bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous wave Doppler velocimetry of the main‐stem uterine arteries: the transvaginal approach
Authors: Weissman A. , Jaffa A. J. , Lurie S. , Har‐Toov J. , Peyser M. R. 
Published: March 2003

AbstractThe purpose of the study was (1) to establish the efficacy of the transvaginal approach for continuous wave Doppler velocimetry of the main‐stem uterine arteries in normal pregnancy and (2) to provide reference values for the flow velocity waveform indices of the main‐stem uterine arteries in normal pregnancy. In a cross‐sectional study from 16 to 40 weeks of pregnancy, 201 healthy normal women were examined by transvaginal continuous wave Doppler, and flow velocity waveforms were obtained from the main branch of the uterine artery on both sides. Nomograms were compiled for the systolic : diastolic ratio, pulsatility index and resistance index. Values for all variables declined during the course of pregnancy until 22 weeks' gestation, and then remained stable to term. Intra‐ and interobserver variations were 5% and 8%, respectively, and the examination time was < 5 min. Flow velocity waveform indices declined during pregnancy, indicating a decrease of resistance in the uteroplacental circulation. Our results are comparable to those obtained transvaginally by pulsed wave Doppler, previously reported in the literature, The transvaginal approach for continuous wave Doppler velocimetry of the main‐stem uterine arteries is a simple, quick, accurate, safe, cheap and highly reproducible method, and is therefore suitable for evaluating the uteroplacental circulation. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Differentiation between adenomyoma and leiomyoma with transvaginal ultrasonography
Authors: Huang R.‐T. , Chou C.‐Y. , Chang C.‐H. , Yu C.‐H. , Huang S.‐C. , Yao B.‐L. 
Published: March 2003

AbstractThe clinical utility of transvaginal ultrasonography in the differentiation of adenomyoma from leiomyoma was evaluated in 147 patients who had been scheduled for surgery due to symptomatic uterine masses. In all subjects, ultrasonographic images obtained preoperatively were correlated postoperatively with surgicopathological findings. Pathological findings showed that 110 patients proved to have fibroids, while 30 had adenomyomata. For the diagnosis of adenomyoma, transvaginal ultrasonography attained a sensitivity of 80%, a specificity of 94.3%, a positive predictive value of 85.7% and a negative predictive value of 90.9%, compared with a sensitivity of 94.3%, a specificity of 80%, a positive predictive value of 90.9% and a negative predictive value of 85.7(H) for leiomyoma diagnosis.Further to assess which characteristic used in ultrasonography was useful in the differential diagnosis, five characteristics were analyzed and compared by χ² test. These were position, number, margin and echogenicity of the uterine masses and the presence or absence of hypoechoic spaces (lacunae). Margin, echogenicity, mass number and lacunae were significantly different between both conditions. A stepwise logistic regression procedure revealed that margin, lacunae and echogenicity were good parameters for differentiating adenomyoma from leiomyoma. If we selected the features of distinct margin and absence of hypoechoic lacunae within the masses for analysis, leiomyoma could be correctly predicted in 97% of patients. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Trisomy 18: first‐trimester nuchal translucency with pathological correlation
Authors: Jackson S. , Porter H. , Vyas S. 
Published: March 2003

AbstractDiagnosis of trisomy 18 was made following prenatal screening at 11 weeks' gestation for ultrasonographically detected nuchal translucency and subsequent chorionic villus sampling. An intact fetus was therapeutically aborted and pathological examination was undertaken. We conclude that, although the etiology of nuchal translucency remains unclear, it does not appear to be lymphatic or cardiac in origin. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of a congenital astrocytoma: a case report and literature review
Authors: Heckel S. , Favre R. , Gasser B. , Christmann D. 
Published: March 2003

AbstractCongenital intracranial tumors are very rare. We report an endovaginal ultrasonographic diagnosis of an anaplastic astrocytoma at 31 weeks' gestation. Other means, such as antenatal magnetic resonance imaging and fetal blood sampling were not shown to have any diagnostic advantage. A detailed literature review of the topic is provided. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasound evaluation of the length of the fetal nasal bones throughout gestation
Authors: Guis F. , Ville Y. , Vincent Y. , Doumerc S. , Pons J. C. , Frydman R. 
Published: March 2003

AbstractSubtle facial abnormalities, including smallness of the nose, are common findings in trisomy 21 and numerous other genetic conditions. The aim of this study was to construct a normal range for the length of the fetal nasal bones with gestation in a Caucasian population. Ultrasound measurements were performed on a strictly mid‐sagittal profile in 376 normal singleton fetuses at 14–34 (mean 24) weeks' gestation. It was found that the length of the nasal bones increased from 4 mm at 14 weeks to 12 mm at 35 weeks' gestation, and that there was a linear relationship between the length of these bones and biparietal diameter and femur length. We conclude that the length of nasal bones can easily be measured in fetuses at 14–34 weeks' gestation and that such measurements might prove useful in the evaluation of pregnancies at high risk for associated fetal abnormalities. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Centile‐based ultrasound morphometric tables
Authors: Lauria M. R. , Zador I. E. , Bottoms S. F. 
Published: March 2003

AbstractCurrent ultrasound morphometric tables estimate centiles assuming normal distribution and similar variation throughout gestation. Our goal was to develop normative tables for biparietal diameter, femur length and average abdominal diameter using actual centiles. We studied the last complete ultrasound examination from 9510 singleton, live pregnancies without major malformations delivered at our hospital. Actual 5th, 10th, 50th, 90th and 95th centiles were calculated for each week and compared to estimates based on means and standard deviations.With advancing gestational age, variation in average abdominal diameter increased and variation in biparietal diameter and femur length remained stable. The largest difference between an actual and an estimated centile limit was 2 mm for biparietal diameter or femur length and 3 mm for average abdominal diameter. Differences between true and estimated centile limits were less than the intraobserver variation of the ultrasound measurements and therefore clinically unimportant. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Effects of thyrotropin releasing hormone on cardiac and extracardiac flows of appropriately grown and growth‐retarded fetuses
Authors: Rizzo G. , Capponi A. , Rinaldo D. , Arduini D. , Romanini C. 
Published: March 2003

AbstractThe objective of this study was to establish the effect of thyrotropin releasing hormone on the fetal circulation of appropriately grown and growth‐retarded fetuses. Doppler recordings were performed immediately before and 15 min after maternal administration of 400 µg of thyrotropin releasing hormone in 14 women with appropriately grown and 19 with growth‐retarded fetuses. Furthermore, in six women with growth‐retarded fetuses, serial recordings were performed at 2‐hourly intervals for 8 h until a second thyro tropin releasing hormone dose was administered. Velocity waveforms were recorded from the outflow tracts, inferior vena cava, umbilical artery, middle cerebral artery and descending aorta, and different Doppler indices calculated. In appropriately grown fetuses, thyrotropin releasing hormone induced a significant increase of peak systolic velocity values in the aorta and pulmonary artery and an increase of Doppler‐estimated cardiac output. In growth‐retarded fetuses, these changes were more evident and associated with a significant decrease in reverse flow in the inferior vena cava during atria1 contraction. No changes were observed in fetal heart rate or in the other fetal vessels investigated. In the growth‐retarded fetuses followed longitudinally, these changes were evident for the following 8 h and were potentiated by the second thyrotropin releasing hormone administration. In conclusion, thyrotropin releasing hormone induces significant hemodynamic effects on the fetal heart that may temporarily improve the impaired cardiac function of growth‐retarded fetuses. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
B‐mode color sonographic images in obstetrics and gynecology: preliminary report
Authors: Dambrosio F. , Amy D. , Colombo A. 
Published: March 2003

AbstractThe standard B‐mode image shows 256 levels of gray, but the human eye can only differentiate 8–16 shades of gray. Color vision theoretically has several advantages in comparison with gray scale, because the human eye can distinguish 128 fully saturated hues and about 350 000 shades. In 1992, B‐mode color maps were introduced in our clinical practice, to establish whether this technology was able to detect the smallest contrast differences better than the gray‐scale map and therefore to increase diagnostic accuracy. This paper describes our experience with the technique and reports B‐mode color images of clinical complications in obstetrics and gynecology. We use the color figures to illustrate this new technology and to demonstrate the advantages of the increased sensitivity of the human eye to color in different clinical situations. We conclude that the use of B‐mode color maps does not change the ultrasonic diagnosis, but does enhance our ability to study and evaluate the morphological structure of different tissues, compared to the gray‐scale map alone. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Fetal exomphalos and chromosomal defects: relationship to maternal age and gestation
Authors: Snijders R. J. M. , Sebire N. J. , Souka A. , Santiago C. , Nicolaides K. H. 
Published: March 2003

AbstractIn an ultrasound screening study involving 15 726 viable, singleton pregnancies at 11–14 weeks of gestation, exomphalos was diagnosed in 0.11% of the cases and, in those with exomphalos, the frequency of trisomy 18, trisomy 13 or triploidy was 61%. The corresponding frequencies of exomphalos of fetuses with these chromosomal defects were 22.5%, 9.1% and 12.5%, respectively. The median maternal age of the screened population was 33 (range 15–48) years, which is higher than in all pregnancies in England and Wales. Expected prevalences of trisomy 18, trisomy 13 and triploidy in the total population were derived on the basis of the age distribution of all deliveries in England and Wales and maternal and gestational age‐specific risks for these chromosomal defects. From these numbers and the observed frequencies of exomphalos in association with the various chromosomal defects, it was estimated that the prevalence of exomphalos in a population with the maternal age distribution of all deliveries in England and Wales was 7.4 per 10 000 at 12 weeks of gestation, and this decreased to 3.5 at 20 weeks and 2.9 in live births. The estimated frequency of chromosomal defects in fetuses with exomphalos decreased from 39.4% at 12 weeks of gestation to 27.5% at 20 weeks and 14.4% in live births. The prevalence of chromosomal defects in 153 fetuses with exomphalos referred to our center at 16–26 (median 20) weeks of gestation was not significantly different from that predicted in an unselected population. However, the reported frequency of chromosomal defects in a total of 299 neonates with exomphalos (9.3%) was significantly lower than expected in an unselected population. This study demonstrates that the prevalence of a fetal abnormality and the frequency of associated chromosomal defects depends on the maternal age and gestational age distributions of the populations examined. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Uterine flow velocity waveform shape as an indicator of maternal and placental development failure mechanisms: a model‐based synthesizing approach
Authors: Talbert D. G. 
Published: March 2003

AbstractHigh pulsatility indices ( PIs) and/or notches on the Doppler flow velocity waveforms of the uterine artery have been interpreted as indications of high placental flow impedance, and are known to be associated with poor fetal outcome. A software model of the uteroplacental blood path and its use to investigate possible interactions within the uteroplacental unit in more detail are described.Increasing transcotyledonary resistance to represent intervillous obstruction raised the cotyledonary core pressure and spiral artery PI. Increased spiral artery flow resistance, representing failed spiral artery invasion, reduced the cotyledonary core pressure and reduced the spiral artery PI. In vivo, such changes in cotyledonary core pressure would modify the transplacental water balance, promoting oligohydramnios for spiral artery invasion failure and polyhydramnios for villous obstruction. Both mechanisms increased the uterine and arcuate PI, but failed to produce a notch.It was found that notch formation depended on terms representing increased compliance (distensibility) of the uterine and/or arcuate artery walls, which have no direct effect on uteroplacental mean flow. The same mechanism steepened and increased uterine artery peak systolic flow, contributing to increased PI.The notch phenomenon seems to be an indicator of abnormal maternal artery wall status, independent of placental obstructive mechanisms, which can mask obstructive PI changes. Computer analysis of the frequency index profile should allow separation. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
In utero sonographic diagnosis of vesicoureteral reflux by percutaneous vesicoinfusion
Authors: Quintero R. A. , Johnson M. P. , Arias F. , Cortez K. , Carreño C. , Romero R. , Evans M. I. 
Published: March 2003

AbstractVesicoureteral reflux affects approximately 1% of newborns. Although most affected children show only sonographic evidence of renal pelvic dilatation, others may show overt hydronephrosis, indistinguishable from that seen in fetuses with obstructive uropathy. Hydronephrosis secondary to fetal vesicoureteral reflux cannot be differentiated on ultrasound examination from that resulting from lower obstructive uropathy with or without reflux. As renal damage from vesicoureteral reflux may occur in up to 70% of cases, early identification and possible in utero treatment of these fetuses may be warranted. We report a sonographic technique, vesicoinfusion, for diagnosis of vesicoureteric reflux in utero. The accurate identification of vesicoureteral reflux in utero may have important diagnostic, prognostic and therapeutic implications. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Transcervical chorionic villus sampling beyond 12 weeks of gestation
Authors: Borrell A. , Costa D. , Delgado R. D. , Fuster J. J. , Soler A. , Cararach J. , Fortuny A. 
Published: March 2003

AbstractThe aim of this study was to evaluate the feasibility of transcervical chorionic villus sampling (CVS) after 12 completed weeks of pregnancy. The transcervical route for CVS, using thin biopsy forceps, was accomplished in 335 procedures in the study group, between 22 + 1 and 15 + 0 weeks. Cases were subdivided into two subgroups, the late (13 + 0 to 15 + 0 weeks) and intermediate (12 + 1 and 12 + 6 weeks) subgroups, and the results were compared with a previous series of 1202 early (8 + O−12 + 0 weeks) transcervical CVS.A successful diagnosis was made in 97.3% of the cases. No differences were found in diagnostic success between the study subgroups, in comparison to the early transcervical CVS series. However, success rates in the study group increased from 90% in the first 60 procedures to 98.9% in the remaining cases (p < 0.001). Amniocentesis was eventually performed in nine cases (2.7%). All cases were rescanned 2 weeks after the procedure, and fetal demise was detected in five cases (1.5%). The spontaneous fetal loss rate up to 28 weeks was 3.1% (2.7% for intermediate and 4.0% for late subgroups). No cases of transverse limb reduction defects were observed.The results of our study suggest that the transcervical route for CVS beyond the 12th week of pregnancy has a satisfactory diagnostic success rate, and an acceptable pregnancy loss rate. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal sonography vs. hysteroscopy in the preoperative staging of endometrial carcinoma
Authors: Gabrielli S. , Marabini A. , Bevini M. , Linsalata I. , Falco P. , Milano V. , Zantedeschi B. , Bovicelli A. , Stagnozzi R. , Cacciatore B. , Gubbini G. , Bovicelli L. 
Published: March 2003

AbstractThe aim of this study was to evaluate the diagnostic accuracy of transvaginal sonography vs. hysteroscopy in the preoperative staging of endometrial carcinoma, in order to establish the most appropriate surgical therapy. Transvaginal sonography and hysteroscopy were used preoperatively in 67 women with histologically proven endometrial carcinoma.Deep myometrial invasion (> 50%) was present at post‐operative pathology in 26/67 (39%) women and spread to the cervix occurred in 1 l/67 (14%) women. Transvaginal sonographic examination was initially directed at assessing myometrial invasion, which was correctly predicted in 52/67 (78%) women. Transvaginal sonography demonstrated a sensitivity of 88% (23/26) and a specificity of 71% (29/41) for deep invasion, with a positive predictive d p value (PPV) of 66% (23/35) and a negative predictive value (NPV) of 91% (29/32).The accuracy of transvaginal sonography in detecting cervical involvement was 82% (55/67), and that of hysteroscopy was 72% (48/67): transvaginal sonography was slightly less sensitive (54% vs. 64%), but more specific (87% vs. 73%) than hysteroscopy. When cervical invasion was present, the PPVs of transvaginal sonography and hysteroscopy were 46% (6/13) and 32% (7/22), respectively, while the NPV was 91% for both techniques (49/54; 41/45). Our data show that the accuracy of transvaginal sonography was comparable with that of hysteroscopy in detecting cervical involvement. Therefore, in the majority of cases, when both techniques showed that disease was limited, the appropriately limited type of surgery would be performed. Conversely, detection of a myometrial invasion of B 50% or an extension to the cervix would lead to an unnecessarily extensive operation if this was the sole criterion used for making the decision. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of left ventricular aneurysm in the late second trimester: a case report
Authors: Sherman S. J. , Leenhouts K. H. , Utter G. O. , Litaker M. , Lawson P. 
Published: March 2003

AbstractFetal echocardiography in a 24‐year‐old woman at 24 weeks' gestation: demonstrated a left ventricular aneurysm and pericardial effusion. The patient was treated with oral digoxin followed by intensive antepartum monitoring. Intrauterine fetal demise occurred at 31 weeks. The autopsy confirmed the presence of an apical left ventricular aneurysm. This is a rare congenital cardiac anomaly, which has been reported in only three prior cases. This represents the earliest prenatal diagnosis of this condition. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal uterine and umbilical artery Doppler examination of 12–16 weeks and the subsequent development of pre‐eclampsia and intrauterine growth retardation
Authors: Harrington K. , Goldfrad C. , Carpenter R. G. , Campbell S. 
Published: March 2003

AbstractWe aimed to determine whether Doppler measurements obtained from the uterine and umbilical arteries in early pregnancy correlate with the subsequent development of pre‐eclampsia, or the delivery of a small‐for‐gestational‐age (SGA) baby. A follow‐up study was carried out in 652 women with singleton pregnancies who had transvaginal uterine and umbilical artery Doppler examinations performed at 12–l6 weeks' gestation. Measurements included: the presence or absence of an early diastolic notch, vessel diameter, resistance index (RI), pulsatility index (PI), time‐averaged mean velocity (TAV), maximum systolic velocity and volume flow in the right and left uterine arteries and RI and PI in the umbilical arteries. The main outcome measures were: intrauterine death, birth weight, pre‐eclampsia (proteinuric pregnancy‐induced hypertension, PPIH) and antepartum hemorrhage.Twelve pregnancies terminated in the second trimester, and in 14 the outcome is unknown. In the remaining 626 women, 44 (7.0%) pregnancies ended in a premature delivery, 30 (4.7%) women developed PPIH, 60 (9.6%) infants were SGA (< 10th centile), of which 19 were < 5th centile and five were < 3rd centile, and 23 (3.7%) women suffered an antepartum hemorrhage. At 12–16 weeks, 205 (32.7%) women had bilateral (right and left) notching of the uterine artery waveforms. When compared to values from women with a normal pregnancy outcome, women who subsequently developed PPIH demonstrated a significant difference in mean uterine artery TAV (24.6 cm/s for PPIH vs. 33.25 cm/s for normal outcome, p < 0.003),volume flow (120.5 ml/min vs. 184.5 ml/min, p < 0.001) and elevated resistance (mean RI = 0.80 vs. 0.695, p < 0.001). In women with bilateral notching, there were significant differences between values for pregnancies with PPIH (odds ratio (OR) 42.02, 9.5% confidence interval(CI) 5.66, 311.99), being SGA at birth (OR: 8.61, 95% CI 4.0, 20.0) or delivering prematurely (OR 2.38, 95% CI 1.19,4.75), compared with pregnancies with a normal outcome.We conclude that abnormal Doppler values, indicative of a failure to modify the uterine circulation in early pregnancy, are associated with premature delivery, the development of PPIH and the delivery of an SGA baby. This information may be of value in increasing our understanding of the pathophysiological events that lead to the subsequent development of uteroplacental complications such as pre‐eclampsia. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Cutaneous hemangioma of the thigh: prenatal diagnosis
Authors: Gonçalves L. F. , Pereira E. T. , Parente L. M. M. , Vitorello D. A. , Barbosa U. C. , Neto J. Abi Saab 
Published: March 2003

AbstractWe report a case of cutaneous hemangioma of the thigh detected by prenatal ultrasound. A hypoechoic homogeneous mass, filled with low‐density echoes, was visualized on the posterior aspect of the right thigh, close to the genital region, at 36 weeks. Low‐velocity arterial flow was detected within the mass by color and pulsed Doppler and the diagnosis of cutaneous hemangioma was suspected. No other anomalies were detected and the pregnancy evolved uneventfully to term. The prognosis and management of this condition are discussed. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology