI 0.21–0.84), P < 0.05) in the treatment group compared with the controls.
Conclusions
The administration of slow‐release aspirin to women identified as high risk, using color Doppler imaging of the uterine arteries at 20 weeks’ gestation, did not significantly alter the incidence of pre‐eclampsia or delivery of a SGA baby. It did, however, improve the outcome by reducing the overall incidence of complications associated with uteroplacental insufficiency.
Fetal weight estimation by three‐dimensional ultrasound
Authors: Schild R. L. , Fimmers R. , Hansmann M. 
Published: March 2003

AbstractObjectiveTo assess the value of three‐dimensional volume scanning in predicting fetal weight at birth.Study designProspective cross‐sectional study within 7 days of delivery. A total of 190 patients were considered for final analysis (formula‐finding group: n = 125, formula evaluation group: n = 65). Inclusion criteria were a singleton pregnancy and absence of chromosomal or significant structural anomalies. Three‐dimensional (3D) volumetric measurements of the fetal thigh, upper arm and abdomen were performed together with conventional two‐dimensional (2D) biometry.ResultsAll measurements were completed successfully in each patient. Polynomial regression analysis with standard biometric parameters and volumes of the upper arm, the thigh and the abdomen was employed to yield the best‐fit formula for prediction of fetal weight at birth. The new 3D formula (estimated fetal weight (EFW) = −1478.557 + 7.242 × thigh volume + 13.309 × upper arm volume + 852.998 × log10 abdominal volume + 0.526 × BPD3) proved to be superior to established 2D equations with the lowest mean error (25.8 ± 194.4 g), the lowest mean absolute error (155.2 ± 118.2 g) and the lowest mean absolute percentage error (6.1 ± 5.0%) when studied prospectively in the evaluation group.Conclusion3D sonography allows superior fetal weight estimation by including soft tissue volume. Further studies at the extremes of fetal weight are needed to confirm the value of our formula in these subsets. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Tissue Doppler imaging of the fetal heart
Authors: Paladini D. , Lamberti A. , Teodoro A. , Arienzo M. , Tartaglione A. , Martinelli P. 
Published: March 2003

AbstractObjectivesThe objectives of this study were: (i) to assess the feasibility of a tissue Doppler imaging (TDI) evaluation in the fetus, (ii) to identify color‐TDI patterns consistent with the various phases of the cardiac cycle; and (iii) to assess myocardial velocities and the myocardial velocity gradient.MethodsEighty‐nine normal fetuses between the 17th and the 37th week of gestation were studied. Color‒TDI was superimposed on an apical four‐chamber view of the fetal heart and three cardiac cycles captured in cine‒loop format. By reviewing the cine‐loop strip, color patterns consistent with the various phases of the cardiac cycle were identified. The procedure was then repeated with a transverse four‐chamber view. On each frame corresponding to mid‐systole, early and late diastole, myocardial velocities were calculated at the subepicardial and subendocardial layer and regressed against gestational age. Statistics included correlation and regression analysis, calculation of the 95% confidence intervals and of the Cronbach's alpha reliability coefficient for repeated observations.ResultsTDI examination is acceptably reproducible in the fetus. We were able to identify color‐TDI patterns depicting the systolic contraction wave, ventricular relaxation and atrial contraction. Statistical evaluation demonstrated that: all variables (systolic right and left subendocardial and subepicardial velocities, early diastolic right and left subendocardial and subepicardial velocities, end diastolic right and left subendocardial velocities, right subepicardial velocities) except end‐diastolic right and left subepicardial velocities, showed a positive correlation with advancing gestational age; subendocardial velocities were higher than subepicardial ones throughout the cardiac cycle in both ventricles; systolic myocardial velocities were higher in the left ventricle whereas early diastolic velocities were higher in the right ventricle; and the ratio between early and late diastolic subendocardial velocities (EM/AM) was constantly <1 and did not change with advancing gestational age.ConclusionsTDI evaluation of the fetal heart is feasible and reproducible. Color‐TDI is able to identify the various phases of the cardiac cycle. Quantitative evaluation of myocardial velocities has shown also in the fetus the existence of the myocardial velocity gradient found in postnatal life. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
In utero diagnosis of obstructed supracardiac total anomalous pulmonary venous connection in a patient with right atrial isomerism and asplenia
Authors: Patel C. R. , Lane J. R. , Muise K. L. 
Published: March 2003

AbstractWe describe a rare case of right atrial isomerism, levocardia, right‐side stomach, obstructed supracardiac total anomalous pulmonary venous connection, double outlet right ventricle with complete atrioventricular septal defect and absent spleen. From the pulmonary venous confluence behind the atrium an ascending as well as a descending vertical vein communicated with the systemic venous system in the supracardiac as well as the infracardiac position. The pulsed and color Doppler examination of the individual pulmonary veins as well as of the vertical vein helped in making the diagnosis of obstructed total anomalous pulmonary venous connection. The diagnosis was made by fetal echocardiographic examination at 22 weeks of gestation and confirmed on postnatal echocardiography, cardiac catheterization, and at surgery. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal color Doppler assessment of venous flow in adnexal masses
Authors: Alcázar J. L. , López‐García G. 
Published: March 2003

AbstractObjectiveTo analyze the usefulness of transvaginal color Doppler assessment of venous flow in the differential diagnosis of adnexal masses.Material and MethodsNinety‐one consecutive patients (mean age: 46.6 years, range: 16–81 years) diagnosed as having an adnexal mass were evaluated by transvaginal color Doppler sonography prior to surgery. Color Doppler was used to detect and analyze the flow velocity waveform from arterial and venous blood flow within the tumor. For arterial signals the resistance index and peak systolic velocity, and for veins the maximum venous flow velocity, were calculated. Receiver operator characteristic curves were plotted to determine the best venous flow velocity cut‐off. According to our previous study using arterial Doppler, a tumor was considered as malignant when flow was detected and the lowest resistance index was ≤ 0.45. Using venous Doppler a mass was considered as malignant when flow was detected and the venous flow velocity was ≥ the best cut‐off found on the receiver operator characteristic curve. Definitive histopathological diagnosis was obtained in all cases. Sensitivity, specificity, positive predictive value and negative predictive value for B‐mode morphology (evaluation performed according to Sassone's scoring system), arterial Doppler, venous Doppler, and a combination of both arterial and venous Doppler were calculated.ResultsTwenty‐five masses (27.5%) were malignant and 66 (72.5%) benign. Arterial and venous flow was found more frequently in malignant than in benign masses (92% vs. 41% (P < 0.001) and 72% vs. 21% (P < 0.001), respectively). The resistance index was significantly lower in malignant tumors (0.42 vs. 0.60, P = 0.0003). No differences were found in peak systolic velocity. Venous flow velocity was significantly higher in malignant masses (18.1 cm/s vs. 8.9 cm/s, P = 0.0006). The best cut‐off of venous flow velocity was 10 cm/s. Sensitivity, specificity, positive predictive value and negative predictive value for morphology, arterial Doppler, venous Doppler, and the combination of both arterial and venous Doppler were 92%, 71%, 45%, 96%; 76%, 95%, 87%, 91%; 68%, 94%, 81%, 89%; and 88%, 91%, 79%, 95%, respectively.ConclusionsOur results indicate that preoperative evaluation by venous flow assessment of adnexal masses may be useful to discriminate between malignant and benign tumors. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Fetal axillary hemangiolymphangioma with secondary intralesional bleeding: serial ultrasound findings
Authors: Tseng J. J. , Chou M. M. , Ho E. S. C. 
Published: March 2003

AbstractA case of fetal axillary hemangiolymphangioma coexisting with intralesional hemorrhage is presented. At 27 weeks' gestation, the fetus was found to have a 52 × 43‐mm left axillary multilocular cystic mass which showed no signals on color Doppler. The mass was composed mostly of sonolucent spaces. At 29 weeks' gestation, an arterial flow signal (15 cm/s) was detected within the mass. In addition, two low‐density echogenic cystic spaces with bidirectional flow waveforms were found, which raised the suspicion of intratumoral bleeding. Two weeks later, a fine‐needle aspiration of the mass revealed both straw‐colored and chocolate‐colored fluid. The tumor size increased from 52 × 43 mm at 27 weeks to 100 × 79 mm at 37 weeks. Blood clots developed gradually in the hemorrhagic spaces. The pregnancy proceeded smoothly to term and at 38 weeks an elective Cesarean section was performed. After a surgical excision of the mass at the age of 4 days, a mixed cavernous hemangioma and cystic lymphangioma with secondary intralesional hemorrhage was confirmed histopathologically. Copyright © 2002 ISUOG
First‐trimester placental volume as a marker for chromosomal anomalies: preliminary results from an unselected population
Authors: Metzenbauer M. , Hafner E. , Schuchter K. , Philipp K. 
Published: March 2003

AbstractObjectiveTo compare first‐trimester placental volume in chromosomally abnormal and normal pregnancies.MethodsPlacental volumes were routinely recorded at the time of nuchal translucency thickness measurement at 10–13 weeks of gestation. This was done using customized three‐dimensional ultrasound equipment and measurements were then converted to the placental quotient (placental volume/fetal crown–rump length). The possible difference in placental quotient between chromosomally normal and abnormal pregnancies was examined.ResultsA total of 2863 pregnancies was evaluated, including 17 with major chromosomal defects (nine cases of trisomy 21, four of trisomy 18, two of trisomy 13, and one each of Turner syndrome and 48,XXY + 21). The median placental quotient in the chromosomally abnormal group (0.67) was significantly lower than that in the normal fetuses (0.98). In nine of the 17 affected pregnancies the quotient was below the 10th centile of the normal range.ConclusionsAssessment of placental volume may prove to be useful in first‐trimester risk assessment for chromosomal anomalies. Copyright © 2002 ISUOG
Marked splenomegaly in fetal cytomegalovirus infection: detection supported by three‐dimensional power Doppler ultrasound
Authors: Chaoui R. , Zodan‐Marin T. , Wisser J. 
Published: March 2003

AbstractAn enlarged fetal spleen can be associated with fetal infection, anemia and different syndromes but its prenatal diagnosis is rare. We report on a diagnosis of splenomegaly at 32 weeks' gestation in a fetus which was found to be affected by cytomegalovirus infection. An enlarged spleen was suspected when the stomach was found to be displaced anteriorly and medially and the diagnosis was supported on visualization of the splenic vessels by color and three‐dimensional power Doppler ultrasound. The patient had been referred because of fetal growth restriction and intracerebral anomalies and the additional finding of splenomegaly was highly suspicious for cytomegalovirus infection. This was confirmed by positive maternal serology and by neonatal virus excretion in urine. Retrospectively, examination of stored blood samples from 9 and 23 weeks' gestation revealed an early cytomegalovirus infection. Antenatal and neonatal magnetic resonance imaging examinations showed microcephaly, lissencephaly and the presence of microcalcifications. At the age of 9 months, the child suffers from severe neurological impairment and blindness due to severe optical atrophy. This case emphasizes that color Doppler and three‐dimensional power Doppler ultrasound can facilitate the antenatal diagnosis of splenomegaly and can help to delineate the spleen from the similar‐looking neighboring liver. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Changes in fetoplacental vessel flow velocity waveforms following maternal administration of betamethasone
Authors: Edwards A. , Baker L. S. , Wallace E. M. 
Published: March 2003

AbstractObjectiveTo determine the timing of the onset of the umbilical artery flow velocity waveform changes following maternal administration of betamethasone in pregnancies complicated by umbilical artery absent end‐diastolic flow, and to explore whether these changes are associated with flow velocity waveform changes in other fetoplacental vessels.Subjects and methodsThis was a prospective study of 12 women with pregnancies complicated by umbilical artery absent end‐diastolic flow. Flow velocity waveforms were recorded from the umbilical artery, fetal middle cerebral artery, renal artery, aorta and ductus venosus, before and after maternal betamethasone administration, using real‐time pulsed wave Doppler.ResultsIn all 12 pregnancies, the administration of maternal betamethasone was followed by the return of end‐diastolic flow within 24 h. End‐diastolic flow was first observed at 4 h and was present in all women studied at 8 h. In addition, there was a statistically significant decrease in the pulsatility index in the fetal aorta at 8 h and the middle cerebral artery at 24 h. No change was observed in the ductus venosus or the renal artery flow velocity waveforms.ConclusionThe findings suggest that, in pregnancies complicated by absent end‐diastolic flow in the umbilical artery, maternally administered betamethasone induces a return in umbilical artery end‐diastolic flow as early as 4 h, along with widespread vasodilatation throughout the fetoplacental vasculature. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Comparison of ovarian cyst formation in women using the levonorgestrel‐releasing intrauterine system vs. hysterectomy
Authors: Inki P. , Hurskainen R. , Palo P. , Ekholm E. , Grenman S. , Kivelä A. , Kujansuu E. , Teperi J. , Yliskoski M. , Paavonen J. 
Published: March 2003

AbstractObjectiveTo analyze the effect of the levonorgestrel‐releasing intrauterine system (LNG‐IUS) on ovarian cyst formation, endometrial thickness and the size of uterus and uterine fibroids by ultrasonography.Subjects and methodsThis was a prospective, randomized trial comparing the LNG‐IUS and hysterectomy in 236 women (age range 35–49 years) referred for menorrhagia. Transvaginal ultrasound examination was used to study the presence of ovarian cysts, uterine size, endometrial thickness, and the size of the uterus and uterine fibroids during a 12‐month follow‐up period.ResultsAt baseline examination, 12 ovarian cysts were detected, eight in the LNG‐IUS group and four in the hysterectomy group. During the follow‐up period, 14 new cysts had emerged at 6 months and 14 new cysts had emerged at 12 months in the LNG‐IUS group, whereas the corresponding figures in the hysterectomy group were three and eight, respectively. All but one of the 14 new cysts (94.1%) detected at 6 months in the LNG‐IUS group resolved spontaneously, whereas two out of the eight cysts detected at the baseline examination persisted for 12 months. Three cysts were removed at operation. The relative risk of the occurrence of ovarian cysts was significantly higher in women with LNG‐IUS, compared with women who underwent hysterectomy. LNG‐IUS did not affect the size of the uterus or uterine fibroids, but it was associated with a decrease in endometrial thickness. The occurrence of cysts did not correlate with age or follicle stimulating hormone levels, but a weak positive correlation between the occurrence of cysts and the presence of irregular bleeding was observed.ConclusionsLNG‐IUS use in the treatment of menorrhagia was associated with the development of ovarian cysts, but these were symptomless and showed a high rate of spontaneous resolution. LNG‐IUS did not affect the size of the uterus or the size of uterine fibroids, but decreased the thickness of the endometrium. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasonographic features of the endometrium and the ovaries in women on etonogestrel implant
Authors: Van Den Bosch T. , Donders G. G. G. , Riphagen I. , Debois P. , Ameye L. , De Brabanter J. , Van Huffel S. , Van Schoubroeck D. , Timmerman D. 
Published: March 2003

AbstractObjectiveTo evaluate the ultrasound features of the endometrium and ovaries in women on etonogestrel implant, and to correlate these features with the bleeding pattern.MethodsObservational study including 188 consecutive women presenting for follow‐up transvaginal ultrasound examination after insertion of an etonogestrel implant contraceptive device. Thirty women had more than one follow‐up examination. The bleeding pattern was considered abnormal if, in the last 3 months, there were more than five episodes of vaginal bleeding, or there was prolonged bleeding exceeding 14 consecutive days.ResultsAt first follow‐up examination, the mean age was 29.7 years and 47% of women had an abnormal bleeding pattern. Most bleeding episodes were of less intensity than menses. The mean endometrial thickness (ET) on ultrasound was 2.9 mm (standard deviation, 2.0). Ovarian follicle growth exceeding 5 mm was observed in 60% of the cases. Ovulation was demonstrated in one woman. Univariate analysis showed a positive association (P < 0.01) between ET, bleeding pattern, and bleeding intensity. Follicle growth was positively associated (P < 0.01) with ET, bleeding pattern, and interval between insertion and examination. Multivariate analysis showed that the ET was on average 1.25 mm greater in women with abnormal bleeding (P = 0.0001). The odds of finding follicle growth were 2.8 times higher (95% confidence interval, 1.2–6.2) in women presenting with a three‐layer type of endometrial morphology. There was no association between the other patients' characteristics and the bleeding pattern.ConclusionsAbnormal uterine bleeding in women on etonogestrel implant was associated with follicle growth and a thicker, three‐layer type of endometrium, suggesting incomplete ovarian inhibition and estrogen stimulation of the endometrium. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Evolution and development of teeth
Authors: McCOLLUM MELANIE , SHARPE PAUL T. 
Published: March 2003

abstractTeeth as a feeding mechanism in an oral cavity (mouth) are functionally and locationally linked with jaws. In fossils, teeth found in the oral cavity are usually linked with jaws, although mineralised structures with the same histology as teeth are known in fossils before jaws appeared. Denticles in the skin occur in both fossil and extant fish. Pharyngeal denticles also occur in both extant and fossil gnathostomes but in only a few fossil agnathans (thelodonts). Complex structures with dentine and enamel have been described in the earliest jawless vertebrates, conodonts. Such fossils have been used to suggest that teeth and jaws have evolved and developed independently. Our understanding of the developmental biology of mammalian tooth development has increased greatly in the last few years to a point where we now understand some of the basic genetic interactions controlling tooth initiation, morphogenesis and patterning. The aim of this review is to see what this developmental information can reveal about evolution of the dentition.