bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening for Down's syndrome by fetal nuchal translucency measurement in a general obstetric population
Authors: Pajkrt E. , van Lith J. M. M. , Mol B. W. J. , Bleker O. P. , Bilardo C. M. 
Published: March 2003

AbstractObjectiveTo examine the effectiveness of nuchal translucency measurement in the detection of trisomy 21 in a low‐risk population.DesignProspective cohort study.SubjectsA total of 1473 women with viable singleton pregnancies between 10 and 14 weeks' gestation attending an antenatal clinic for routine obstetric care.MethodsThe fetal nuchal translucency was measured in all women. Fetal karyotyping was performed for the usual indications and in cases of a nuchal translucency measurement ≥3 mm.ResultsDown's syndrome was found in nine fetuses (0.6%). Screening by maternal age would have diagnosed six out of nine fetuses (67%) with trisomy 21 for an invasive testing rate of 24%. Because the actual uptake of prenatal diagnosis for maternal age was 79%, only 44% of the Down's syndrome fetuses would have been detected prenatally by this screening method. A nuchal translucency of 3 mm or more identified 67% of the fetuses with trisomy 21, for an invasive testing rate of 2.2%. The combination of nuchal translucency thickness, corrected for the influence of gestation by ‘delta‐value’, and maternal age performs differently according to the chosen cut‐off point for adjusted risk. A minimum risk of 1 : 100 would detect 78% of the Down's syndrome fetuses for a testing rate of 8.1%. By offering karyotyping to all women with a posttest risk of 1 : 300, the detection rate would increase to 100% with an invasive testing rate of 19.8%. This is lower than the invasive testing rate of maternal age screening.ConclusionsThese data suggest that nuchal translucency measurement is an effective screening method for trisomy 21 in an unselected obstetric population. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Early prenatal diagnosis of cord entanglement in monoamniotic multiple pregnancies
Authors: Arabin B. , Laurini R. N. , van Eyck J. 
Published: March 2003

AbstractObjectivesCord entanglement is a severe complication in monoamniotic multiple pregnancies. Three cases were reviewed to determine how early ultrasound diagnosis might improve counselling and management.MethodsIn two monoamniotic twin and one dichorionic diamniotic triplet pregnancies, cord entanglement was detected between 10 and 18 gestational weeks by color Doppler and pulsed Doppler velocimetry. Pregnancies were followed up on a weekly basis with special observation of fetal behavior and use of color Doppler velocimetry.ResultsIn Case 1, a monoamniotic twin pregnancy with cord entanglement close to the umbilical insertions was diagnosed at 10 weeks. Longitudinal follow‐up showed intrauterine death of both twins at 15 weeks.In Case 2, entanglement of the umbilical cords of two monoamniotic triplets within a dichorionic diamniotic triplet pregnancy was diagnosed at 10 weeks. The pregnancy continued uneventfully until 35 weeks when cord entanglement was confirmed at Cesarean section. All triplets have since developed normally.In Case 3, monoamniotic twins were diagnosed at 18 weeks. Color Doppler detected side‐by‐side insertion of the umbilical cords and Doppler velocimetry suggested an entanglement at the chorionic plate. The pregnancy was complicated by polyhydramnios. Cesarean section at 36 weeks confirmed cord entanglement at the chorionic plate. Postnatal computer angiography and morphological examination of the placenta showed the presence of superficial artery‐to‐artery and vein‐to‐vein anastomoses and of deep arteriovenous shunts. The development of the twins was uneventful.ConclusionsDiagnosis of cord entanglement is feasible early in gestation. Future protocols are proposed to document the gestational age at detection, the location, and the Doppler flow patterns and to facilitate the assessment of short‐ and long‐term development. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Congenital hernia of the abdominal wall: a differential diagnosis of fetal abdominal wall defects
Authors: Stepan H. , Horn L. C. , Bennek J. , Faber R. 
Published: March 2003

AbstractA 28‐year‐old woman was referred at 33 weeks of gestation with suspected fetal intestinal atresia. Sonography showed a large extra‐abdominal mass on the right of the normal umbilical cord insertion. Following Cesarean section at 36 weeks and immediate surgical treatment, the malformation was not definable either as an omphalocele or as gastroschisis. This reported case involves a previously undocumented malformation of the fetal abdominal wall described as a ‘hernia’ of the fetal abdominal wall. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Doppler velocimetry of normal human fetal venous intrapulmonary branches
Authors: Laudy J. A. M. , Ursem N. T. C. , Mulder P. G. H. , Wladimiroff J. W. 
Published: March 2003

AbstractObjectivesTo describe the nature of flow velocity wave‐forms from fetal middle and distal venous pulmonary branches in the second half of normal pregnancy in relation to gestation, and to test repeatability and interrelationships of flow velocity waveform recordings from proximal, middle and distal venous pulmonary branches.DesignCross‐sectional study.Subjects/methodsA total of 111 normal singleton pregnancies between 20 and 40 weeks' gestation were studied using a color‐coded Doppler ultrasound system. Pulmonary waveforms were obtained at the level of the fetal cardiac four‐chamber view. Repeatability was tested from two recordings at 15‐min time intervals in 25 separate normal pregnancies.ResultsThe nature of middle and distal venous pulmonary flow velocity waveforms was comparable with that of proximal waveforms. Acceptable repeatability of pulmonary venous flow velocity waveforms with coefficients of variation below 15% was established for nearly all velocity parameters and their ratios. A gestational age‐dependent change was found for all flow velocity waveform parameters including pulsatility index for veins at both middle and distal venous levels. Significant interpulmonary changes were observed for nearly all pulmonary venous waveform parameters.ConclusionsIt is speculated that increase in volume flow and venous pulmonary pressure gradient plays a role in gestational age‐dependent changes, whereas changes in vessel diameter and distance between the heart and more distal venous pulmonary vessels are responsible for interppulmonary changes. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Morphology assessed by transvaginal ultrasonography differs in patients in preterm labor with vs. without bacterial vaginosis
Authors: Surbek D.V. , Hoesli I.M. , Holzgreve W. 
Published: March 2003

Objective To determine whether cervical morphology in preterm labor patients differs in the presence or absence of bacterial vaginosis.Design Observational study.Subjects One hundred and twelve consecutive patients with objectively confirmed preterm labor admitted to a tertiary care centre were included in the study. Patients with placenta previa, active uterine bleeding or indication for an immediate delivery (e.g. severe pre‐eclampsia or suspected fetal asphyxia), or severe fetal anomalies were excluded.Methods Transvaginal ultrasonography was used to measure cervical length and internal os width. Bacterial vaginosis was diagnosed by Gram stain of a vaginal smear.Results A total of 36 patients (32%) had bacterial vaginosis. Cervical length in this group was shorter than in patients with normal flora (mean 20.4 ± 7.2 mm vs. 26.4 ± 6.7 mm, P = 0.0002), and more patients with bacterial vaginosis had a dilated internal cervical os ≥ 5 mm (67% vs. 30%, P = 0.001). There were no significant differences, however, in preterm delivery rate and birth weight between the two groups; the overall preterm delivery rate was 40%. A cervical length < 25 mm was predictive of preterm delivery (P = 0.001, RR 4.2, 95% CI 1.8–9.7).Conclusions These data suggest that cervical change in preterm labor is more pronounced in patients with bacterial vaginosis but without a concomitant increase in the risk for preterm delivery. Despite this association, the cervical length measured by transvaginal ultrasonography alone is a useful predictor of preterm delivery, independent of the presence or absence of bacterial vaginosis.
Three‐dimensional (3‐D) ultrasonography for obtaining the four and five‐chamber view: comparison with cross‐sectional (2‐D) fetal sonographic screening
Authors: Meyer‐Wittkopf M. , Rappe N. , Sierra F. , Barth H. , Schmidt S. 
Published: March 2003

AbstractObjectivesTo assess the ability of Doppler‐gated 3‐D fetal echocardiography to reconstruct and display specific cardiac structures routinely visualized during antenatal ultrasound in a population at low risk for cardiac anomalies. To determine whether any advantage is offered by 3‐D sonographic cardiac examination over conventional sonographic fetal screening techniques.DesignAfter routine two‐dimensional sonographic examination, 3‐D cardiac data were collected prospectively in 30 fetuses with gestational ages between 19 and 23 weeks from a low risk patient population. Basic echocardiographic key views were derived from 3‐D data and selected for reconstruction and analysis. Four‐ and five‐chamber views were rated and only those views judged to be well visualized were considered as positive results.ResultsThe four‐ and five‐chamber views were well visualized in all but one fetus using conventional 2‐D imaging. Gated 3‐D volume data sets enabled visualization of these stuctures in only 19 of 30 fetuses but provided additional structural depth and allowed a dynamic 3‐D perspective of valvar morphology and ventricular wall motion. The right ventricular outflow tract was available from the 3‐D volumes in 16 subjects.ConclusionsConsidering the versatility of gated 3‐D fetal cardiac imaging we believe that it may soon become an important component of fetal screening thus helping to retrieve standard cardiac cross sections when 2‐D imaging is limited by lack of sonographer experience or sonographic windows. Diagnostically acceptable echocardiographic views were obtained more consistently with 2‐D ultrasound than with 3‐D volume data. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Increased fetal nuchal translucency: possible association with esophageal atresia
Authors: Brown R. N. , Nicolaides K. H. 
Published: March 2003

AbstractWe describe a case in which in‐utero diagnosis of an esophageal atresia with a tracheo‐esophageal fistula in the third trimester followed the finding of an increased nuchal translucency in the first trimester and suggest a mechanism by which these two findings might be associated. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Antenatal diagnosis of congenital hepatoblastoma in utero
Authors: Shih J.‐C. , Tsao P.‐N. , Huang S.‐F. , Yen B. L.‐J. , Lin J.‐H. , Lee C.‐N. , Hsieh F.‐J. 
Published: March 2003

AbstractA fetus with a huge hepatic tumor was detected by sonography at 36 weeks of gestation. The mass appeared as a single, solid and polylobular tumor located in the right lobe of the liver. Foci of hemorrhage, necrosis and some tiny calcifications were seen. The adjacent right kidney appeared normal but was displaced. The right adrenal gland was not visualized. Three‐dimensional power Doppler sonography further depicted the corresponding vascular anatomy of the tumor, including its vascularization pattern and blood supply. The tumor was situated to the right of the umbilical vein and portal sinus, possibly deriving its blood supply from the portal circulation. The fundamental findings suggested the diagnosis of hepatoblastoma by exclusion of other possibilities. The baby was delivered by Cesarean section at 36 weeks' gestation, due to signs of fetal distress. Unfortunately, hypotension, tachycardia, and tachypnea developed shortly after birth. Surgical intervention was performed, but intractable bleeding occurred intra‐operatively. The infant died at 6 days of age. Autopsy confirmed the diagnosis of hepatoblastoma. We believe this is the first reported case of the antenatal diagnosis of congenital hepatoblastoma. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Three‐dimensional ultrasonographic and power Doppler characterization of ovarian lesions
Authors: Kurjak A. , Kupesic S. , Sparac V. , Kosuta D. 
Published: March 2003

AbstractObjectiveTo determine whether three‐dimensional ultrasound (3D US) and 3D power Doppler can improve the ability to differentiate benign from malignant ovarian lesions.MethodsTransvaginal ultrasound, transvaginal color Doppler, 3D US and 3D power Doppler were performed on 90 patients with ovarian lesions during the week prior to surgery. Four independent sonographers were blinded to the results of other ultrasound studies.ResultsColor Doppler studies added to transvaginal gray‐scale characterization of ovarian lesions resulted in sensitivity of 88.89% and specificity of 97.53% in diagnosing ovarian malignancy. Qualitative analysis of tumor vascularity by 3D power Doppler added to morphological features obtained by 3D US is clinical pertinent and reached sensitivity and specificity of 100 and 98.76%, respectively.ConclusionThree‐dimensional ultrasound and power Doppler can enhance and facilitate the morphologic and functional evaluation of both benign and malignant ovarian lesions. Introduction of the 3D quantitative technique for measurements of blood flow and vascularization may increase clinical relevance of these studies. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Three‐dimensional hysterosalpingo‐contrast sonography (3D‐HyCoSy) as an outpatient procedure to assess infertile women: a pilot study
Authors: Kiyokawa K. , Masuda H. , Fuyuki T. , Koseki M. , Uchida N. , Fukuda T. , Amemiya K. , Shouka K. , Suzuki K. 
Published: March 2003

AbstractObjectiveThis study aimed to assess the use of three‐dimensional hysterosalpingo‐contrast sonography (3D‐HyCoSy) as a routine outpatient procedure for evaluating infertile women.MethodsIn 25 unselected infertile patients, tubal patency and uterine cavity were investigated by 3D‐HyCoSy with saline as a contrast medium. The efficacy of the procedure was evaluated with X‐ray hysterosalpingography (XHSG) as reference.ResultsThe positive predictive value, negative predictive value, sensitivity, and specificity of predicting tubal patency by 3D‐HyCoSy were 100, 33.3, 84.4, and 100%, respectively. The full contour of the uterine cavity was depicted in 96% of cases by 3D‐HyCoSy and 64% by XHSG (P < 0.005). The uterine cavity area measured on 3D‐HyCoSy correlated well with the volume of contrast medium required on XHSG (r
2 = 0.8166).Conclusions3D‐HyCoSy provided advantages of better assessment of uterine cavity over XHSG. Compared with conventional XHSG, the efficacy of 3D‐HyCoSy to assess tubal patency was acceptable. In addition, the procedure of 3D‐HyCoSy appears to be better tolerated, requiring no sedation or anesthesia and a reduced examination time. Thus, 3D‐HyCoSy with saline as a contrast medium is feasible and could comprise a routine outpatient procedure in the initial evaluation of infertile women. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Real‐time intraoperative ultrasound guidance: the transrectal approach
Authors: Bar‐Hava I. , Rabinerson D. , Kaplan B. , Orvieto R. , Levy T. , Shalev Y. , Ben‐Rafael Z. , Dekel A. 
Published: March 2003

AbstractObjectiveTo assess the role of real‐time transrectal ultrasound guidance in complicated gynecologic procedures.DesignIn 1998–99, real‐time guidance with transrectal ultrasound was utilized in our department to assist the gynecologic surgeon in two procedures: completing the evacuation of the uterine cavity after identification of uterine wall perforation during first trimester termination of pregnancy, and drainage of infected vaginal vault hematoma following hysterectomy.ResultsThe technique was applied for 11 patients, six abortions and five infected hematomas. All the procedures were completed without any further complications and the patients were discharged on the following day. Follow‐up was uneventful.ConclusionsOn‐line intraoperative transrectal ultrasound can effectively provide real‐time assistance to the gynecologic surgeon during complicated pelvic procedures. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Subendometrial contractility is not predictive for in vitro fertilization (IVF) outcome
Authors: Vlaisavljevic V. , Reljic M. , Gavric–Lovrec V. , Kovacic B. 
Published: March 2003

AbstractObjectivesThe aim of the study was to investigate whether endometrial thickness, endometrial pattern, endometrial movement and serum estradiol and progesterone affect the outcome of in vitro fertilization.MethodsProspectively collected data of endometrial thickness, endometrial pattern and subendometrial activity were analyzed in 122 consecutive in vitro fertilization cycles. All measurements were made on the day of hCG administration (day −2), day of embryo transfer (day +2), day +6 and day +12.ResultsIt would appear that pregnant women tend to have a thicker endometrium on day +12 than non‐pregnant women. There appears to be no appreciable difference between pregnant and non‐pregnant women in endometrial movement and thickness, nor in serum estradiol and progesterone on day +2 and day +6. In combining three echographic variables (thickness, pattern and movement) and hormone level (estradiol and progesterone), only progesterone on day +12 could be used to predict the outcome.ConclusionsSubendometrial contractility plays no important role in implantation on the day of embryo transfer or 4 days later. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Thermal balloon endometrial ablation therapy induces a rise in uterine blood flow impedance: a randomized prospective color Doppler study
Authors: Järvelä I. , Tekay A. , Santala M. , Jouppila P. 
Published: March 2003

AbstractObjectiveTo evaluate the possible hemodynamic changes in uterine blood flow using transvaginal color Doppler ultrasonography after thermal balloon endometrial ablation therapy.Study designProspective randomized study.Patients and methodsTwenty‐seven pre‐ and post‐menopausal women with either menorrhagia or endometrial hyperplasia (no sign of atypia) were randomized to receive either thermal balloon ablation therapy (n = 13) or gestagen therapy (n = 14). In the gestagen therapy group, a 3‐month period of medroxyprogesterone acetate (10 mg/day) was given to premenopausal women during cycle days 15–24 and it was given to postmenopausal women continuously. Thermal balloon endometrial ablation therapy was carried out on cycle days 3–8. All the color Doppler measurements were also carried out on cycle days 3–8. Flow waveforms were obtained from the main branch of the uterine arteries, from arcuate arteries and from a subendometrial spiral artery. Doppler flow parameters were used for subsequent statistical analysis. The measurements took place before the initiation of treatment, on the first postoperative day (thermal ablation group only), and 1 month and 6 months after initiation of the study.ResultsNo within‐group or between‐group differences were detected until the time of the last measurement 6 months after initiation of the treatment. Between the two randomized groups, the pulsatility index (PI) was significantly higher in the thermal ablation group in all three arteries in comparison with the gestagen group, in which no change in the PI took place. In the thermal ablation group, a significant rise from the pretreatment level was observed in the PI in the uterine arteries and in the spiral artery 6 months after the therapy.ConclusionThermal balloon endometrial ablation therapy induces a rise in uterine blood flow impedance, but not until 6 months after the treatment. The rise in impedance may be due to fibrosis in the uterine cavity which thermal balloon therapy has been shown to produce. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Fanconi anemia associated with increased nuchal translucency detected by first‐trimester ultrasound
Authors: Tercanli S. , Miny P. , Siebert M. S. , Hösli I. , Surbek D. V. , Holzgreve W. 
Published: March 2003

AbstractIncreased nuchal translucency between 10 and 14 weeks of gestation has now been established as a marker for chromosomal defects in several large‐scale studies. In addition, a growing number of structural defects and some rare genetic syndromes have been identified in association with this marker. We describe a case of a fetus with increased nuchal translucency at 12 weeks of gestation, in which second‐trimester evaluation by ultrasound showed an enlarged cisterna magna, a ventricular septal defect and moderate signs of dysmorphia. Karyotyping by chorionic villus sampling revealed a high rate of chromosomal breaks. The diagnosis of Fanconi anemia with early onset was confirmed following the development of severe postnatal anemia 2 months after birth. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Familial recurrence of spontaneous fetal intracranial hemorrhage: ultrasonographic diagnosis and postnatal magnetic resonance imaging (MRI)
Authors: Felderhoff–Müser U. , Brauer M. , Bührer C. , Wagner M. , Hierholzer J. , Obladen M. 
Published: March 2003

AbstractWe report fetal intracranial hemorrhage in term siblings from consanguineous parents, spontaneously occurring in the third trimester of pregnancy. Prenatal ultrasound in one case and postnatal MRI in both demonstrated massive parenchymal bleeding involving large areas of the cerebral cortex, white and gray matter. Vasculopathies, vascular malformations, coagulopathies, thrombocytopenia and relevant metabolic disorders could be excluded. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Uterine artery score and perinatal outcome
Authors: Hernandez‐Andrade E. , Brodszki J. , Lingman G. , Gudmundsson S. , Molin J. , Maršál K. 
Published: March 2003

AbstractObjectiveTo evaluate a modified uterine artery score based on the pulsatility index and presence or absence of notching in the Doppler velocity waveform recorded from both uterine arteries in relation to the perinatal outcome.MethodsA retrospective analysis was performed in 741 third‐trimester high‐risk pregnancies. The uterine artery score was constructed assigning one point to each abnormal parameter—high pulsatility index and presence of notch—thus ranging from 0 (normal findings in both uterine arteries) to 4 (notch and high pulsatility index in both uterine arteries). In a subgroup with lateral placenta (n = 359), two definitions of abnormal pulsatility index were compared. In the uniform uterine artery score, a pulsatility index >1.20 in both uterine arteries was considered abnormal, disregarding the placental location; in the subgroup with lateral placenta, the high pulsatility index was defined as >1.00 on the placental side and >1.40 on the non‐placental side.ResultsReceiver‐operating characteristic curves did not reveal any difference in the diagnostic capacity between the group with a uniform uterine artery score and the subgroup with lateral placenta (P = 0.54). In the total material, the odds ratios and linear regression analysis showed an increased risk for an adverse perinatal outcome with increasing uterine artery score (P < 0.01). At a uterine artery score >2, there was a significantly increased risk for operative delivery for fetal distress, neonatal intensive care unit admission, 5‐min Apgar score <7, preterm delivery and delivery of a small‐for‐gestational age fetus.ConclusionIn high‐risk third‐trimester pregnancies, Doppler velocity waveforms of the uterine arteries can be evaluated using the uterine artery score disregarding the placental location. The uterine artery score possesses a high predictive value regarding adverse perinatal outcome. Copyright © 2002 ISUOG