bluuebunny/crossref_metadata_2025_split huggingface dataset:
Doppler findings in chronic ectopic pregnancy: case report
Authors: Abramov Y. , Nadjari M. , Shushan A. , Prus D. , Anteby S. O. 
Published: March 2003

AbstractChronic ectopic pregnancy is an uncommon form of tubal pregnancy manifested as a pelvic mass with minimal symptoms and a low or absent titer of human chorionic gonadotropin. For this reason, most of the reported cases have been diagnosed only after explorative laparotomy. The value of Doppler ultrasonography for preoperative diagnosis of this entity has not yet been established. We report on a 36‐year‐old patient who was admitted for intermittent right lower quadrant abdominal pain of 3 months' duration, and a right adnexal mass found on pelvic examination. On Doppler ultrasonography, a right complex adnexal mass was demonstrated, characterized by extensive external vascularization, aberrant vessels and arteriovenous shunting, but with no internal blood flow. Explorative laparotomy revealed a right tubal mass adherent to the omentum, and covered by numerous enlarged and tortuous blood vessels originating in the omentum. Pathological examination of the mass revealed a chronic ectopic pregnancy. The possible contribution of Doppler‐specific characteristics for the diagnosis of chronic ectopic pregnancy is described and discussed. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Dilated coronary sinus in the fetus: misinterpretation as an atrioventricular canal defect
Authors: Park J. K. , Taylor D. K. , Skeels M. , Towner D. R. 
Published: March 2003

AbstractThe ostium of the coronary sinus opens directly into the right atrium in close proximity to the insertion of the atrioventricular valves. If the coronary sinus is dilated, it can create the appearance of an atrioventricular canal defect in the fetal echocardiographic four‐chamber view. The diagnosis of a serious heart lesion, such as a canal defect, necessitates decisions regarding pregnancy termination or optimal timing/location of delivery. We present three women who were referred at 23, 36 and 38 weeks' gestation with a preliminary diagnosis by level II ultrasound of a fetal atrioventricular canal defect. In each patient, the targeted fetal echocardiogram demonstrated a dilated coronary sinus and no evidence of an atrioventricular canal defect. The fetal echocardiographic presentation of a dilated coronary sinus can be mistaken for an atrioventricular canal defect. Misdiagnosis can be avoided by utilizing both variable angulation in the four‐chamber projection and additional transducer views to confirm an intact atrioventricular septum and two normal atrioventricular valves. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal ultrasonographic detection of the tracheal atresia sequence
Authors: Kassanos D. , Christodoulou C. N. , Agapitos E. , Pavlopoulos P. M. , Pagalos N. 
Published: March 2003

AbstractWe report on a rare case of tracheal atresia, without fistula, in a 29 weeks' female fetus. The abnormality was detected by prenatal ultrasonography, which demonstrated a bilateral and uniform hyperechogenicity and enlargement of the lungs, associated with ascites and moderate oligohydramnios. We suggest that oligohydramnios may be helpful in distinguishing the upper respiratory tract obstruction from congenital cystic adenomatoid malformation of the lungs, type III. A morphometric study revealed a three‐fold more dense pulmonary vasculature in comparison with two control cases of the same gestational age. The pathological finding of pulmonary and vascular hyperplasia as well as the pathophysiology of the syndrome are discussed. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Human fetal right ventricular ejection force under abnormal loading conditions during the second half of pregnancy
Authors: Rasanen J. , Debbs R. H. , Wood D. C. , Weiner S. , Weil S. R. , Huhta J. C. 
Published: March 2003

AbstractOur objective was to determine whether abnormal loading conditions can modify human fetal right ventricular ejection force during the second half of pregnancy. By Doppler echocardiography, we studied 73 normal fetuses between 19 and 41 weeks of gestation, 27 fetuses with hypoplastic left heart syndrome (chronic volume overload) between 18 and 38 weeks of gestation, 14 fetuses with mild to moderate constriction of the ductus arteriosus (pulsatility index (PI) between 1.0 and 1.9) and seven fetuses with severe constriction (PI < 1.0) or occlusion of the ductus arteriosus (relatively acute pressure overload) between 28 and 34 weeks of gestation. In the normal and ductal constriction/occlusion groups, blood velocity waveforms were recorded at the level of the aortic and pulmonary valves, and in the group with hypoplastic left heart syndrome at the level of the pulmonary valve. The ventricular ejection forces were calculated.In the normal group, right (RVEF; r = 0.91, p < 0.0001) and left (LVEF; r =: 0.86, p < 0.0001) ventricular ejection forces increased and were equal during the second half of gestation. In the group with hypoplastic left heart syndrome the RVEF increased (r = 0.76, p < 0.0001) with advancing gestation. The RVEF (p < 0.0005) and its average weekly increase (p < 0.0001) were greater in the hypo plastic left heart syndrome group than in the normal group. In the group with mild to moderate ductal constriction, both ventricular ejection forces were similar to those of the normal group. The RVEF (p < 0.003) and its average weekly increase (p < 0.03) were lower in the group with severe ductal constriction or occlusion than in the normal group. The LVEF did not differ from that of the normal group.We conclude that chronic volume overload increases and relatively acute pressure overload decreases human fetal RVEF. The right ventricular performance is modified by abnormal loading conditions. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Fetal inguinoscrotal hernia: sonographic diagnosis and obstetric management
Authors: Kesby G. , BeiLby R. , Petroni M. 
Published: March 2003

AbstractFetal inguinal hernia is a rare antenatal diagnosis. We present the sonographic features and outcome of a fetus diagnosed at 36 weeks' gestation as having an (indirect) inguinoscrotal hernia. Sonographic criteria for antenatal diagnosis are discussed within the context of differential diagnoses raised by the presence of a perineal mass. Guidelines for obstetric management and counselling are suggested. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Sonographic evaluation of intervillous flow in early pregnancy: use of echo‐enhancement agents
Authors: Simpson N. A. B. , Nimrod C. , De Vermette R. , Leblanc C. , Fournier J. 
Published: March 2003

AbstractThe uteroplacental circulation of the cynomolgus monkey was examined in early pregnancy using a high‐resolution ultrasound scanner. Intravenous injection of an echo‐contrast agent, Albunex (sonicated albumin), was used to enhance the color Doppler images obtained. The flow of blood into and out of the intervillous compartment was readily assessed and quantified using pulsed and color Doppler. Flow within the intracotyledonary space was pulsatile and indicative of a low‐resistance system. Flow within the decidual veins was non‐pulsatile. The use of echo‐contrast agents may assist in the determination of intervillous flow in human pregnancy at a correspondingly early stage. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
The effect of nuchal cord on nuchal translucency measurement at 10–14 weeks
Authors: Schaefer M. , Laurichesse‐Delmas H. , Ville Y. 
Published: March 2003

AbstractThe aim of this study was to determine the incidence of nuchal cord and its possible effect on nuchal translucency thickness at 10–14 weeks' gestation. Out of 316 consecutive pregnancies in which nuchal translucency thickness was measured transabdominally, 26 (8.23%) fetuses were shown to have the umbilical cord around the neck. The umbilical cord can be measured together with the nuchal translucency thickness when it passes around the fetal neck and this adds a mean of 0.8 mm to the actual translucency measurement. After the thickness of the cord was subtracted, the measurements of nuchal translucency thickness did not differ from those in the overall population studied. Of the 22 fetuses available for follow‐up, a nuchal cord was found in only one at 20 weeks and in none at delivery. Our findings indicate that the presence of a nuchal cord may bias the results of fetal nuchal translucency measurement and that the use of color Doppler might decrease the false‐positive rate in screening for fetal aneuploidy by nuchal translucency measurement at 10–14 weeks' gestation. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
The second‐trimester fetal iliac angle as a sign of Down's syndrome
Authors: Shipp T. D. , Bromley B. , Lieberman E. , Benacerraf B. R. 
Published: March 2003

AbstractObjectiveTo determine whether the iliac angle of second‐trimester fetuses is a useful sonographic marker for the detection of fetuses with Down's syndrome.MethodsWe prospectively measured the iliac angle for all fetuses karyotyped over a 17‐month period. A transverse view of the upper fetal pelvis was obtained at the time of amniocentesis and, by means of a protractor, the angle between the two iliac bones was measured. The angles of all those fetuses with Down's syndrome and the first 500 fetuses with normal karyotypes were compared, as was gestational age and maternal age.ResultsNineteen fetuses with Down's syndrome and 1167 fetuses with normal karyotypes underwent genetic amniocentesis over the study period. The mean gestational age of the fetuses with Down's syndrome was 16.6 weeks (± 1.9 weeks), and for the controls, 16.1 weeks (± 1.4 weeks) (p = 0.3). The mean maternal ages were 34.7 years (± 4.8 years) and 35.4 years (± 4.1 years) for those pregnancies with Down's syndrome and with normal karyotypes, respectively (p = 0.5). The mean iliac angle was 80.1° (± 19.7°) for those fetuses with Down's syndrome, and 63.1°(± 20.3°) for those fetuses with normal karyotypes (p = 0.0004). The iliac angle was at least 90° in 36.8% (seven of 19 fetuses) with Down's syndrome and in 12.8% (64 of 500 fetuses) with normal karyotypes (p = 0.003).ConclusionFetuses with Down's syndrome have a significantly larger iliac angle than fetuses with normal karyotypes. Use of an iliac angle cut‐off point of 90° would identify over one‐third of second‐trimester fetuses with Down's syndrome. However, because of the high false‐positive rate (12.8%), the iliac angle is not useful in a high‐risk population as a screening test when used in isolation. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Cost issues surrounding the use of computerized telemedicine for obstetric ultrasonography
Authors: Malone F. D. , Athanassiou A. , Craigo S. D. , Simpson L. L. , D'Alton M. E. 
Published: March 2003

AbstractObjectiveThe purpose of this study was to describe the cost implications of converting an established videotape review network for obstetric ultrasonography to one based on telemedicine technology.DesignRetrospective review of fixed and non‐fixed costs associated with interpreting obstetric ultrasound examinations using both videotape and telemedicine transmission.SubjectsA network of three community offices transmitting 600 obstetric ultrasound examinations per month to a central tertiary level facility.MethodsSonographers at the community offices record ultrasound examinations onto videotape, which are then sent by courier to a central facility for interpretation. At the completion of this videotaped examination, sonographers repeat the ultrasound scan while transmitting real‐time images over a telemedicine link to the central facility. Costs associated with the videotape review technique that can be avoided by converting to telemedicine interpretation were derived and compared with the fixed and non‐fixed costs associated with establishing the telemedicine network.ResultsFor this network, the fixed costs for establishing telemedicine are $101 750. Monthly non‐fixed cost savings by eliminating videotape review include $1620 to $2700 for printing still images, $1200 for courier charges and $7000 for fewer repeat ultrasound examinations. Monthly non‐fixed costs for the telemedicine network are $2415. Net monthly savings in non‐fixed costs for a telemedicine network are therefore $7405 to $8585, which may pay for the initial fixed costs in 12 to 14 months.ConclusionsThe high cost of a telemedicine network may be offset by possible savings in non‐fixed costs compared with alternative systems for interpreting obstetric ultrasonography. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Screening for Down's syndrome by fetal nuchal translucency measurement in a high‐risk population
Authors: Pajkrt E. , Mol B. W. J. , van Lith J. M. M. , Bleker O. P. , Bilardo C. M. 
Published: March 2003

AbstractObjectiveTo examine the discriminative capacity of nuchal translucency measurement in the detection of trisomy 21 and other chromosomal anomalies.DesignProspective cohort study.SubjectsA total of 2247 women with viable singleton pregnancies between 10 and 14 weeks' gestation attending a prenatal diagnosis center for fetal karyotyping.MethodsThe fetal nuchal translucency was measured transabdominally in all women before invasive prenatal testing.ResultsChromosomal abnormalities were found in 63 fetuses, including 36 with Down's syndrome. The likelihood of the presence of chromosomal abnormalities increased with larger nuchal translucency thickness. A nuchal translucency of 3 mm or more identified 25 out of 36 fetuses (69%) with trisomy 21 at the expense of a 4.0% false‐positive rate. Correction of nuchal translucency measurements for differences due to variation of the measurement with gestational age, either by using the ‘delta‐value’ or multiples of the median (MoM), did not improve the detection rate in our patient data set.ConclusionsThe discriminative capacity of nuchal translucency measurement makes it a useful tool in screening for trisomy 21 and other chromosomal anomalies. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Antenatal diagnosis of velamentous umbilical cord insertion and vasa previa with color Doppler imaging
Authors: Nomiyama M. , Toyota Y. , Kawano H. 
Published: March 2003

AbstractObjectiveTo determine whether cord insertion can be consistently visualized and whether velamentous cord insertion and vasa previa can be consistently identified with color Doppler imaging during routine sonography in the mid‐trimester.DesignA prospective study.SubjectsA total of 587 fetuses at 18–20 weeks' gestation.MethodsDuring routine ultrasound examinations, the sonographer was instructed to take additional time and to image the placental cord insertion with color Doppler imaging and classify this as normal, velamentous or ‘not seen’. When the insertion was velamentous, the sonographer was instructed to indicate whether or not it was vasa previa. The sonogram obtained at 18–20 weeks' gestation was used for comparison with outcome data.ResultsCord insertion was visualized by color Doppler imaging in 99.8% (586/587) of the fetuses in our study. The mean time required for examination was 20 s and, in 95% of the cases, cord insertion was visualized within 1 min. The sonographic identification of velamentous cord insertion had a sensitivity of 100% (5/5), a specificity of 99.8% (580/581), a positive predictive value of 83% (5/6) and a negative predictive value of 100% (580/580). In our study, vasa previa was diagnosed at 18 gestational weeks in two cases and, in one of the cases, vasa previa was confirmed at delivery.ConclusionsWe could consistently identify cord insertion and velamentous cord insertion with color Doppler imaging during routine sonography in the mid‐trimester. Transvaginal color Doppler imaging and serial scans were needed to identify vasa previa. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Definitive diagnosis of intestinal volvulus in utero
Authors: Yoo S.‐J. , Park K. W. , Cho S. Y. , Sim J. S. , Hhan K. S. 
Published: March 2003

AbstractMidgut volvulus with or without intestinal malrotation can occur in fetal life. Several reports have described congenital midgut volvulus showing non‐specific sonographic findings of intestinal obstruction and perforation in utero. None of the previously reported cases, however, were definitively diagnosed as midgut volvulus by fetal sonography. We report two cases both exhibiting the sonographic ‘whirlpool’ sign, in utero. Color Doppler interrogation provided a clue to the viability of the involved intestinal segment. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Gastroschisis associated with bladder evisceration complicated by hydronephrosis presenting antenatally
Authors: Ikhena S. E. , de Chazal R. C. , Konje J. C. 
Published: March 2003

AbstractWe report here a case of gastroschisis associated with bladder evisceration and complicated by rapidly developing hydronephrosis diagnosed antenatally. The timing of delivery was determined by the hydronephrosis, associated bowel dilatation and polyhydramnios. The case highlights the need for continuing ultrasonographic surveillance of fetuses with gastroschisis to identify further associated complications which were hitherto absent but whose presence may influence the timing of delivery and neonatal care. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Hormonal replacement therapy and urinary problems as evaluated by ultrasound and color Doppler
Authors: Battaglia C. , Salvatori M. , Giulini S. , Primavera M. R. , Gallinelli A. , Volpe A. 
Published: March 2003

AbstractObjectiveTo determine how hormone replacement therapy modifies bladder vascularization and urinary symptoms.Study designTwenty‐eight postmenopausal women with urinary symptoms (day‐time frequency > 8; nocturia > 1; urgency and/or dysuria) were analyzed before and after 1, 3 and 6 months of hormone replacement therapy. The patients underwent transvaginal ultrasound evaluation of the pelvic organs and endometrial and bladder wall thickness. Transvaginal color Doppler analysis of blood flow impedance of the uterine and intramural bladder wall arteries was performed in all cases.ResultsHormone replacement therapy significantly increased bladder wall and endometrial thickness. This result was associated with significant improvements in uterine and bladder wall vascularization. Urinary symptoms also improved during therapy.ConclusionThe study of bladder wall thickness and vascularization provides additional information regarding the beneficial effect of hormone replacement therapy on lower urinary tract symptoms in postmenopausal women. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Double‐outlet right ventricle: an antenatal diagnostic dilemma
Authors: Smith R. S. , Comstock C. H. , Kirk J. S. , Lee W. , Riggs T. , Weinhouse E. 
Published: March 2003

AbstractObjectiveThe purpose of this study was to describe the antenatal ultrasonographic findings of fetuses with double‐outlet right ventricle (DORV).DesignThe records were reviewed of all fetuses scanned in our ultrasound unit which were suspected of having DORV during a 6‐year period ending in April 1996. A medical record search for all infants with a postnatal diagnosis of DORV was also undertaken to identify cases that were not detected antenatally. Records were examined to determine the accuracy of antenatal diagnosis and the reasons for diagnostic errors. Fetuses without follow‐up were excluded.ResultsThere were 20 fetuses with antenatally detected conotruncal defects that had DORV included in the differential diagnosis. Three fetuses were excluded, seven did not have DORV and ten were confirmed postnatally as having DORV. Two additional infants were found to have DORV from the medical record search, producing a total of 12 cases. Antenatal sonographic cardiac findings included malpositioned (overriding or transposed) great arteries (n = 11), ventricular septal defect (n = 11) and small pulmonary artery suggesting stenosis (n = 4). Confirmed post‐natal cardiac findings that were missed antenatally included aortic coarctation (n = 2), right‐sided aortic arch (n = 2) and pulmonary stenosis (n = 1). Seven of the 12 fetuses had extracardiac findings. Nine of the 12 fetuses tested had a normal karyotype. Eleven of the 12 infants were liveborn. Nine of these 11 survived the neonatal period and underwent surgical repair within the first year of life; two subsequently died. In total, seven fetuses survived and five did not.ConclusionMost fetuses with DORV can be identified antenatally as having an abnormal heart. However, it is very difficult to distinguish this particular defect from other conotruncal abnormalities. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
The clinical significance of fetal isolated cerebral borderline ventriculomegaly: report of 31 cases and review of the literature
Authors: Pilu G. , Falco P. , Gabrielli S. , Perolo A. , Sandri F. , Bovicelli L. 
Published: March 2003

AbstractObjectiveTo assess the clinical significance of fetal isolated borderline cerebral lateral ventriculomegaly defined as a width of the atrium of the lateral cerebral ventricles of 10–15 mm in the absence of other sonographically demonstrable malformations.DesignRetrospective study of the outcome of fetuses with a sonographic diagnosis of isolated borderline cerebral lateral ventriculomegaly and review of the English‐language literature.ResultsOf 31 fetuses, two had chromosomal aberrations (trisomy 21 and trisomy 13) and three had neurological complications (one infant developed shunt‐dependent hydrocephalus, one lissencephaly and one cerebral hemorrhage and periventricular leukomalacia). The literature search revealed eight independent studies. Including the present series, 234 cases were available for analysis. An abnormal outcome was documented in 22.8% of cases. Perinatal death occurred in 3.7%. Chromosomal aberrations, mostly trisomy 21, were present in 3.8%, malformations undetected at a second‐trimester sonogram in 8.6% and neurological sequelae, mostly a mild to moderate delay in cognitive and/or motor development, were present in 11.5%. The risk of an abnormal neurological outcome was increased in females versus males (22.6% versus 4.6%, relative risk 4.892; 95% confidence interval 1.356–17.656), when the atrial width was 12 mm or more (13.9% versus 3.8%, relative risk 3.6, 95% confidence interval 1.035–12.846) and when the diagnosis was made in the second trimester versus later in gestation.ConclusionsIn most cases, isolated borderline cerebral lateral ventriculomegaly has no consequence. However, this finding carries an increased risk of cerebral maldevelopment, delayed neurological development and, possibly, chromosomal aberrations. The optimal management of these cases remains uncertain. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology