bluuebunny/crossref_metadata_2025_split huggingface dataset:
Doppler studies of the placental and fetal circulation in pregnancies with preterm prelabor amniorrhexis
Authors: Carroll S. G. , Papaioannou S. , Nicolaides K. H. 
Published: March 2003

AbstractThis study has investigated the effect of intrauterine infection on placental perfusion, fetal circulation and fetal oxygenation in patients with preterm prelabor amniorrhexis. In 69 pregnancies with preterm prelabor amniorrhexis, Doppler ultrasound studies of the uterine and umbilical arteries and the fetal middle cerebral artery and thoracic aorta were performed. Within 1 h after the Doppler studies, cordocentesis and amniocentesis were carried out for microbiological investigations and measurement of blood pO2 and pH. In the amniorrhexis group, there were no significant differences from the appropriate normal mean for gestation in any of the Doppler indices or blood gas results. Furthermore, there were no significant differences between the groups with positive fetal blood or amniotic fluid cultures and those with no evidence of infection. These data demonstrate that, in preterm prelabor amniorrhexis, microbial invasion of the amniotic cavity and fetal bacteremia are not associated with detectable changes in placental perfusion, fetal circulation or fetal oxygenation. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal ultrasonographic diagnosis of ductus arteriosus aneurysm with spontaneous neonatal closure
Authors: Puder K. S. , Sherer D. M. , Ross R. D. , Silva M. L. , King M. E. , Treadwell M. C. , Romero R. 
Published: March 2003

AbstractAneurysm of the ductus arteriosus may be either spontaneous or acquired as a complication of surgical closure of a patent duct. Patients may be asymptomatic or present with a wide spectrum of symptoms, including hoarseness, respiratory symptoms, aortic or pulmonary thrombosis or embolism, or rupture of the aneurysm. We present the first report of prenatal ultrasonographic diagnosis of isolated ductus arteriosus aneurysm. The aneurysm presented at 39 weeks as an enlarged, dilated, vascular structure 15 mm in diameter, which began at the bifurcation of the main pulmonary artery and ended in the descending aorta. Doppler imaging demonstrated turbulent flow in this lesion. Following spontaneous delivery, a bidirectional shunt in the ductus arteriosus was found on the 1st day, but the caliber of the vessel was normal. An almost completely functionally closed ductus was found on the 2nd day. Spontaneous resolution of the lesion was confirmed by magnetic resonance imaging at 4 weeks of age. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
In utero sonographic appearance of intestinal duplication cysts
Authors: Degani S. , Mogilner J. G. , Shapiro I. 
Published: March 2003

AbstractThe antenatal appearance of gastrointestinal duplication cysts is described. Two cases are presented: a duplication cyst of the pylorus and a cyst of the terminal ileum. The embryogenesis and the clinical utility of prenatal diagnosis of these malformations of the alimentary tract are discussed.Antenatal detection of these cystic masses allowed close neonatal surveillance and timely surgical intervention prior to neonatal complications. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Recurrent uterine rupture diagnosed by ultrasound
Authors: van Alphen M. , van Vugt J. M. G. , Hummel P. , van Geijn H. P. 
Published: March 2003

AbstractA case of recurrent rupture of the uterus is presented. The patient had a history of left cornual uterine rupture, which was repaired, and she was considered to be suitable for a subsequent pregnancy. During the subsequent pregnancy, attempts were made to evaluate the condition of the uterine scar by ultrasound in order to anticipate threatening rupture of the scar. No signs of dehiscence could be detected until the patient presented with clinical signs. Ultrasound examination revealed protrusion of the membranes at the fundus uteri.Uterine rupture is a rare, but hazardous, obstetric complication that can affect both mother and child. The possible role of ultrasound in cases of elevated risk for uterine rupture is discussed. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Blood flow velocity waveforms of the abdominal arteries in appropriate‐ and small‐for‐gestational‐age fetuses
Authors: Mari G. , Abuhamad A. Z. , Uerpairojkit B. , Martinez E. , Copel J. A. 
Published: March 2003

AbstractThe aim of this study was to describe flow velocity waveforms of abdominal arteries in the appropriate‐ and small‐for‐gestational‐age fetus. Splenic artery, superior mesenteric artery, hepatic artery and renal artery velocity waveforms were obtained from 57 appropriate‐for‐gestational‐age and nine small‐for‐gestational‐age fetuses with color flow Doppler ultrasonography. The pulsatility index was used to quantify the arterial waveforms.Repeated measure analysis of variance indicated significant differences in the pulsatility index values in both the appropriate‐for‐gestational‐age and small‐for‐gestational‐age fetuses. A multiple comparison test revealed a significantly lower value for the pulsatility index in the splenic artery when compared to that of the other vessels for both the appropriate‐ and small‐for‐gestational‐age fetuses. In the small‐for‐gestational‐age fetuses, a lower pulsatility index value was observed at the superior mesenteric artery level when compared to the renal artery. Because of its lower frequency of successful insonation, the hepatic artery was not considered for the analysis.In the normal fetus, the splenic artery had the lowest pulsatility index when compared to the other arteries we investigated. This difference remained in small‐for‐gestational‐age fetuses, reflecting a lower vascular resistance at the fetal spleen in both normal and small‐for‐gestational‐age fetuses. It appears that in small‐for‐gestational‐age fetuses the renal artery has a higher pulsatility index than the superior mesenteric artery, suggesting a preferential distribution of blood flow to the bowel. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Changes observed in Doppler studies of the fetal circulation in pregnancies complicated by pre‐eclampsia or the delivery of a small‐for‐gestational‐age baby. I. Cross‐sectional analysis
Authors: Harrington K. , Carpenter R. G. , Nguyen M. , Campbell S. 
Published: March 2003

AbstractThe aim of this study was to compare changes in Doppler ultrasound studies of the fetal circulation in normal pregnancies with a group of pregnancies complicated by proteinuric pregnancy‐induced hypertension (PPIH), delivery of a small‐for‐gestational‐age (SGA) baby, or both. A total of 167 uncomplicated pregnancies with a term delivery of an appropriately grown baby (AGA) were used to define the normal range. Altogether, 123 high‐risk pregnancies with a known outcome constituted the study group. A color duplex ultrasound machine was used to perform biometry and fetal Doppler studies. Measurements obtained from the fetal circulation included the umbilical artery (UA) pulsatility index (PI), the middle cerebral artery (MCA) PI and time‐averaged velocity (TAV), the thoracic aorta (AO) PI and TAV In addition, the ratio between the MCA PI and UA PI, the MCA PI and the A0 PI, and the product of the MCA PI and A0 TAV were used in the analysis.A total of 105 pregnancies had a complicated outcome. They were divided into three categories: PPIH only (pregnancies complicated by PPIH with the delivery of an AGA fetus, n = 17), SGA only (delivery of an SGA baby, with no evidence of PPIH, n = 55), and PPIH + SGA (pregnancies complicated by pre‐eclampsia and delivery of an SGA baby, n = 37). The PPIH + SGA group represented true clinical intrauterine growth retardation.Cross‐sectional reference ranges were created using the observations from the normal group. z‐scores (standard deviation from the mean of the normal range) of the last observations made before delivery were calculated for each of the vessel velocimetry measurements and ratios. The statistical significance of z‐score values was calculated using analysis of variance.The MCA and UA PI values showed the greatest deviation for any single‐vessel parameter. The ratios of fetal Doppler indices (MCA/UA PI ratio, MCA/AO PI ratio and the MCA PI/A0 TAV index) demonstrated greater deviation from normal than any individual vessel. The UA PI z‐score for PPIH + SGA delivering < 34 weeks gestation (2.92) was significantly greater than the z‐score for PPIH + SGA delivering ≥ 34 weeks (1.20, p < 0.05).Fetal Doppler indices, in particular ratios that include measurements obtained from the cerebral circulation, help in the recognition of the small fetus that is growth‐retarded. At term, evidence of fetal hemodynamic redistribution may exist in the presence of a normal umbilical artery PI. Fetal Doppler indices provide information that is not readily obtained from more conventional tests of fetal well‐being. It therefore has an important role to play in the management of the growth‐retarded fetus. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Is ultrasound unsound? A review of epidemiological studies of human exposure to ultrasound
Authors: Salvesen K. Å. , Eik‐Nes S. H. 
Published: March 2003

AbstractWe have reviewed the epidemiological studies of human exposure to diagnostic ultrasound during pregnancy. Studies have concentrated on possible associations between ultrasound exposure in utero and childhood malignancies, neurological maldevelopment, dyslexia, left‐handedness, delayed speech development and low birth weight. It is concluded that no associations between ultrasound exposure in utero and childhood maldevelopment have been proven. There are, however, some issues, such as non‐right handedness and low birth weight after frequent Doppler ultrasound exposures, for which no firm conclusions can yet be drawn. These issues need to be tested in future studies. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Modified Neonatal Growth Assessment Score: a multivariate approach to the detection of intrauterine growth retardation in the neonate
Authors: Deter R. L. , Nazar R. , Milner L. L. 
Published: March 2003

AbstractThe objective of this investigation was the development of a modified Neonatal Growth Assessment Score (mNGAS) for use in the evaluation of neonatal growth status. The growth of 74 fetuses at risk for intrauterine growth retardation (IUGR) was followed longitudinally, beginning in the first or early second trimester. Rossavik growth models derived from data obtained in the second trimester were used to predict the weight (WT), crown‐heel length (CHL) and head(HC) abdominal (AC) and thigh circumferences (ThC) at birth, which were then actually measured within 24 h after delivery. These measurements were compared to age‐specific size curves and used to calculate sets of five growth potential index (GPRIi) values, which in turn were used to calculate five‐variable Neonatal Growth Assessment Scores (NGAS5). Neonates were initially classified as normal or IUGR on the basis of NGAS5, GPRIi, and anatomic measurements. A final classification based on principal component analysis and linear discriminant analysis was carried out. The score obtained using the first principal component function was defined to be mNGAS51. The effectiveness of mNGASij values, determined from 1–4 GPRIi values, in separating normal and IUGR neonates was also evaluated.Neonates initially considered to be normal had very few abnormal GPRI values or anatomic measurements, whereas the frequency of these abnormalities in IUGR neonates was significantly increased. However, no single anatomic variable was 100% normal in the normal neonates and 100% abnormal in IUGR neonates. Only 40% of IUGR neonates were small for gestational age. Classification of these neonates using principal component analysis and linear discriminant analysis was essentially the same (98.6%) as that made initially after reclassification of two IUGR neonates as normal. The characteristics of the initial and final normal and IUGR groups were very similar and the mNGAS51 was strongly correlated with the NGAS5 in the IUGR group. The effectiveness of mNGASij in separating normal and IUGR neonates increased with the number of GPRIi values included and the types used. GPRIThC and GPRIWT were the most important, followed by GPRIAC. GPRICHL and GPRIHC were much less important and in some cases detrimental. These findings support the concepts of a decrease in soft tissue mass as the initial step in the development of IUGR and the protection of head growth (brain‐sparing).The characteristics of mNGAS51, particularly its comprehensiveness, its independence of differences in growth potential, its weighting of GPRIi values according to their importance in the detection of IUGR and its ability to detect different manifestations of IUGR in different individuals, indicate that this should be a most effective parameter for separating normal and IUGR neonates. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal sonographic assessment of the fetal urinary tract in early pregnancy
Authors: Rosati P. , Guariglia L. 
Published: March 2003

AbstractFetal renal size in the first trimester and the early second trimester of pregnancy was evaluated by high‐frequency transvaginal sonography in 537 singleton fetuses at risk for cytogenetic abnormality but not at risk for congenital kidney disease. The percentage of visualization of both kidneys and bladder at different menstrual ages (1l–l6 weeks) is presented, and centile reference charts for evaluating kidney growth have been compiled. All kidney measurements were found to increase as pregnancy progressed. At 13 weeks, fetal kidneys and fetal urinary bladder were visualized in 92% of the cases screened. The incidence of pyelectasis was high in our population (4.5%), and this pathology was studied by other sonographic scans during pregnancy and postnatally. All fetuses had normal karyotypes. The results presented provide a reference for the assessment of normal renal morphology and growth in early pregnancy. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Uterine and spiral artery flow velocity waveforms in pregnancy‐induced hypertension and/or intrauterine growth retardation
Authors: Murakoshi T. , Sekizuka N. , Takakuwa K. , Yoshizawa H. , Tanaka K. 
Published: March 2003

AbstractThe objectives of this study were to characterize spiral artery flow velocity waveforms in normal pregnancies and pregnancies complicated by pregnancy‐induced hypertension and/or intrauterine growth retardation, and to examine the diagnostic potential for predicting adverse perinatal outcomes in complicated pregnancies compared with uterine and umbilical artery flow velocity waveforms.In this cross‐sectional study, 160 normal and 43 complicated pregnancies were assessed by color and pulsed Doppler during 18–41 weeks of gestation. Flow velocity waveforms were obtained from the spiral, uterine and fetal umbilical arteries.In normal pregnancies, the resistance index of spiral artery flow velocity waveforms decreased significantly with advancing gestation (r = −0.256, p < 0.001). In abnormal pregnancies complicated by pregnancy‐induced hypertension and/or intrauterine growth retardation, the incidence of adverse perinatal outcome was significantly higher in patients with abnormal spiral artery resistance indices than in patients with normal spiral artery resistance indices (p < 0.001). An abnormal spiral artery resistance index had a better diagnostic accuracy for adverse perinatal outcome (sensitivity 8.5.0%, specificity 91.3%, positive predictive value 89.5%, negative predictive value 87.5%, accuracy 88.4%) when compared with the resistance index of uterine and umbilical artery waveforms and presence of a diastolic notch of the uterine artery waveform.Color flow imaging facilitates the precise analysis of spiral artery flow velocity waveforms and provides more accurate information about the uteroplacental circulation in the evaluation of placental function. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Pathognomonic echo patterns of benign cystic teratomas of the ovary: classification, incidence and accuracy rate of sonographic diagnosis
Authors: Caspi B. , Appelman Z. , Rabinerson D. , Elchalal U. , Zalel Y. , Katz Z. 
Published: March 2003

AbstractThe great variability in the sonographic appearance of ovarian cystic teratomas poses difficulties for their diagnosis and classification. To overcome such difficulties, we have proposed a simplified classification of the pathognomonic echo patterns of ovarian cystic teratomas based on three basic types of echo pattern. In a prospective study of 118 echogenic adnexal masses, with postoperative histological confirmation, this classification enabled the correct diagnosis to be made in 11.5 cases (accuracy rate, 97.45%). In the three cases misdiagnosed preoperatively as ovarian cystic teratoma, the tumors proved to be benign and included a serous cyst adenoma, a serous cyst adenofibroma and a Brenner tumor. We suggest that, with our proposed classification of the echo patterns of ovarian cystic teratomas, sonography can become a quick and accurate tool in the recognition of this condition. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Cardiac functional changes in the human fetus in the late first and early second trimesters
Authors: van Splunder I. P. , Wladimiroff J. W. 
Published: March 2003

AbstractFetal cardiac function was studied in 52 women at 10–20 weeks of normal gestation using Doppler ultrasonography. According to a cross‐sectional study design, transmitral and ascending aortic flow velocity waveforms were obtained simultaneously, in order to calculate filling and ejection time as well as isovolumic contraction and relaxation time. A statistically significant gestational age‐dependent increase was established for both transmitral and ascending aortic flow velocities. Cardiac cycle length and filling time displayed a statistically significant increase with advancing gestational age, whereas ejection time and isovolumic relaxation time showed a gestational age‐related decrease. No relationship existed between isovolumic contraction time and gestational age. A statistically significant decrease was demonstrated for atria1 contribution to ventricular filling at 10–l4 weeks of gestation, with a constant pattern during the remainder of the study period. No relationship existed between the different components of the cardiac cycle and mitral and aortic flow velocity parameters.This study shows that the late first and early second trimesters of pre,gnancy are characterized by gestational age‐related changes in fetal cardiac function. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Sonographically guided aspiration: an alternative therapy for tubo‐ovarian abscess
Authors: Caspi B. , Zalel Y. , Or Y. , Bar Dayan Y. , Appehan Z. , Katz Z. 
Published: March 2003

AbstractOur objective was to evaluate the role of single‐step ultra‐sound‐guided aspiration in conjunction with intracavitary antibiotic instillation for the treatment of tubo‐ovarian abscess. Ten women with the clinical and sonographic diagnosis of tubo‐ovarian abscess, who failed to respond to systemic antibiotic therapy, were treated by ultrasound‐guided aspiration of the abscess followed by intracavitary instillation of a combination of antibiotics.All ten women improved clinically and none required surgery. The mean time from aspiration to hospital discharge was 3.1 days with mean duration of hospitalization 7.8 days. No major complications were observed. The average time interval between aspiration of the lesion and resolution on sonographic follow‐up was 9.5 weeks. In three cases, pelvic inflammatory disease recurred, but none needed surgical intervention. The average follow‐up period of the patients was 12 months.One‐step sonographically guided aspiration of tubo‐ovarian abscess followed by intracavitary antibiotic instillation may serve as an easy and safe alternative therapy in patients in whom treatment with systemic antibiotics has failed. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Uterine arcuate artery Doppler and decidual microvascular pathology in pregnancies complicated by type I diabetes mellitus
Authors: Barth W. H. , Genest D. R. , Riley L. E. , Frigoletto F. D. , Benacerraf B. R. , Greene M. F. 
Published: March 2003

AbstractThe objective was to correlate Doppler indices from the uterine arcuate arteries with an analysis of the decidual vascular histology in patients with type I diabetes. Pulsed wave Doppler was used to sample the uterine arcuate artery system beneath the placenta within 8 days of delivery in 47 patients with type I diabetes mellitus. A placental pathologist, without knowledge of either clinical outcome or Doppler information, classified the histological appearance of the decidual arteries as normal, type A (hyalinization, mural thickening), or type B (fibrinoid necrosis, atherosis, thrombosis). Patients were then grouped according to the histology of the decidual arteries. An analysis of variance (ANOVA) of the systolic/diastolic (S/D) ratios (log. S/D) showed significant variation (p < 0.025). A multiple range comparison test showed that patients with normal or only mildly abnormal (type A) vessels had similar values, whereas those with severe vasculopathy (type B) had significantly higher S/D ratios (p < 0.05). The study confirmed a relationship between arcuate artery Doppler indices and downstream decidual vascular pathology. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Early second‐trimester determination of fetal gender by ultrasound
Authors: Meagher S. , Davison G. 
Published: March 2003

AbstractUltrasound identification assists in determining chorionicity in twins, in the interpretation of sex chromosome mosaicism and aneuploidy and in sex‐linked conditions presenting after 14 weeks. This study addresses the frequency and accuracy of gender identification in a series of consecutive patients presenting for amniocentesis for genetic indications. Amniocentesis was performed at 14–20 weeks in 843 fetuses over a 5‐year period. Ultrasound prediction of fetal gender was documented in 93.3% (770/843). The overall accuracy of diagnosis of fetal gender was 99.3% (765/770). Errors in diagnosis of gender were more likely to occur in the assessment of the female fetus. Such errors in diagnosis may be minimized by combining both tangential/transverse and sagittal views of the fetal perineum. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Hysteroscopy provides proof of trophoblastic tumors in three cases with negative color Doppler images
Authors: Lindholm H. , Rådestad A. , Flam F. 
Published: March 2003

AbstractColor Doppler sonography has replaced pelvic arteriography as well as real‐time ultrasound in the assessment of patients with gestational trophoblastic disease. In about 25% of patients in whom human chorionic gonadotropin (hCG) levels are suggestive of trophoblastic disease, there will be no evidence of abnormal vessels in the uterus. In these cases it is assumed that hCG was produced by metastatic lesions. We present here three cases in which color Doppler examination was negative and where myometrial biopsies containing tumor were obtained by means of hysteroscopy. The fact that color Doppler, in its present form, does not detect small areas of trophoblastic tumor might also have implications for other kinds of tumors. Knowledge of the exact microscopic diagnosis in molar patients with persistent disease may have an impact on management. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology