bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ectopic pregnancy treatment using pelviscopic or vaginosonographically‐guided intrachorionic injection of methotrexate and POR 8®
Authors: Popp L. W. , Mettler L. , Weisner D. , Mecke H. , Freys I. , Semm K. 
Published: March 2003

AbstractIt is believed by some that the basis of modern first‐trimester pregnancy care should involve screening for ectopic pregnancy using vaginal ultrasonography. This has led to this condition being diagnosed in most cases at an earlier stage than has previously been possible. This advance in diagnostic ability has introduced the concept of conservative management for this condition.The authors describe the conservative management of nine cases of ectopic pregnancy using intrachorionic injection of either methotrexate alone or in combination with POR 8®. In all cases less than 9 weeks had passed since the last menstrual period, and the ectopic pregnancies treated under ultrasound control were all thought to be viable. Five cases were treated using pelviscopy, whilst in another four the needle was guided using vaginal ultrasonography. There were no procedure‐related complications.Following therapy, the women were followed up using serial levels of serum β‐hCG. In seven cases there was a gradual reduction to normal levels. There were two treatment ‘failures’. In both these cases methotrexate alone, rather than in combination with POR 8®, was used for injection. Although formal tests of tubal patency have not been performed in all cases, one woman in the series has since conceived and has a normal intrauterine pregnancy.It is concluded that vaginal instillation of methotrexate is an alternative treatment for early ectopic pregnancy. It should be limited to viable ectopic pregnancies whose chorionic cavities are less than 2.0 cm in diameter. A plan for the management of ectopic pregnancy is presented, involving selection for both ultrasound‐guided injection and pelviscopic surgery. Laparotomy is not considered to be a treatment option in the majority of cases. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
In utero appearance of idiopathic infantile arterial calcification: ultrasound study of a 28‐week fetus
Authors: Crade M. , Lewis D. F. , Nageotte M. P. 
Published: March 2003

AbstractAn ultrasound study of a 28‐week gestation demonstrated changes of poor cardiac function associated with calcifications of the wall of major arteries. Sudden in utero deterioration into hydrops prompted the delivery of a female infant who was diagnosed at autopsy of having a rare disease entity, idiopathic infantile arterial calcification.When a hydropic fetus is defined by ultrasound, this rare diagnosis should be included in the diagnostic considerations. Recent reports suggest successful therapy regimens for an otherwise fatal disease, making accurate diagnosis especially important. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
The pathophysiology of acute syphilitic funisitis
Authors: Schulman H. , Miller J. N. , Dolisi F. 
Published: March 2003

AbstractThere is an increase in the number of cases of syphilis in pregnancy in the United States. Fetal death may occur in syphilis from acute or chronic infections. A case is presented in which an acute fetal infection occurred. The patient presented at 31 weeks' gestation, with a decrease in fetal movements and non‐reactive cardiotocography. Ultrasound and Doppler analysis of the fetal heart, cerebral and umbilical arteries, aorta and umbilical vein led to the suspicion of acute cardiac failure. An amniocentesis yielded a white cell count of 1122 white blood cells, with 91% polymorphs, but the Gram stain was negative. The fetus developed a persistent bradycardia and was delivered. The diagnosis of acute severe syphilitic funisitis was suspected from histological sections of the cord. Diagnosis was established from maternal and fetal blood. Modern ultrasound techniques, including imaging, Doppler and cardiotocography, can lead to the analysis of the pathophysiology of disease states. An acute syphilitic infection should be suspected when this constellation of findings is found. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Cord vessel compression by an expanding allantoic cyst: case report
Authors: Battaglia C. , Artini P. G. , D'Ambrogio G. , Genazzani A. R. 
Published: March 2003

AbstractThe umbilical cord has been inadequately studied by ultrasound. Umbilical cord masses are rare and often misdiagnosed.A case of a 4.3 × 3.2 cm anechoic floating cystic umbilical mass is reported. Doppler examination of the cord proximal to the cyst revealed a high resistance index of 0.84. Twelve hours later the cyst was larger (5.0 × 4.5 cm) and appeared tense; Doppler velocimetry worsened and absence of end‐diastolic flow in the umbilical artery was found. Cardiotocography a few hours later showed a bradycardiac non‐reactive trace with late decelerations. A live male weighing 1980 g was delivered by Cesarean section. At birth the cord position was normal. Pathological examination showed the lesion to be consistent with an allantoic cyst.This is the first case in which antenatal evidence of cord compression by an expanding allantoic cyst has been demonstrated. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal ultrasound diagnosis of fetal candida infection: a complication of a retained intrauterine contraceptive device
Authors: Silver D. A. T. , Ashworth M. T. , Andrews H. S. 
Published: March 2003

AbstractA 32‐year‐old woman was referred complaining of abdominal pain and bleeding at 18 weeks' gestation. The striking finding on ultrasound examination was of symmetrically enlarged echogenic fetal lungs. In addition, mediastinal compression, increased echogenicity of the kidneys and bowel, an enlarged liver of decreased echogenicity, and hydrops fetalis, as evidenced by ascites and skin edema, were all present. The differential diagnosis included upper respiratory tract obstruction and cystic kidney disease. The presence of fetal hydrops together with the other findings suggested a poor outcome, and on these grounds therapeutic abortion was recommended and performed. Subsequent postmortem findings explained all the ultrasound abnormalities on the basis of extensive fetal candida infection. The presence of a retained intrauterine contraceptive device was considered to be the likely cause and the implications of this, together with the ultrasound abnormalities and differential diagnoses, are discussed. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Real‐time quasi‐three‐dimensional viewing in sonography, with conventional, gray‐scale volume imaging
Authors: Kossoff G. , Griffiths K. A. , Warren P. S. 
Published: March 2003

AbstractReal‐time three‐dimensional views of the fetus can be obtained with minor modification to conventional scanners. The modification consists of placing a divergent lens in the out‐of‐scan plane of the transducer to generate a beam fan‐beam in the insonated volume. All of the echoes from which insonates a volume rather than a slice of tissue. Scanning is performed using oblique angles of incidence to provide total reflection conditions. Echoes are then received only from anterior surfaces, automatically generating the three‐dimensional views. Intriguing portrayal of fetal detail can be obtained with this form of imaging which is likely to expand the clinical utility of sonographic examinations. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Doppler flow velocimetry of the umbilical artery, uteroplacental arteries and fetal middle cerebral artery in prolonged pregnancy
Authors: Zimmermann P. , Albäck T. , Koskinen J. , Vaalamo P. , Tuimala R. , Ranta T. 
Published: March 2003

AbstractA total of 153 pregnant women, of at least 287 days' menstrual age, were studied in a prospectively designed cross‐sectional trial. In addition to the non‐stress test, contraction stress test, sonographic estimate of amniotic fluid and grade of placental maturation, Doppler measurements of the resistance index (RI) were taken in the umbilical artery, the uteroplacental arteries in the region of placental implantation and the fetal middle cerebral artery. Data were analyzed with regard to asphyxia and otherwise complicated fetal outcome. Furthermore, a possible relationship between grade of placental maturation, Doppler flow velocity waveforms and fetal outcome was investigated.Doppler resistance indices in the umbilical artery, uteroplacental arteries in the region of placental implantation and fetal middle cerebral artery did not change significantly with increasing gestation from 41 to 43 weeks. The grade of placental maturation on ultrasound examination was not related to fetal outcome or Doppler indices in the first two vessels. In all vessels examined in this study, the majority of Doppler measurements in pregnancies with subsequent asphyxia or otherwise complicated fetal outcome were within the 95% prediction interval for patients with normal fetal outcome. None of the patients showed absent diastolic flow in the umbilical artery. With the use of a cut‐off value of RI = 0.62 in the umbilical artery, asphyxia could be predicted with 37% sensitivity and 75% specificity. Oligohydramnios and antepartum cardiotocography predicted asphyxia with 16% and 8% sensitivity and 95% and 96% specificity, respectively. Sensitivity for prediction of otherwise complicated fetal outcome by umbilical artery Doppler was only 7%.We conclude that vascular resistance in the umbilical artery, uteroplacental arteries in the region of placental implantation and the middle cerebral artery does not change abruptly, when gestation exceeds 287 days. Ultrasonographic grading of placental maturation has no use in post‐term pregnancies. Doppler investigations of the umbilical artery had somewhat better sensitivity in the prediction of asphyxia when compared to ultrasound diagnosis of oligohydramnios or antepartum cardiotocography. However, Doppler showed only modest specificity compared to the other methods and probably has few advantages compared to the traditional methods of fetal surveillance. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Longitudinal study of fetal growth in subgroups of a low‐risk population
Authors: Mongelli M. , Gardosi J. 
Published: March 2003

AbstractWe investigated fetal weight gain in relation to maternal characteristics within a normal, heterogeneous population in Nottingham, UK. A total of 226 low‐risk pregnancies with normal neonatal outcome were examined longitudinally by serial ultrasound examination. Gestation was calculated from early measurements of biparietal diameter. A modified Hadlock's formula for fetal weight was employed, using the biparietal diameter, abdominal circumference and femur length, which was not associated with any significant systematic error. Individual curves were obtained by fitting serial fetal weight estimates and birth weight in a weighted log‐polynomial model for fetal growth. The overall growth formula showed an almost linear relationship between gestational age and fetal weight at term. Maternal height and weight at the first hospital visit were positively correlated with fetal weight in the third trimester. The fetuses of parous women were also heavier in late pregnancy, as were those of European compared to Indo‐Pakistani mothers. Intrauterine weight gain in the third trimester shows variation with pregnancy characteristics which need to be considered when fetal growth is assessed. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Resolving polyhydramnios: clinical significance and subsequent neonatal outcome
Authors: Hill L. M. , Lazebnik N. , Many A. , Martin J. G. 
Published: March 2003

AbstractThe objective of this study was to determine the clinical significance and neonatal outcome of patients with polyhydramnios that subsequently resolved prior to delivery. A retrospective review of 275 cases of polyhydramnios, defined as an amniotic fluid index of ≥ 25.0 cm, identified 41 cases in which the amniotic fluid volume returned to normal prior to delivery.A total of 40 out of 41 patients with resolving polyhydramnios had a mild to moderate excess of amniotic fluid. There was a significant difference in the distribution of neonatal delivery weights between the study group and a matched control group. Twelve of 41 (29.3%) neonates from the study vs. none of the neonates in the control group were large for gestational age (p < 0.001). A total of 21 of 41 patients (51.2%) in the study group vs. three of 41 (7.3%) patients in the control group had at least minimal glucose intolerance (p < 0.01).We conclude that patients with resolving polyhydramnios have a significantly higher prevalence of glucose intolerance and fetal macrosomia than patients with normal pregnancies. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of ectrodactyly: the ‘lobster claw’ anomaly
Authors: Leung K. Y. , MacLachlan N. A. , Sepulveda W. 
Published: March 2003

AbstractEctrodactyly is a rare condition characterized by absence of digits, ranging from single absence of a finger to the split hand/foot deformity. This anomaly has been reported as sporadic and in association with a number of genetic and non‐genetic syndromes, such as the autosomal dominant ectrodactyly and the ectrodactyly‐ectodermal dysplasia‐cleft palate (EEC) syndromes. In this report we present two cases of ectrodactyly prenatally diagnosed by ultrasonography during the second trimester of pregnancy. Routine examination of fetal hands and feet during secnd‐trimester ultrasonography should make the detection of hand and foot malformations more frequent. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal ultrasonographic diagnosis of fetal hepatic hyperechogenicities: clinical significance and implications for management
Authors: Achiron R. , Seidman D. S. , Afek A. , Malinger G. , Lipitz S. , Mashiach S. , Goldman B. , Yagel S. 
Published: March 2003

AbstractThe clinical significance of sonographically detected fetal hepatic hyperechogenicities has not been fully established. The aim of this study was to assess various aspects of fetal hepatic hyperechogenicities detected in utero, including natural history, prenatal investigation and pregnancy outcome.In a retrospective survey of pregnant women presenting to the ultrasonographic unit, five fetuses with a mean gestational age of 20 weeks (range 14–24 weeks) were antenatally diagnosed as having hepatic hyperechogenicities. All cases underwent extensive investigation to establish the etiology and to determine the spectrum of ultrasonographic presentation. In three fetuses, only parenchymal lesions were found, while two had combined lesions: parenchymal and peritoneal. The earliest prenatal ultrasonographic diagnosis was made at 14 weeks' gestation in a fetus with combined hyperechogenic lesions, which, at 12 weeks' gestation, demonstrated unexplained fetal ascites. Associated abnormalities were found in only one fetus in which a solitary parenchymal lesion was associated with direct communication of the intra hepatic portion of the umbilical vein with the right atrium, and high output cardiac failure. In this case, termination of pregnancy confirmed ischemic hepatic necrosis. In the other four cases, no direct etiology could be determined, and all four pregnancies continued to term with normal neonatal follow up until 12 months of age. The present data suggest that in cases of fetal hepatic hyperechogenicities, where apparent intrauterine infection or neoplasia can be ruled out, a vascular disruption phenomenon is a putative etiology. If there are no associated morphological abnormalities or abnormal karyotypes, the prognosis may be favorable. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Color Doppler analysis in lean and obese women with polycystic ovary syndrome
Authors: Battaglia C. , Artini P. G. , Genazzani A. D. , Sgherzi M. R. , Salvatori M. , Giulini S. , Volpe A. 
Published: March 2003

AbstractThe objective of this study was to determine whether obese patients with polycystic ovary syndrome (PCOS) show different ovarian and uterine blood flow patterns in comparison with lean patients.Sixteen obese (body mass index: BMI = 31.4 ± 3.4 kg/m²) and 22 lean (BMI = 21.1 ± 1.3 kg/m²) PCOS patients underwent, in the early follicular phase if oligomenorrheic or randomly if amenorrheic, ultrasonographic evaluation of ovarian volume, echodensity and follicle number; transvaginal color Doppler evaluation of uterine and intraovarian blood flow; and radioimmunological assay of luteinizing hormone, follicle stimulating hormone, growth hormone, estradiol, progesterone, testosterone, androstenedione, insulin, insulin‐like growth factor I, and other hormonal parameters. Hematocrit, plasma glucose, total cholesterol, high density lipoprotein and triglycerides were also evaluated.Insulin levels were significantly higher in the obese group, whereas levels of growth hormone were significantly lower. Moreover, a more adverse lipid profile was observed in overweight patients. This was associated with higher hematocrit values. At Doppler analysis, a significantly higher mean uterine artery pulsatility index (PI) was observed in the obese group. Furthermore, the PI was inversely correlated with high density lipoprotein values (r = −0.4820; p <0.05). In both groups, androstenedione was correlated with the uterine PI.The above findings may, in part, explain the increased risk in women with PCOS of developing cardiovascular diseases, and emphasize that obesity may further increase the risk. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Tamoxifen and the uterus: an old drug tested by new modalities
Authors: Achiron R. , Grisaru D. , Golan‐Porat N. , Lipitz S. 
Published: March 2003

AbstractTamoxifen has been widely used in the treatment of breast cancer. The effects on the uterus include epithelial metaplasia, hyperplasia and even carcinoma. Transvaginal sonography has been used for visualization of endometrial changes during tamoxifen treatment. However, its use has disclosed that the drug may cause cystic changes in the subendometrial zone without epithelial pathology. Therefore, other sonographic techniques have been suggested for the evaluation of the patient receiving tamoxifen treatment, among them saline contrast hysterosonography and endometrial blood flow studies. These new modalities provide us with tools to evaluate the effect of tamoxifen on the endometrium, prior to the decision to perform invasive procedures. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Esophageal and duodenal atresia in a fetus with Down's syndrome: prenatal sonographic features
Authors: Chitty L. S. , Goodman J. , Seller M. J. , Maxwell D. 
Published: March 2003

AbstractUltrasound examination of a 22‐week fetus demonstrated a grossly distended stomach and proximal duodenum, with a large cystic area in the chest. There was associated poly‐hydramnios. A presumptive diagnosis of duodenal atresia with a congenital diaphragmatic hernia was made. Analysis of a fetal blood sample showed that the fetus had Down's syndrome. Histological examination after termination of the pregnancy revealed the unusual combination of duodenal and esophageal atresia, with an intact diaphragm. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
The onset of inter‐human contacts: longitudinal ultrasound observations in early twin pregnancies
Authors: Arabin B. , Bos R. , Rijlaarsdam R. , Mohnhaupt A. , van Eyck J. 
Published: March 2003

AbstractTwin pregnancies provide us with the opportunity to observe first reactions towards touch in utero, and this study illustrates the onset and development of these contacts. Forty women with twin pregnancies volunteered to take part in this study, 25 of whom (five monochorionic, 20 dichorionic pairs) fulfilled the inclusion criteria. Between 8 and 12 weeks' gestation, ultrasound examinations were performed transvaginally, and from 13 weeks onwards transabdominally, at weekly intervals. Ultrasound findings were recorded on videotapes and were analyzed retrospectively. The first contacts producing reactions in the co‐twin were defined as primary contacts, which could be slow or fast arm/leg/bead/body contacts. Primary contacts followed an action‐reaction model, and usually lasted < 3 s. These contacts were initially slow and then became fast. The first reactions of the co‐twin towards touch were observed at 65 postmenstrual days. Contacts of longer duration between both bodies including extremities, or contacts initiated by sucking movements towards the co‐twin were defined as complex contacts and were observed from 85 and 92 postmenstrual days, respectively. Nearly all contacts occurred significantly earlier in monochorionic compared to dichorionic twins. Female/female pairs seemed to develop complex body contacts earlier than male/male pairs, but for the onset of other contacts we have not yet found significant differences between gender combinations. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Triphasic umbilical venous blood flow with prolonged survival in severe intrauterine growth retardation: a case report
Authors: Baschat A. A. , Gembruch U. 
Published: March 2003

AbstractWe report a case of a singleton pregnancy with severe intrauterine growth retardation diagnosed at 24 + 0 weeks' gestation. Pulsed wave Doppler sonography revealed unilateral elevation of the pulsatility index with a diastolic notch in one uterine artery in association with reversed end‐diastolic flow in the umbilical artery. From 24 + 3 weeks onwards there were pathological indices in the descending aorta, inferior vena cava and ductus venosus, with biphasic pulsatile flow in the umbilical vein, while indices in the middle cerebral artery were normal. Coronary blood flow was demonstrated in both coronary arteries with the use of color‐coded and pulsed wave Doppler sonography. The clinical course was marked by minimal growth and persistence of pathological venous indices. At 29 + 3 weeks' gestation the venous flow pattern in the umbilical vein was noted to be triphasic pulsatile. At this time there was cardiac dilatation with tricuspid and mitral insufficiency. The parents did not want active management and intrauterine fetal death was diagnosed at 30 + 4 weeks' gestation. This case illustrates the fact that prolonged intrauterine survival, despite highly pathological Doppler indices in the venous and arterial circulation, is possible, indicating the extreme adaptability of some fetuses with early onset intrauterine growth retardation. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Fetal diaphragmatic hernia presented with transient unilateral pleural effusion
Authors: Lau T. K. , Fung H. Y. M. , Fung T. Y. 
Published: March 2003

AbstractIsolated fetal pleural effusion is rare. A good outcome of 100% survival rate can be expected in cases of spontaneous resolution of the anomaly in utero. If resolved, they are usually not associated with any structural abnormality. We report a case of diaphragmatic hernia presenting as isolated unilateral pleural effusion which resolved spontaneously. This has important implications for the management of isolated fetal pleural effusion. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology