bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal cerebral hemodynamics in pregnancy‐related hypertension. A prospective transcranial Doppler study
Authors: Zunker P. , Happe S. , Georgiadis A. L. , Louwen F. , Georgiadis D. , Ringelstein E. B. , Holzgreve W. 
Published: March 2003

AbstractAimTo compare maternal cerebral hemodynamics, as assessed by transcranial Doppler studies, with the clinical and radiological findings in different types of pregnancy‐related hypertension and to determine their pathophysiology.MethodsA prospective study of 66 consecutive pregnant women with hypertensive disorders (eclampsia, n = 3; pre‐eclampsia, n = 41; isolated hemolysis, elevated liver enzymes, and low platelet count (HELLP)‐syndrome, n = 12; pre‐eclampsia superimposed on chronic hypertension, n = 5; chronic hypertension, n = 5) and 21 women with uncomplicated pregnancies. Mean blood flow velocities (Vmean) were assessed serially by means of transcranial Doppler in all basal arteries and correlated with changes in mean arterial blood pressure (MABP) and the clinical course.ResultsPatients with the pre‐eclampsia/eclampsia syndrome showed significantly elevated Vmean values as compared to controls. In the course of the illness Vmean over the whole length of all insonated basal arteries rose simultaneously. The three eclamptic patients showed the highest Vmean values (156, 182, 192 cm/s, respectively), of the middle cerebral artery (MCA) while MABP was 135, 135, and 150 mmHg, respectively. In pre‐eclamptic patients the maximal Vmean MCA ranged from 80 (67, 93) to 145 (114, 151) cm/s [median (25th, 75th percentile)] depending on the severity of clinical presentation. In patients with isolated HELLP‐syndrome changes in Vmean were either mild (5/12 cases) or absent (7/12 cases).ConclusionsConsiderable differences in cerebral hemodynamics were observed in the various types of pregnancy‐related hypertensive disorders examined in this study. Our findings in patients with pre‐eclampsia/eclampsia syndrome suggest a breakdown of autoregulation with hyperperfusion and vasogenic edema being the most probable pathophysiological mechanism. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Femur length and trisomy 21: impact of gestational age on screening efficiency
Authors: Snijders R. J. M. , Platt L. D. , Greene N. , Carlson D. , Krakow D. , Gregory K. , Bradley K. 
Published: March 2003

AbstractObjectiveThis study assesses two methods used to define relatively short femur in screening for trisomy 21 and examines changes in performance of screening with gestational age.DesignRetrospective analysis of data on menstrual age, femur length (FL) and biparietal diameter (BPD) in 49 trisomy 21 pregnancies and 6069 normal controls. Reference ranges were derived for BPD/FL versus menstrual age and for FL versus BPD. Two methods of defining short femur (BPD/FL and observed‐to‐expected FL ratio) were examined for false‐positive rates and detection rates for trisomy 21 at different gestational ages.ResultsIn the control group the BPD/FL ratio and its standard deviation decreased with menstrual age. Trisomy 21 was associated with a significantly higher BPD/FL ratio (P < 0.001) and the deviation increased significantly with menstrual age (P < 0.05). Eleven percent of 28 fetuses examined at 15–17 weeks had a BPD/FL above the 95th centile compared with 24% of 21 fetuses examined at 18–20 weeks (P = 0.40). The median observed‐to‐expected FL ratio in the control group was 1.0 throughout the gestational age range but the standard deviation decreased significantly with menstrual age (P < 0.01). Trisomy 21 was associated with a significantly reduced observed‐to‐expected FL ratio (P < 0.001) and the deviation increased significantly with menstrual age (P < 0.05). A fixed cut‐off of 0.91 for observed‐to‐expected FL ratio provided a false‐positive rate of 12% at 15–17 weeks compared with 6% at 18–20 weeks of gestation (P < 0.001) with detection rates of 29 and 38%, respectively (P = 0.73).ConclusionIrrespective of the definition used to define the condition, relatively short femur is a poor marker for trisomy 21 particularly when the assessment takes place before 18 weeks of gestation. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
The fetal lung 2: pulmonary hypoplasia
Authors: Laudy J. A. M. , Wladimiroff J. W. 
Published: March 2003

AbstractThis review describes the pathogenesis of pulmonary hypoplasia and highlights its clinical, radiological and pathologic features, with emphasis on oligohydramnios‐related pulmonary hypoplasia. Since pulmonary hypoplasia may lead to severe respiratory distress immediately after birth and even to neonatal death, an accurate and patient‐friendly prenatal test for early detection and distinction between lethal and non‐lethal pulmonary hypoplasia is still highly desirable. An extended overview of the proposed methods for the prenatal prediction of pulmonary hypoplasia is presented. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
The size of the fetal thoracolumbar spine: a three‐dimensional ultrasound study
Authors: Schild R. L. , Wallny T. , Fimmers R. , Hansmann M. 
Published: March 2003

AbstractObjectiveTo evaluate three‐dimensional sonographic measurements of the thoracolumbar spine in the 16–37 week fetus.DesignProspective cross‐sectional study.SubjectsTwo hundred and eighty‐nine patients between 16 and 37 weeks of gestation were enrolled at the time of their anomaly scan or routine third trimester scan if fetal size was appropriate for gestational age and if no fetal anomalies were apparent.MethodsThree‐dimensional (3D) volume calculation of the first and fifth lumbar vertebral body, the 12th thoracic vertebral body and the whole lumbar spine was performed in the transverse plane of the multiplanar mode while lumbar spine length was determined in the sagittal plane.ResultsAll volumetric measurements were significantly correlated with gestational age and estimated fetal weight. For each examined parameter regression analysis was performed to describe the ‘best‐fit’ equation.Conclusions3D sonography allows volume calculation of the fetal spine. Our study provides further data relating to volume changes in the developing fetal spine between 16 and 37 weeks of gestation. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Cumulus assessment by three‐dimensional ultrasound for in vitro fertilization
Authors: Poehl M. , Hohlagschwandtner M. , Doerner V. , Dillinger B. , Feichtinger W. 
Published: March 2003

AbstractObjectiveTo correlate the appearances of intrafollicular cumulus‐like structures using three‐dimensional (3D) ultrasound technology with the recovery of mature oocytes.Materials and methodsA prospective, observational study using 3D ultrasound examination was performed in 50 women undergoing in vitrofertilization (IVF) after ovarian stimulation. Examination was performed on the day of human chorionic gonadotropin (hCG)‐ovulation induction. Estradiol‐17‐β (E2) levels were measured on the same day. The ovaries were examined for the presence of cumuli in all follicles greater than 15 mm in diameter. Only cumuli demonstrable in all three planes, or in a computer‐animated 3D reconstruction, were recorded as ‘visible’. The number, maturity, and fertilization rate of retrieved oocytes were compared with the pre‐ovulatory assessment of cumuli by 3D ultrasound.StatisticsCorrelation coefficients (Pearson) between the variables were calculated and stepwise regression analyses performed.ResultsA total of 262 cumuli were visualized within 318 follicles from which 296 mature oocytes were retrieved and 218 fertilized. There was a significant correlation between the number of detected cumuli and the number of retrieved oocytes (r
2 = 0.83; P < 0.0001), mature oocytes (r
2 = 0.78; P < 0.0001), and the number of the fertilized oocytes (r
2 = 0.65; P < 0.0001). There was a marked correlation between E2 and the number of follicles and the number of fertilized oocytes.ConclusionsCumulus visualization by 3D ultrasound appears to be an indicator for mature oocytes and successful fertilization. Follicles in which the cumulus cannot be visualized in all three planes are unlikely to contain mature oocytes or oocytes in which fertilization is achieved. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Varix of the fetal intra‐abdominal umbilical vein: prenatal sonographic diagnosis and suggested in utero management
Authors: Zalel Y. , Lehavi O. , Heifetz S. , Aizenstein O. , Dolitzki M. , Lipitz S. , Achiron R. 
Published: March 2003

AbstractVarix of the fetal intra‐abdominal umbilical vein (FIUV) is a rare entity. We describe an ultrasound diagnosis of this condition together with a review of the literature relating to its prognosis and management. Our conclusion is that close fetal monitoring should be performed, and delivery should be induced when lung maturity has been accomplished or any fetal distress is apparent. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Fetal heart rate in chromosomally abnormal fetuses
Authors: Liao A. W. , Snijders R. , Geerts L. , Spencer K. , Nicolaides K. H. 
Published: March 2003

AbstractObjectiveTo determine the effects of chromosomal defects on fetal heart rate at 10–14 weeks of gestation.MethodsFetal heart rate at 10–14 weeks of gestation in 1061 chromosomally abnormal fetuses was compared to that from 25 000 normal pregnancies. The chromosomally abnormal group included 554 cases of trisomy 21, 219 cases of trisomy 18, 95 of trisomy 13, 50 of triploidy, 115 of Turner syndrome and 28 of sex chromosome abnormalities other than Turner syndrome.ResultsIn the normal group, fetal heart rate decreased from a mean value of 170 beats per minute (bpm) at 35 mm of crown–rump length to 155 bpm at 84 mm crown–rump length. In trisomy 21, trisomy 13 and Turner syndrome fetal heart rate was significantly higher, in trisomy 18 and triploidy the heart rate was lower and in other sex chromosome defects it was not significantly different from normal. Fetal heart rate was above the 95th centile of the normal range in 10%, 67% and 52% of fetuses with trisomy 21, trisomy 13 and Turner syndrome, respectively. The fetal heart rate was below the 5th centile in 30% of fetuses with triploidy and 19% of those with trisomy 18.ConclusionsTrisomy 21, trisomy 13 and Turner syndrome are associated with fetal tachycardia, whereas in trisomy 18 and triploidy there is fetal bradycardia. Inclusion of fetal heart rate in a first‐trimester screening program for trisomy 21 by a combination of maternal age and fetal nuchal translucency thickness is unlikely to provide useful improvement in sensitivity. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of umbilical cord aneurysm in a fetus with trisomy 18
Authors: Berg C. , Geipel A. , Germer U. , Gloeckner‐Hofmann K. , Gembruch U. 
Published: March 2003

AbstractAneurysm of the umbilical cord is an extremely rare vascular anomaly. We report a case of umbilical cord aneurysm with arteriovenous fistula in a fetus with trisomy 18. At 34 weeks' gestation a fetus with suspected intrauterine growth restriction and oligohydramnios was referred to our institution. Ultrasound examination was confirmatory and additionally revealed multiple markers for trisomy 18. In the umbilical cord an aneurysm was diagnosed characterized by a cystic lesion with hyperechogenic rim measuring 18 × 18 × 19 mm in diameter. Color flow and spectral Doppler examinations showed a jet originating from one of the umbilical arteries entering the cystic lesion which appeared to be the dilated umbilical vein. Fetal blood sampling and subsequent karyotyping revealed trisomy 18 (47, XY, +18). The patient elected to terminate the pregnancy. Pathologic examination of placenta and umbilical cord confirmed the prenatal diagnosis of umbilical cord aneurysm and arteriovenous fistula. Histology demonstrated a strongly dilated umbilical vein, one moderately dilated artery and a second, apparently normal artery. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Ductus venosus Doppler study in fetuses with homozygous α‐thalassemia‐1 at 12 to 13 weeks of gestation
Authors: Lam Y. H. , Tang M. H. Y. , Tse H. Y. 
Published: March 2003

AbstractObjectiveFetuses affected by homozygous α‐thalassemia‐1 are anemic from the first trimester of pregnancy. We investigated ductus venosus Doppler velocimetry in these affected fetuses at 12–13 weeks of gestation.DesignProspective observational study.SubjectsWomen referred for the prenatal diagnosis of homozygous α‐thalassemia‐1 before 14 weeks of gestation.MethodsAll fetuses underwent pulsed Doppler investigations following color flow mapping at 12 or 13 weeks of gestation. Homozygous α‐thalassemia‐1 was diagnosed by DNA or hemoglobin study. The ductus venosus Doppler indices – V
max (peak velocity during ventricular systole), V
min (minimum forward velocity during atrial systole), TAMX (time‐averaged maximum velocity), PIV (pulsatility index for veins, V
max − V
min/TAMX), PLI (preload index, V
max − V
min/V
max) and V
max/V
min ratio – were compared between the affected fetuses and fetuses unaffected by homozygous α‐thalassemia‐1.ResultsBetween June 1998 and October 1999, 102 eligible women were recruited. Fetal ductus venosus Doppler study was successful in 96 pregnancies (94%). Of these, 20 fetuses were affected by homozygous α‐thalassemia‐1. None of them showed hydropic changes at the time of Doppler study. The affected fetuses had significantly higher ductus venosus V
max (30% increase), V
min (50% increase) and TAMX (20% increase) and significantly lower V
max/V
min ratio, PIV and PLI values.ConclusionFetuses affected by homozygous α‐thalassemia‐1 at 12–13 weeks had increased forward flow velocities in the ductus venosus throughout the cardiac cycle. The increase of venous return is consistent with our previous report of cardiac dilatation and an increase of cardiac output in the affected fetuses at this stage as a compensatory mechanism for anemia and hypoxia. However, extensive overlap of the ductus venosus Doppler indices between affected and unaffected fetuses precludes its use in predicting anemia at 12–13 weeks. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Antenatal ultrasonographic features of fetal giant hemangiolymphangioma
Authors: Senoh D. , Hanaoka U. , Tanaka Y. , Tanaka H. , Hayashi K. , Yanagihara T. , Hata T. 
Published: March 2003

AbstractA giant multiseptate cystic mass covering the whole left hemitruncus of fetus was detected by ultrasonography at 23 weeks of gestation. Color and pulsed Doppler ultrasonography revealed marked blood flow in the mass. No other anomaly or chromosomal abnormality was recognized. Although the cystic lesion increased in size with advancing gestation a male infant weighing 4096 g was delivered in good condition at term. Histological examination of the lesion demonstrated hemangiolymphangioma with hyperplasia of both capillaries and lymphoducts. The infant was treated effectively with OK‐432 and interferon‐alfa‐2a. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal power Doppler findings in laparoscopically proven acute pelvic inflammatory disease
Authors: Molander P. , Sjöberg J. , Paavonen J. , Cacciatore B. 
Published: March 2003

AbstractObjectivesTo evaluate the usefulness of power Doppler transvaginal sonography (TVS) in the diagnosis of pelvic inflammatory disease (PID) and to assess the diagnostic reliability of specific sonographic findings.PopulationThe study population consisted of 30 women admitted for suspected acute PID. The reference group consisted of 20 women with proven hydrosalpinx formation.MethodsBoth conventional TVS and power Doppler TVS were performed. All patients with suspected acute PID underwent laparoscopy in order to confirm the diagnosis. Sonographic criteria described earlier were used for the diagnosis of acute PID. Power Doppler was used to assess the vascularity of any adnexal mass.ResultsLaparoscopy confirmed the diagnosis of PID in 20 (67%) of the 30 women with clinically suspected acute PID. Specific TVS findings, including wall thickness > 5 mm, cog‐wheel sign, incomplete septa, and the presence of cul‐de‐sac fluid, discriminated women with acute PID from the control women with hydrosalpinx formation. Power Doppler TVS revealed hyperemia in all women with acute PID, but in only two women with hydrosalpinx (P = 0.01). Pulsatility indices were significantly lower in the acute PID group than in the control group (pulsatility index 0.84 ± 0.04 vs. 1.50 ± 0.10; P < 0.01).ConclusionPower Doppler TVS was 100% sensitive and 80% specific in the diagnosis of PID (overall accuracy 93%). Specific sonographic landmark findings and power Doppler findings augment the clinical diagnosis of PID and allow simple classification of the severity of the disease. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Hypoechoic hepatomegaly associated with transient abnormal myelopoiesis provides clues to trisomy 21 in the third‐trimester fetus
Authors: Hamada H. , Yamada N. , Watanabe H. , Okuno S. , Fujiki Y. , Kubo T. 
Published: March 2003

AbstractWe present two cases of transient abnormal myelopoiesis associated with trisomy 21 that had hypoechoic hepatomegaly during the late fetal period. Fetal chromosomal abnormality and fetal myeloproliferative disorder should be suspected in such cases. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of fetal abdominal lymphangioma by ultrasonography
Authors: Deshpande P. , Twining P. , O'Neill D. 
Published: March 2003

AbstractWe present a case of abdominal lymphangioma in a fetus together with a review of the literature. Diagnosis was made at 20 weeks' gestation by antenatal ultrasonography. In keeping with other reports, the lesion was located on the left and serial ultrasonography demonstrated rapid growth with extension into the lower extremity. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Abdominal circumference: a single measurement versus growth rate in the prediction of intrapartum Cesarean section for fetal distress
Authors: Williams K. P. , Nwebube N. 
Published: March 2003

AbstractObjectiveThe fetal abdominal circumference is the most sensitive ultrasound biometric measurement for predicting intrauterine growth restriction, which is associated with an increased risk of intrapartum fetal distress. We sought to evaluate and compare whether a third‐trimester ultrasound measurement of abdominal circumference made within 1 week prior to delivery better predicts operative delivery for fetal distress when compared with the growth velocity of the abdominal circumference in the third trimester.MethodsRetrospective analysis was carried out of prospectively collected ultrasound data on 117 patients with singleton gestations who had had at least two ultrasound assessments performed less than 6 weeks apart in the third trimester, with the last ultrasound performed within 1 week prior to delivery. The abdominal circumference value of the last ultrasound prior to delivery was placed into one of three categories: ≤ 5% centile, > 5 to ≤ 10% centile and > 10% centile for gestational age. The growth velocity of the abdominal circumference per week was placed into one of three categories: ≤ 5 mm/week, 6–10 mm/week and ≥ 11 mm/week. The chi‐squared test was used to compare differences between the incidence of fetal distress between the groups.ResultsThe incidences of Cesarean section for fetal distress in relation to a single measurement of the abdominal circumference were: ≤ 5% centile, 8/23 (35%); > 5 to ≤ 10% centile, 3/12 (25%); > 10% centile, 8/81 (10%) (P < 0.05). The incidences of Cesarean section for fetal distress with the three abdominal circumference growth velocities were: ≤ 5 mm/week, 9/55 (16%); 6–10 mm/week, 4/11 (36%); ≥ 11 mm/week, 8/51 (16%) (P = 0.9401).ConclusionA single measure of the fetal abdominal circumference made within 1 week prior to delivery is superior to an assessment of growth rate of the fetal abdomen in the third trimester in discriminating patients who require Cesarean section for fetal distress. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Sonographic findings of the umbilical cord: implications for the risk of fetal chromosomal anomalies
Authors: Weissman A. , Drugan A. 
Published: March 2003

AbstractIn this review we summarize current knowledge on sonographic findings of the umbilical cord and the risk they impose for chromsomal abnormalities of the fetus. A Medline search of the literature was performed and the pertinent English‐language literature was reviewed. Anatomical and Doppler abnormalities of the umbilical cord may be associated with an increased risk of chromosomal aberrations in the fetus. Therefore, level II prenatal sonography should also include a careful examination of the umbilical cord. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of ventriculocoronary fistula
Authors: Baschat A. A. , Love J. C. , Stewart P. A. , Gembruch U. , Harman C. R. 
Published: March 2003

AbstractBackgroundCardiac anomalies may be associated with abnormal coronary vascular connections. We report the prenatal diagnosis of ventriculocoronary fistula in three fetuses with associated cardiac anomalies.Materials and MethodsFetal echocardiography was performed in three patients referred for suspected cardiac anomaly. Two‐dimensional fetal echocardiography was complemented by color Doppler flow imaging and spectral Doppler in all cases.ResultsA ventriculocoronary fistula was diagnosed in three patients referred at 22, 23 and 32 weeks. The first patient had hypoplastic left heart associated with transposition of the great arteries and pulmonary atresia with an intact interventricular septum. The coronary fistula arose from the transposed aorta to the left ventricle. In two patients ventriculocoronary fistula was found in association with pulmonary atresia and an intact interventricular septum. In all cases there was bidirectional flow within the fistula (diastolic blood flow towards the ventricle with reversal during ventricular systole). The pregnancy with hypoplastic left heart with transposition, and one of those with pulmonary atresia resulted in neonatal death and stillbirth, respectively. In the third instance the ventriculocoronary fistula was verified by postpartum cardiac angiography. The infant initially received a Blalock–Taussig shunt, subsequently replaced by a bidirectional Glenn shunt, and was doing well at the time of writing.ConclusionA ventriculocoronary fistula can be identified prenatally by color and spectral Doppler. This anomaly should be sought in fetuses with outflow tract obstructive cardiac lesions and an intact interventricular septum. Prenatal diagnosis allows early angiography postnatally. Delineation of coronary vascular regions may therefore facilitate preoperative planning. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology