bluuebunny/crossref_metadata_2025_split huggingface dataset:
Braxton‐Hicks contractions can alter uteroplacental perfusion
Authors: Bower S. , Campbell S. , Vyas S. , McGirr C. 
Published: March 2003

AbstractColor flow imaging was used to study the effect of spontaneous low‐amplitude uterine contractions (Braxton‐Hicks) on flow velocity waveforms obtained from the main uterine artery in 13 women between 26 and 34 weeks' gestation. Eight women had abnormal waveforms, as defined by the presence of an early diastolic notch, and five women had normal waveforms. In the former group, three women with chronic hypertension were started on the calcium antagonist nifedipine during this study. Contractions, which were monitored by external tocography, occurred more frequently in the group with abnormal waveforms and were temporally associated with an increase in impedance to blood flow. This effect occurred to the same degree in both normal and abnormal groups, but in the abnormal group the already impaired blood flow to the intervillous space was further diminished, resulting in absence of forward flow in diastole. Such acute reductions of flow in response to frequent, impalpable uterine contractions may cause a prolonged and silent insult to uteroplacental perfusion, which could hasten fetal compromise. This effect appeared to be abolished in patients on nifedipine, suggesting a possible therapeutic role for this drug in uteroplacental insufficiency. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Sonographic depiction of postmenopausal endometrium with transabdominal and transvaginal scanning
Authors: Nasri M. N. , Shepherd J. H. , Setchell M. E. , Lowe D. G. , Chard T. 
Published: March 2003

AbstractThe thickness of the endometrium was measured in postmenopausal women by both the transvaginal and transabdominal ultrasound approaches in two separate groups of patients. The first group consisted of 90 women who received a transabdominal scan of the endometrium before dilatation and curettage or hysterectomy for either postmenopausal bleeding or uterine prolapse. The second group consisted of 111 women who underwent a transvaginal scan of the endometrium for similar postmenopausal conditions.Both methods suggested that an endometrial thickness of 5 mm may be used as a cut‐off level in the conservative management of patients with postmenopausal bleeding or in a screening program for endometrial carcinoma.Patient acceptance and image quality were better in the group examined transvaginally. The proximity of the transvaginal probe to the endometrium, in the absence of a full bladder compressing the endometrium, revealed a unique group of patients with atrophic endometrium but thick endometrial cavity caused by intracavity fluid. In the presence of uterine fibroids distorting the uterine cavity, transvaginal scanning was better than transabdominal scanning for visualizing the endometrium. The transabdominal full‐bladder technique can be of value in detecting asymptomatic bladder pathology. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
Relationship between fetal acidemia at cordocentesis and subsequent neurodevelopment
Authors: Soothill P. W. , Ajayi R. A. , Campbell S. , Ross E. M. , Candy D. C. A. , Snijders R. M. , Nicolaides K. H. 
Published: March 2003

AbstractTo determine whether there is a relationship between chronic fetal acidemia and subsequent neurodevelopment, a follow‐up study was undertaken of 36 children with normal karyotype and morphology, who had prenatal cordocentesis for severe growth retardation. The main outcome measure was the Griffiths neurodevelopmental quotient. The children who had acidemia as fetuses (n = 13) had a significantly lower developmental quotient (mean = 91.8, SD = 6.3) than those with normal (n = 23) fetal blood pH (mean = 100.3, SD = 10.3; t = −2.68, p = 0.011). There was also a significant correlation between developmental quotient and the degree of fetal acidemia (r = 0.41, n = 36, p = 0.012). The pregnancies with acidemic fetuses had similar epidemiological characteristics to those with fetuses with a normal pH, except for a higher incidence of smoking. There was no significant correlation between the degree of growth retardation (birth weight expressed as multiples of SD from the mean for gestational age and sex) and fetal acidemia (r = −0.23, n = 36, NS) or subsequent Griffiths developmental quotient (r = −0.005, n = 36, NS).The results show an association between chronic fetal acidemia and subsequent impaired neurodevelopment. This observation suggests that future preventative interventions may be possible. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
Ectopic pregnancy: transvaginal sonographic findings of 152 cases
Authors: Ekici E. , Yapar E. G. , Gökmen O. , Danişman N. , Özmen S. 
Published: March 2003

AbstractIn a retrospective study performed on 152 cases of verified ectopic pregnancy, the features at transvaginal sonography were evaluated. A total of 146 (96%) of the patients had at least one abnormal sonographic feature and pelvic/cul‐de‐sac fluid was the most common finding, detected in all of the 146 patients. Pelvic/cul‐de‐sac fluid was particulate in 103 patients and simple in 43. Pelvic/cul‐de‐sac fluid together with extrauterine findings were found to be present in 93.8% (137/146) of the patients, suggesting the fact that if pelvic/cul‐de‐sac fluid was detected, every effort should be made to image the tube. The extrauterine transvaginal sonographic features included 102 (63.0%) patients with a mass, 60 (41.1%) with a gestational sac (with or without yolk sac or embryo), and eight (5.3%) with a living embryo. Comparison of the sonographic findings according to the status of the ectopic pregnancy revealed that particulate fluid (98.9%), and an extra‐uterine mass (88.2%) were the features that aided in the diagnosis of ruptured and aborted ectopic pregnancies, whereas an extrauterine gestational sac (72.9%), and a living embryo (11.9%) were associated with intact ectopic pregnancies. Our findings support the practice of using transvaginal sonography, and ß‐human chorionic gonadotropin measurements in the diagnosis and prediction of the status of ectopic pregnancy. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Routine ultrasonography in utero and speech development
Authors: Salvesen K. Å. , Vatten L. J. , Bakketeig L. S. , Eik‐Nes S. H. 
Published: March 2003

AbstractThe purpose of this paper is to examine a possible association between prenatal ultrasonography and delayed speech among children. A follow‐up study was carried out on primary school children born to women who took part in two randomized controlled trials of routine ultrasonography during pregnancy. Of 2428 eligible singletons, 2161 (89%) were followed up with a parental questionnaire and with information from maternal and child health centers. Parents assessed the development of speech during the childhood years and reported their observations in a questionnaire. Maternal and child health center records provided data on the children's development of speech and any referrals of children to a speech therapist. No significant differences between ultrasound‐screened children and their controls were found in the parental assessment of speech development. According to health center records, screened children were less likely to be referred to a speech therapist (odds ratio, 0.51; 95% confidence interval 0.31, 0.85), but there were no other significant differences in speech development as reported in the health center records. We conclude that routine ultrasonography in utero is not associated with delayed speech in children. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Characteristics of follicular evacuation during human ovulation
Authors: Hanna M. D. , Chizen D. R. , Pierson R. A. 
Published: March 2003

AbstractOur objectives were to determine the rate and extent of follicular evacuation during human ovulation. Female volunteers were given 5000 or 10 000 IU human chorionic gonadotropin to induce ovulation when a follicle reached 18–20 mm. Ovulations were observed via transvaginal ultrasonography and recorded. Images were digitized for computer‐assisted analysis. Areas of the follicles, taken to reflect follicular volume, were measured at specific time intervals from the moment of the first leakage of fluid until complete follicular evacuation. Twenty‐five ovulations were visualized. In 23 cases (92%) all of the follicular fluid was expelled, but in two cases the follicle failed to empty completely. In all complete ovulations the initial fluid loss was rapid. The time to reach 70% evacuation was 0.9 ± 0.3 min (± SEM). The remaining fluid leaked out more slowly; the mean time to complete follicular evacuation was 6.1 ± 1.1 min. There was considerable variability in the rates of ovulation (range 6 s to 18.5 min). An association was observed between the type of stigma formed prior to ovulation and the initial rate of fluid loss. The data provide evidence of variability during follicular evacuation, which may in turn influence the successful expulsion of the oocyte from the follicle. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
The head‐to‐abdomen circumference ratio: a reappraisal
Authors: David C. , Gabrielli S. , Pilu G. , Bovicelli L. 
Published: March 2003

AbstractOur objective was to assess the clinical significance of the sonographically derived head‐to‐abdomen circumference ratio in small‐for‐gestational‐age (SGA) fetuses. The head‐to‐abdomen ratio was determined in 134 singleton SGA fetuses without ultrasound evidence of malformations at 26–40 weeks' gestation. Data were collected regarding antenatal surveillance, umbilical artery Doppler velocimetry and neonatal outcome.In SGA fetuses, the head‐to‐abdomen ratio, adjusted for gestational age, had a normal frequency distribution, positively skewed with regard to fetuses with normal birth weight. An elevated head‐to‐abdomen ratio was found in 56 SGA fetuses (42%), and was associated with increased perinatal mortality (odds ratio 3.27; 95% confidence internal 1.04–9.34), lower birth weight (1533 ± 635 g vs. 2022 ± 655 g, p < 0.0001) and lower gestational age at delivery (34 ± 3.6 weeks vs. 36.3 ± 3.6 weeks, p < 0.005). However, logistic regression revealed that the most powerful antenatal determinants of pregnancy outcome were Doppler velocimetry of the umbilical artery, followed by biophysical profile, while no independent correlation was found with the head‐to‐abdomen ratio.The existence of two distinct categories of SGA fetuses, ‘symmetric’ and ‘asymmetric’, remains uncertain. An elevated head‐to‐abdomen ratio is an adverse risk factor for pregnancy outcome. However, this parameter has no clear‐cut clinical value when umbilical artery Doppler velocimetry and biophysical antenatal testing are available. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Biometry of the fetal cisterna magna: estimates of the ability to detect trisomy 18
Authors: Steiger R. M. , Porto M. , Lagrew D. C. , Randall R. 
Published: March 2003

AbstractMeasurements of the fetal cisterna magna were obtained from a prospective sample of patients undergoing diagnostic obstetric ultrasound examinations. These normal measurements were then compared to a retrospective sample of ultrasound scans from fetuses with the diagnosis of trisomy 18 by amniocentesis. The fetal cisterna magna increases in size throughout pregnancy. The sample from fetuses with trisomy 18 was different and had a higher rate of small and large cisterna magnas. After the two samples were mixed, it was determined that a cut‐off of 2.5 standard deviations for the fetal cisterna magna would give a sensitivity of 26.3%, specificity of 99.1%, positive predictive value of 50.0% and negative predictive value of 97.6% for trisomy 18. The probability that a fetal cisterna magna of abnormal size will predict trisomy 18 in an early second‐trimester ultrasound examination with the 2.5 standard deviation cut‐off was estimated at 0.019. A fetal cisterna magna that is of abnormal size appears to be of diagnostic value in identifying the fetus with trisomy 18, but its sensitivity is low. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Isolated pericardial effusion: an indication for fetal karyotyping?
Authors: Sharland G. , Lockhart S. 
Published: March 2003

AbstractThe outcome and associations of 35 consecutive cases of isolated pericardial effusion detected in the fetus are presented. In all cases included in the study, there was no evidence of a structural abnormality or a rhythm disturbance detectable antenatally. Karyotyping revealed that 26% of cases had trisomy 21 and 31% of the total had some form of chromosomal anomaly. Our study shows that the outlook for isolated pericardial effusion is good. However, there is a high incidence of associated karyotypic anomalies, in particular trisomy 21. Fetal karyotyping is therefore recommended in these cases. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Prognostic value of transvaginal sonography in asymptomatic endometrial cancers
Authors: Osmers R. G. W. , Osmers M. , Kuhn W. 
Published: March 2003

AbstractIn the period between 1985 and 1991, 83 postmenopausal women with endometrial cancer were examined by transvaginal sonography. None of them were on hormone replacement therapy and all had amenorrhea of more than 2 years. Twenty‐two were asymptomatic and had an endometrial cancer detected by transvaginal sonography and 61 showed atypical bleeding as their only clinical symptom.Women with asymptomatic endometrial cancers detected by transvaginal sonography exhibited significantly less mean myometrial tumor infiltration and more well‐differentiated tumors than those with atypical bleeding (4 mm and 45% compared with 10 mm and 18%, respectively). In 75% of the cases the estimation by transvaginal sonography of tumor stage completely agreed with the histological staging.These preliminary data show that asymptomatic endometrial cancers screened by transvaginal sonography are likely to have a better prognosis than symptomatic cancers. Furthermore, transvaginal sonography can be used as a reliable tool for tumor staging prior to surgery or radiotherapy. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
The length of human pregnancy as calculated by ultrasonographic measurement of the fetal biparietal diameter
Authors: Kieler H. , Axelsson O. , Nilsson S. , Waldenströ U. 
Published: March 2003

AbstractPregnancy length was calculated from ultrasonic measurement of the fetal biparietal diameter (BPD) in the second trimester and compared with the corresponding length calculated from the last menstrual period (LMP) in 86.5 women with exactly 28‐day cycles and spontaneous onset of labor. The effects of maternal age, parity, smoking and sex of the child on BPD‐based pregnancy length were evaluated in 1998 women with spontaneous onset of labor. The mean pregnancy length was 280.6 days when based on BPD and 283.4 days when based on LIMP. The corresponding median values were 281 days and 284 days, respectively. Probably because of more preterm deliveries, women below 20 years of age had a significantly shorter pregnancy length than women 20–34 years of age. Women carrying girls had a significantly shorter pregnancy length than women carrying boys. There was a tendency to shorter pregnancy lengths among multiparae and among smokers. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal sonography in suspected pelvic inflammatory disease
Authors: Taipale P. , Tarjanne H. , Ylöstalo P 
Published: March 2003

AbstractTransvaginal sonography was used in the evaluation of clinically suspected pelvic inflammatory disease (PID). A total of 86 patients with PID were examined by transvaginal sonography within l‐3 days, 14 days and 90 days after hospitalization. The diagnosis of PID was confirmed in 37% of patients by laparoscopy, laparotomy or positive cervical culture of Chlamydia trachomatis or Neisseria gonorrhoea. In the remainder, the diagnosis was based on tenderness of the uterus, fever and lower abdominal pain that responded rapidly to antibiotics. At the time of admission, 31% of patients had a thick‐walled (≥ 5 mm) echogenic tube raising the suspicion of pyosalpinx or pyo‐ovary. During the following 3 months, 52% of patients developed tubes that were thin‐walled (< 5 mm) and poorly echogenic, and hydrosalpinx was suspected. At the first transvaginal sonographic examination, 64% showed no adnexal mass, but 16% of these developed suspected hydrosalpinx during the following 3 months. Of the total of 86 patients, 6% exhibited a hydrosalpinx for the first time after 3 months. C‐reactive protein concentrations and sedimentation rate values correlated positively with the ultrasonically determined volumes of pyosalpinx/pyoovaries, cul‐de‐sac fluid and ovaries. Transvaginal sonography appears to be very useful in the diagnosis of suspected PID and is recommended at least 3 months after symptoms have subsided for those patients with an adnexal mass at the time of the acute episode and for infertile patients. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Fetal inguinoscrotal hernia: prenatal diagnosis and pathogenetic evaluation
Authors: Paladini D. , Palmieri S. , Morelli P. M. , Forleo F. , Morra T. , Salviati M. , Zampella C. , D'Angelo A. , Martinelli P. 
Published: March 2003

AbstractCongenital inguinal hernias, relatively common among infants, have rarely been reported in utero. In this brief report, the prenatal diagnosis of this condition based on movement of the intestinal content within the ileal loops is described. The differential diagnosis with other masses protruding from the abdominal wall (omphalocele) or the perineal region (sacrococcygeal teratoma, hydrocele) is discussed. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Penetration of the bladder by a perforating intrauterine contraceptive device: a sonographic diagnosis
Authors: Caspi B. , Rabinerson D. , Appelman Z. , Kaplan B. 
Published: March 2003

AbstractWe describe a case of penetration of the urinary bladder by an intrauterine contraceptive device with perforation of the uterine wall. This finding was discovered incidentally during an ultrasound examination for an earlier non‐specific mild abdominal pain of short duration. No abnormality had been noted on pelvic examination, during which the device's strings were found to protrude through the patient's cervix; a short laboratory workup including urinalysis, urine culture, blood count and blood sedimentation rate was also negative. The sonographic diagnosis was confirmed by cystoscopy. The device was retrieved transcervically. No complications were observed on follow‐up.Bladder perforation by an intrauterine contraceptive device is very rare, and only a handful of such cases have been described. In all previous cases, the diagnosis followed a rather prominent clinical presentation, whereas, in this case, the patient complained of intermittent low abdominal pain of short duration. We therefore suggest that pelvic ultrasound examination be performed in every patient with unexplained low abdominal pain who is known to carry an intrauterine contraceptive device. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Patterns of perinasal fluid flow and contractions of the diaphragm in the human fetus
Authors: Badalian S. S. , Fox H. E. , Zimmer E. Z. , Fifer W. P. , Stark R. I. 
Published: March 2003

AbstractOur aim was to identify patterns of fetal perinasal fluid flow, and to determine the relationship of pattern of flow to the diaphragmatic component of fetal breathing movements. Twenty‐four fetuses were studied with the use of two ultrasound systems simultaneously. Continuous video‐tape records of the color and spectral Doppler imaging of fluid flow velocity in the nose and of the movements of the fetal diaphragm were made on two video recorders during 30‐min study sessions. Two different patterns of fetal perinasal flow were recognized. One type had a rapid rate and low amplitude, and was independent of ultrasonographically observed movements of the fetal diaphragm. The other type had a lower rate and higher amplitude, and was uniformly related to diaphragmatic contractions. The breath‐to‐breath interval, time of inspiration, time of expiration and peak inspiratory and expiratory velocities were determined for each type of perinasal flow. Two ratios were used to quantify the change of peak flow velocity. There were significant differences in the values of all timing parameters between diaphragm‐related perinasal flow velocities and those not related to the diaphragm, at both 30–36 and 37–41 weeks of gestation. The rate of perinasal flow related to diaphragmatic contraction cycles was one‐third that of the flow cycles not related to diaphragmatic contraction (approximately 50 vs. 148 cycles/min). For both patterns of perinasal flow velocity, the expiratory peak velocity ratio was about 1.6 times higher than the inspiratory peak velocity ratio.We conclude that, in uncomplicated pregnancy, one pattern of fetal perinasal fluid flow reflects activity of the diaphragm. We speculate that the contractions of the fetal airway smooth muscle or oropharyngeal‐laryngeal muscle groups are the origin of the second pattern of perinasal flow. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Abnormal fetal aortic velocity waveform and minor neurological dysfunction at 7 years of age
Authors: Ley D. , Laurin J. , Bjerre I. , Marsal K. 
Published: March 2003

AbstractMeasurements of fetal aortic blood flow velocity and fetal growth were performed in 178 pregnancies. In 87 cases, the estimated fetal weight was ≥ 2 SD below the gestational age‐related mean of the population. Three fetuses died in utero. In 149 children (85%), a neurological examination was performed at 7 years of age with special emphasis on minor neurological dysfunction. The frequency of the more severe form of minor neurological dysfunction, MND‐2, was higher in the group with blood flow class (BFC) III (absent or reversed end‐diastolic flow velocity (8/21) than in the group with BFC 0 (normal velocity waveform) (14/105). Logistic regression analysis revealed that abnormal blood flow class, both independently and in combination with other factors, was the most significant predictor of MND‐2.The association found between abnormal fetal aortic velocity waveforms and adverse outcome in terms of minor neurological dysfunction suggests that hemodynamic evaluation of the fetus has a predictive value regarding postnatal neurological development. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology