bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prenatal depiction of angioarchitecture of an aneurysm of the vein of Galen with three‐dimensional color power angiography
Authors: Lee T.‐H. , Shih J.‐C. , Peng S.S.‐F. , Lee C.‐N. , Shyu M.‐K. , Hsieh F.‐J. 
Published: March 2003

AbstractA fetus with a large supratentorial cyst and cardiomegaly was encountered at 33 weeks of gestation. The cyst appeared as an aneurysmal, fluid‐filled structure extending posteriorly with a finger‐like appendage. Using color flow mapping, we disclosed rapid in‐and‐out blood flow with marked turbulence within the cyst. For evaluation of its blood supply and venous drainage of the vascular malformation, a three‐dimensional reconstruction of the power Doppler image was conducted. The results revealed that the vascular malformation was supplied by a small contralateral aneurysm from the branches of Willis' circle, draining posteriorly into an abnormal falcine sinus and then into the superior sagittal sinus. No other fetal abnormality such as hydrocephalus or hydrops was discovered. The prenatal diagnosis of an aneurysm of the vein of Galen was made on the basis of the gray‐scale, color Doppler findings, and also the angioarchitecture obtained by three‐dimensional power Doppler imaging. The woman was admitted at 37 weeks of gestation due to labor onset and delivered the baby via the vaginal route without complication. Postnatal angiography and magnetic resonance imaging confirmed the diagnosis of an aneurysm of the vein of Galen, and the angioarchitecture depicted it before birth. We suggest that three‐dimensional power Doppler ultrasonography may assist in the diagnosis of an aneurysm of the vein of Galen, and precisely delineate the complicated corresponding vasculature. This may guide postnatal management and predict the prognosis more accurately. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Blood flow velocity waveforms of the fetal pulmonary artery and the ductus arteriosus: reference ranges from 13 weeks to term
Authors: Mielke G. , Benda N. 
Published: March 2003

Objective To establish reference ranges for blood flow velocity waveforms of the fetal main pulmonary artery and the ductus arteriosus during the second and third trimesters of pregnancy.Methods A prospective cross‐sectional echocardiographic study was performed in 222 normal fetuses from 13 to 41 weeks of gestation using high resolution/color Doppler ultrasound equipment.Results Gestational age‐specific reference ranges are given for peak velocity across the pulmonary valve, velocities in the ductus arteriosus, peak systolic velocity in the ductus arteriosus‐to‐peak velocity across the pulmonary valve ratio, ductal systolic velocity‐to‐diastolic velocity ratio, ductal resistance index and ductal pulsatility index. In the ductus arteriosus, increasing fetal heart rate was significantly associated with increasing end‐diastolic velocity and decreasing systolic‐to‐diastolic ratio, decreasing resistance index, and decreasing pulsatility index.Conclusions Based on a prospective study in more than 200 normal fetuses, the data provide gestational age specific reference ranges for blood flow velocity waveforms of the fetal pulmonary artery and the ductus arteriosus. The reference ranges may be helpful in prenatal diagnosis of cardiac malformations and ductal obstruction from 13 to 41 weeks of gestation.
Cervical assessment at the routine 23‐weeks' scan: problems with transabdominal sonography
Authors: To M.S. , Skentou C. , Cicero S. , Nicolaides K.H. 
Published: March 2003

AbstractObjectivesTo compare transabdominal and transvaginal sonographic measurements of cervical length in pregnancy and examine the factors that may influence these measurements.MethodsThe study population consisted of 149 women with singleton pregnancies attending for routine ultrasound examination at 23 weeks of gestation. In all women the cervix was successfully visualized by transvaginal sonography and cervical length was measured after emptying of the bladder. This measurement was compared to that obtained by transabdominal sonography. In addition the ability to visualize the cervix transabdominally was examined in relation to body mass index (BMI), bladder volume and cervical length.ResultsThe percentage of cases in which the cervix could be seen transabdominally increased from 42% for bladder volume of < 50 ml to 73% for volumes > 150 ml, and 13% for cervical length < 20 mm to 51% for lengths > 40 mm. The ability to visualize the cervix was unrelated to BMI. Although there was a significant association between measurements taken transabdominally with those made transvaginally, measurements taken with a full bladder were significantly longer than those with an empty bladder.ConclusionThe aim of cervical assessment in pregnancy is to identify women with a short cervix because they are at high risk of preterm delivery. This aim can not be fulfilled by transabdominal sonography. Such a scan fails to visualize the cervix in a high proportion of cases and in particular those with a short cervix. Furthermore, successful visualization requires a full bladder which falsely increases cervical length. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of a subdural hematoma associated with reverse flow in the middle cerebral artery: case report and literature review
Authors: De Spirlet M. , Goffinet F. , Philippe H. J. , Bailly M. , Couderc S. , Nisand I. 
Published: March 2003

AbstractTo our knowledge this is the first reported case of a subdural hematoma, related to fetal autoimmune thrombocytopenia, diagnosed prenatally by ultrasound. The underlying etiology was hidden maternal autoimmune thrombocytopenia. This disease, which is as serious as alloimmune thrombocytopenia, causes severe fetal thrombocytopenia, which carries with it a high risk of intracranial hemorrhage and recurrence in subsequent pregnancies. Only 14 cases of fetal subdural hematomas have been reported in the literature. The etiologies of these cases were principally traumatic, or due to disorders of hemostasis. Their prognoses were generally poor, with 50% resulting in fetal death in utero and the remaining 50% demonstrating post‐natal sequelae. The presence of reverse flow in the middle cerebral artery is rare and its association with a subdural hematoma unusual. Abnormalities found on cerebral Doppler studies indicate an adaptive response to a fetal condition for which the prognosis is then very poor. Monitoring fetuses at risk for hemorrhage by ultrasound imaging and Doppler studies enables us to detect indicators of a worsening prognosis before the ultrasound appearance of morphological hemorrhage. The development of intracranial hemorrhage raises difficult management issues during the index pregnancy and in subsequent pregnancies. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Transabdominal sonography of the cavum septum pellucidum in normal fetuses in the second and third trimesters of pregnancy
Authors: Falco P. , Gabrielli S. , Visentin A. , Perolo A. , Pilu G. , Bovicelli L. 
Published: March 2003

AbstractObjectivesTo assess the visualization rate and size of the cavum septum pellucidum (CSP) by transabdominal sonography in normal fetuses throughout pregnancy.MethodsThe CSP was prospectively researched and measured using an axial transventricular plane in 286 consecutive uncomplicated singleton pregnancies between 15 and 41 weeks of gestation.ResultsThe CSP was seen in 40% of cases at 15 weeks, 82% at 16–17 weeks, 100% at 18–37 weeks and 79% at 38–41 weeks. Compared to biparietal diameter (BPD), the visualization rate was 33% between 31 and 32 mm, 45% between 33 and 34 mm, 84% between 35 and 43 mm, 100% between 44 and 88 mm and 86% between 89 and 99 mm. Mean CSP width was 5.3 ± 1.7 mm (range 2–9 mm). The CSP width increased with gestational age and BPD but with a slight decrease around term.ConclusionsIn normal fetuses the CSP should always be visualized between 18 and 37 weeks, or with a BPD of 44–88 mm. Failure to observe the CSP in this interval, or possibly the presence of a large CSP, may indicate abnormal cerebral development and warrant further investigation. Conversely, absence of the CSP prior to 18 weeks, or later than 37 weeks, is a normal finding. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Early screening for fetal cardiac anomalies by transvaginal echocardiography in an unselected population: the role of operator experience
Authors: Rustico M. A. , Benettoni A. , D'Ottavio G. , Fischer‐Tamaro L. , Conoscenti G. C. , Meir Y. , Natale R. , Bussani R. , Mandruzzato G. P. 
Published: March 2003

AbstractObjectiveTo examine the accuracy of early transvaginal fetal echocardiography performed in an unselected population by operators with different levels of experience and to compare the results with those obtained from a referral population.DesignProspective study.MethodsA series of 4785 unselected fetuses and 221 referred fetuses were screened at 13–15 weeks' gestational age by transvaginal echocardiography. For each fetus, visualization of the four‐chamber view plus the origin of the great arteries was attempted. Color Doppler imaging was only performed in cases of cardiac malformations already identified by two‐dimensional echocardiography. The scans were performed by seven operators with different levels of experience. Reliability was assessed by conventional transabdominal echocardiography at 20–22 weeks, by postnatal follow‐up in the first 3 months of life, and/or by autopsy in all cases of termination or fetal death.ResultsThe rate of complete visualization (four‐chamber view plus great arteries) was 47.5% in the unselected population, and 76.9% in the referral population. There were four (0.08%) true positives among the unselected fetuses, and five (2.3%) among referrals, mostly with enlarged nuchal translucency or other malformations. Among the unselected fetuses, nine false negatives were detected by transabdominal echocardiography. Improvement in the operators' ability to recognize cardiac anomalies in unselected population was disappointing and was influenced more by individual approach than by the number of examinations performed.ConclusionsEarly screening for cardiac anomalies among unselected fetuses is ill‐advisable. The usefulness of an early approach is confirmed in high risk fetuses or in the presence of enlarged nuchal translucency when performed by expert operators. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Cervical length at 23 weeks in triplets: prediction of spontaneous preterm delivery
Authors: To M.S. , Skentou C. , Cicero S. , Liao A.W. , Nicolaides K.H. 
Published: March 2003

AbstractObjectivesTo establish the distribution of cervical length at 23 weeks of gestation in triplet pregnancies and to examine the relation to preterm delivery before 33 weeks.MethodsCervical length was measured by transvaginal sonography at 23 (range 22–24) weeks of gestation in 43 triplet pregnancies. The distribution of cervical length was determined and the relationship between cervical length and the rate of spontaneous preterm delivery before 33 weeks was calculated.ResultsThe cervical length distribution was skewed to the left with a median of 34 mm. The rate of spontaneous labor and delivery before 33 weeks increased exponentially with decreasing cervical length at 23 weeks from 8% at 36–48 mm, to 11% at 26–35 mm, 33% at 16–25 mm and 67% at 15 mm or less. Cervical length was ≤30 mm, ≤25 mm and ≤15 mm in 37%, 16% and 8% of cases, respectively, and the corresponding sensitivities in the prediction of spontaneous delivery before 33 weeks were 67%, 50% and 33%.ConclusionsIn triplet pregnancies, measurement of cervical length provides a useful prediction of risk for spontaneous early preterm delivery. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Color Doppler imaging of placental masses: differential diagnosis and fetal outcome
Authors: Prapas N. , Liang R.‐I. , Hunter D. , Copel J. A. , Lu L.‐C. , Pazkash V. , Mari G. 
Published: March 2003

AbstractObjectivesTo evaluate the application of Doppler imaging in the differential diagnosis of placental masses and perinatal outcome.MethodsA retrospective study of all cases referred for suspicion of placental chorioangioma over a nine and a half year period. Only cases in which color flow mapping and pulsed Doppler examination were performed were considered.ResultsFourteen cases fulfillled the criteria and included seven cases of chorioangioma, two cases of placental hemorrhage and five cases of a placental mass which resolved during pregnancy. All cases of chorioangioma could be distinguished by increased blood flow within the mass. Polyhydramnios was associated with six cases of chorioangioma. Rapid tumor growth, premature labor and neonatal death occurred in one case. Premature labor occurred in six cases of chorioangioma and both cases of placental hemorrhage. IUGR was associated with two cases of chorioangioma and both cases of placental hemorrhage. All cases of resolving placental mass delivered uneventfully at term.ConclusionsColor Doppler is a useful tool in the differentiation of placental masses. Such masses should be followed up regularly because their growth rate is variable and unpredictable. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Fetal urine production and accuracy when estimating fetal urinary bladder volume
Authors: Fägerquist M. , Fägerquist U. , Odén A. , Blomberg S. G. 
Published: March 2003

AbstractObjectivesThe volume of the fetal urinary bladder can be estimated by measuring bladder diameters on an ultrasound image. The calculated urine production rate might reflect the fetal status in compromised pregnancies. The aim of this study was to assess the fetal urine production rate and the accuracy of measurements of diameters and volumes of the bladder.DesignUrine production rate and the variability in volume measurement error were assessed by ultrasound examinations of fetal bladder images documented on videotapes. In material comprising 101 longitudinal and 90 transverse bladder images, the variability (SD) in distance measurement error was estimated for the bladder diameters. Using this SD, the variability in volume measurement error in the selected bladder image was also calculated.ResultsThe urine production rate for fetuses of 20, 25, 30, 35 and 40 weeks is 4.2, 12.1, 22.7, 36.1 and 52.2 mL/h, respectively. The SD for volume measurement error when selecting bladder images with a volume of 5, 10, 20, 30 and 40 mL is 17.3%, 13.6%, 11.8%, 11.2% and 10.9% of the actual volume, respectively. The corresponding SD when measuring the volume of selected bladder images accounted for 3.7–2.0%.ConclusionsThe urine production rate presented here is in parity with recent previous reports. We distinguish between different kinds of measurement error. The variability was mostly related to the selection of appropriate bladder image, whereas measurement of the selected bladder image accounted for only a minor part of the resulting variability. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Congenital absence of portal vein in the fetus: a case report
Authors: Venkat‐Raman N. , Murphy K. W. , Ghaus K. , Teoh T.‐G. , Higham J. M. , Carvalho J. S. 
Published: March 2003

AbstractCongenital absence of portal vein (CAPV) is a rare abnormality, which may be associated with other abnormalities. We report a case of prenatal diagnosis of absent portal vein confirmed on postnatal ultrasonography and computed tomography scan. The ultrasound features of CAPV include dilated intra‐abdominal segment of umbilical vein, dilated inferior vena cava and the presence of hyperechogenic areas in the liver. Blood coming from the umbilical vein directly drains into the inferior vena cava. The dilated intra‐abdominal segment of the umbilical vein shows high velocity pulsatile flow, resembling that of ductus venosus. These findings should prompt a careful search for the portal vein and any associated anomalies. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasound asessment of the fetal foramen ovale
Authors: Kiserud T. , Rasmussen S. 
Published: March 2003

AbstractObjectivesBased on the assumption that the horizontal area between the fetal foramen ovale valve and the atrial septum (the outlet) represents the limiting structure for the foramen ovale flow, our objective was to determine the normal size of this section during the second half of pregnancy.MethodsOne hundred and thirty‐eight women with low‐risk singleton pregnancies were examined in a cross‐sectional study between 18 and 42 weeks of gestation. Using ultrasound imaging and M‐mode, the area and diameter between the foramen ovale valve and the atrial septum were determined in a four‐chamber view of the fetal heart above the foramen ovale limbus. The inferior vena cava cross section and right atrial width were also determined.ResultsThe mean foramen ovale width increased from 3 mm at 18 weeks to 6 mm at term. Correspondingly, the horizontal area grew from 15 to 50 mm2. The mean ratio between this area and the area of the inferior vena cava fell from 1 at 18 weeks to 0.5 at term. The ratio between the transverse width of the foramen ovale and the right atrium remained at average 0.45–0.50 until 32 weeks, when a slight reduction was observed towards term.ConclusionsNormal values for the horizontal cross section and transverse diameter of the foramen ovale outlet were established for the second half of pregnancy. In particular, the horizontal transverse diameter and its ratio to the right atrial width are easy to determine, and use of these measurements is thus suggested for the assessment of the fetal foramen ovale. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Cervical length at 22–24 weeks of gestation: comparison of transvaginal and transperineal‐translabial ultrasonography
Authors: Cicero S. , Skentou C. , Souka A. , To M. S. , Nicolaides K. H. 
Published: March 2003

AbstractObjectivesTo investigate the feasibility of measuring cervical length by transperineal or translabial sonography and compare the measurements obtained by this approach with those obtained transvaginally.MethodsIn 500 women measurement of cervical length by translabial‐transperineal sonography was attempted immediately before transvaginal scanning at 22–24 (median 23) weeks of gestation. In the first phase of the study, considered to be the learning period, 200 patients were examined and their results reviewed, before carrying out the second phase in which 300 patients were examined. A comparison was made of the patient acceptability of both techniques.ResultsCervical length was successfully measured transvaginally in all cases. In the first phase of the study cervical length was measured by translabial‐transperineal sonography in 84% of the 200 patients but there was poor agreement with measurements obtained transvaginally and the 95% tolerance interval for paired observations was −11.0 mm to 16.1 mm. After audit of results it became apparent that the translabially‐transperineally derived images were inadequate in more than half of the cases but in those with adequate paired measurements there was a very good agreement between the two and the 95% tolerance interval for paired observations was −5.8 mm to 5.2 mm. In the second phase of the study special attention was paid towards recording measurements of cervical length only in cases where both the internal and external os were adequately visualized. Successful measurements by translabial‐transperineal sonography were obtained in 78% of cases and the 95% tolerance interval for paired observations was −5.8 mm to 6.1 mm. The degree of patient acceptability of the two methods was similar.ConclusionsThe findings of this study suggest that at 22–24 weeks of gestation the cervix can be visualized adequately by translabial‐transperineal sonography in about 80% of patients and the measurements of cervical length obtained by this approach are very similar to those obtained by transvaginal sonography. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Prediction of preterm delivery in twins by cervical assessment at 23 weeks
Authors: Skentou C. , Souka A. P. , To M. S. , Liao A. W. , Nicolaides K. H. 
Published: March 2003

AbstractObjectiveTo establish the relation between cervical length at 23 weeks of gestation in twin pregnancies and risk of spontaneous delivery before 33 weeks.MethodsCervical length was measured by transvaginal sonography at 23 (range 22–24) weeks of gestation in 464 twin pregnancies attending for routine antenatal care. In the patients who were managed expectantly the relation between cervical length and the rate of spontaneous delivery before 33 weeks was determined.ResultsThe cervical length distribution was skewed to the left and the median value was 36 mm. The rate of spontaneous delivery before 33 weeks was inversely related to cervical length at 23 weeks. It increased gradually from about 2.5% at 60 mm, to 5% at 40 mm and 12% at 25 mm, and exponentially below this length to 17% at 20 mm and 80% at 8 mm. Cervical length of 20 mm or less is found in about 8% of the population and this group contained about 40% of women delivering spontaneously before 33 weeks.ConclusionsIn twin pregnancies measurement of cervical length provides useful prediction of risk for spontaneous early preterm delivery. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Assessment of endothelial function in normal twin pregnancy
Authors: Savvidou M. D. , Donald A. E. , Nicolaides K. H. 
Published: March 2003

AbstractObjectiveTo assess the maternal endothelial function in normal twin pregnancy.DesignCross‐sectional study.SubjectsEndothelial function was investigated in 74 women with normal twin pregnancy at 11–30 weeks of gestation and the results were compared to previous reported findings in 98 women with normal singleton pregnancy and 19 non‐pregnant controls.MethodsEndothelial function was assessed by measuring the changes of the brachial artery diameter in response to reactive hyperemia (flow‐mediated dilatation) using external high resolution ultrasound.ResultsFlow‐mediated dilatation of the brachial artery in both twin and singleton pregnancies was significantly higher than in non‐pregnant women (P = 0.002 and P = 0.02, respectively). However, there was no significant difference in flow‐mediated dilatation between women with twin and singleton pregnancy (9.61 ± 4.36 vs. 8.84 ± 3.18, P = 0.38). Resting vessel size, baseline flow and reactive hyperemia did not change significantly with gestation in twin pregnancy and were similar to values in singleton pregnancies and controls.ConclusionOur findings indicate that although in pregnancy endothelial function is enhanced, this change may not be affected by the number of fetoplacental units present. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology