bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transvaginal sonography and serum hCG in monitoring of presumed ectopic pregnancies selected for expectant management
Authors: Cacciatore B. , Korhonen J. , Stenman U.‐H. , Ylöstalo P. 
Published: March 2003

AbstractWe studied sonographic findings and levels of human chorionic gonadotropin (hCG) in 71 patients with a presumed ectopic pregnancy, recruited for conservative management, to find out whether these parameters may be useful in monitoring treatment. Patients were selected on the basis of decreasing hCG levels, minimal symptoms and an adnexal mass, suggestive of ectopic pregnancy, of ≤ 5 cm at transvaginal sonography. In 49 (69%) patients the ectopic pregnancy resolved spontaneously: the adnexal mass resolved significantly more slowly than did hCG levels. In 22 (31%) of the cases laparoscopy was required after an average of 9 days, because of worsening clinical symptoms. The initial size of the ectopic pregnancy did not significantly differ between the two groups, but it increased constantly in the laparoscopy group. The number of patients with free pelvic fluid also increased significantly in the laparoscopy group, whereas blood flow patterns at admission and during follow‐up did not differ between the two groups. A decrease in ectopic pregnancy size at day 7 had a sensitivity of 84% and a specificity of 100% in predicting spontaneous resolution. Transvaginal sonography monitoring appears useful in recognizing the ectopic pregnancies most likely to resolve spontaneously without complications. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Interobserver agreement in the results of Doppler examinations of extrauterine pelvic tumors
Authors: Sladkevicius P. , Valentin L. 
Published: March 2003

AbstractThe aim of this study was to evaluate interobserver agreement in the results of Doppler measurements of peak systolic velocity (PSV), time‐averaged maximum velocity (TAMXV) and the color content of tumor scans in extrauterine pelvic tumors. The results of transvaginal color and spectral Doppler examinations of 66 extrauterine pelvic masses obtained by two observers experienced in ultrasonography were compared. Each observer aimed to obtain the highest possible Doppler shift from arteries in the wall, septa and solid parts of each tumor. Tumor vascularization was assessed in terms of the ‘tumor color score’, i.e. the color content of the Doppler scan as rated for the tumor as a whole by each observer on a visual analog scale. The tumors were classified according to arbitrarily chosen cut‐off limits for the tumor color score, the highest tumor TAMXV and the highest tumor PSV. Inter‐class correlation coefficient values for TA MXV and PSV were ≥ 0.75, whereas that for tumor color score was 0.89. Interobserver agreement was complete for the detection of color in tumors (Kappa value 1.0), excellent for the recording of arterial Doppler shift spectra from tumors (Kappa value 0.82)) and moderate or good for classifying tumors based on cut‐off limits for TAMXV, PSV (Kappa values ranging from 0.44 to 0.67) and tumor color score (Kappa values ranging from 0.59 to 0.66). Despite the fact that two observers did not obtain the same absolute values for TAMXV, PSV or tumor color score, the interobserver agreement in the classification of tumors based on cut‐off limits for these variables was good. Therefore, in terms of reproducibility, it should be possible to use Doppler measurements of TAMXV, PSV and tumor color score as clinical variables to characterize extrauterine pelvic masses. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Measuring the thickness—is that all we have to do for sonographic assessment of endometrium in postmenopausal women?
Authors: Weigel M. , Friese K. , Strittmatter H.‐J. , Melchert F. 
Published: March 2003

AbstractFor sonographic assessment of the endometrium in postmenopausal women, measurement of the maximum thickness is used in many cases as the sole criterion. The cut‐off values stated in the literature, however, vary considerably. This prospective study examined 200 female patients in order to ascertain the value of echomorphology in addition to endometrial biometry.Up to an overall endometrial thickness of 3 mm, we observed only histologies without any pathological findings, whereas from an endometrial thickness of 10 mm upwards, only polyps, hyperplasias and carcinomas were found. In more than a third of our patients, the endometrial thickness was between 3 and 10 mm where the structure of the endometrium could reflect the possible histological finding. homogeneity, low echo and a sonographically depictable central echo between symmetrical endometrial leaves were an indication for absence of pathological findings, whereas heterogeneity and high echogenicity were pointers for pathological changes.In contrast to the sole measurement of endometrial thickness in the postmenopause, the combined metric and morphological parameters improve not only the predictability of pathological findings but, above all, the selectivity of the vaginosonographic assessment of the endometrium in postmenopausal women. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
The effect of feedback on anxiety levels during ultrasound scanning for ovarian cancer
Authors: Tadmor O. P. , Zlotogorski Z. , Galron‐Duniec M. L , Rabinowitz R. , Neuman M. , Beller U. , Diamant Y. Z. 
Published: March 2003

AbstractWomen undergoing ultrasound scanning for the detection of ovarian cancer benefit psychologically from the examination, which has been shown to reduce levels of anxiety, depression, hostility and complaints about somatic symptoms. However, it is not completely clear what aspects of the ultrasound examination are responsible for these effects, and how these beneficial psychological effects vary under different circumstances. This study examined, in particular, the effect of various levels of feedback on patients' anxiety levels before and after ultrasound examination.Two hundred and seven women were randomly assigned to two different experimental conditions: high feedback and low feedback. The subjects' levels of anxiety (both trait and state anxiety) were measured immediately before and after the ultrasound examination. The women's individual risk factors for ovarian cancer were also recorded.This study showed a significant decrease in the level of trait anxiety following ultrasound scanning. The decrease in anxiety did not relate to the level of feedback provided to the patients, nor to the woman's degree of risk for ovarian cancer. The results are discussed in terms of possible implications for clinical care and the allocation of resources in the medical system. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Normal fetal pulmonary venous blood flow velocity
Authors: Laudy J. A. M. , Huisman T. W. A. , de Ridder M. A. J. , Wladimiroff J. W. 
Published: March 2003

AbstractOur objectives were to describe the normal pulmonary venous blood flow velocity waveform and to establish reference ranges for the second half of pregnancy in healthy human fetuses. A total of 123 women with uncomplicated pregnancies of between 20 and 40 weeks were examined, using a combined color‐coded Doppler and two‐dimensional real‐time ultrasound system. Pulsed Doppler flow velocity waveforms of pulmonary venous drainage into the left atrium were obtained from a transverse cross section of the fetal chest at the level of the cardiac four‐chamber view. All waveforms were obtained during fetal apnea.The success rate in obtaining the pulmonary venous waveform was 81%. The waveform displayed a biphasic forward flow profile with a systolic and diastolic component. Peak systolic, peak diastolic and time‐averaged velocities demonstrated a gestational age‐related rise, whereas the peak systolic/peak diastolic ratio showed a gestational age‐related reduction. The nature of the fetal pulmonary venous flow velocity waveform pattern suggests positive pressure towards the left atrium throughout the cardiac cycle. We speculate that an increase in volume flow and the pulmonary venous pressure gradient play a role in the gestational age‐related changes in pulmonary venous flow velocities. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Impact of prenatal mid‐trimester screening on the prevalence of fetal structural anomalies: a prospective epidemiological study
Authors: Papp Z. , Tóh‐Pál E. , Papp Cs. , Tóz Z. , Szabó M. , Veress L. , Tórók O. 
Published: March 2003

AbstractThe objective of this study was to evuluate the effectiveness of the measurement of maternal serum α‐fetoprotein (MSAFP) at 16 weeks and a subsequent routine ultrasound screening at 18–20 weeks' gestation and the impact on the birth prevalence of congenital structural anomalies in an unselected pregnant populution of Hungary in a prospective epidemiological study.A total of 63 794 pregnant women (representing one‐sixth of the population of Hungary) were offered this screening program over 3 years (1988–90). Of the pregnant population, 75.7% (48 312) received MSAFP screening and in 81.0% (51675), at least one ultrasound scan was performed.In the screened pregnancies, 496 craniospinal, thoracoabdominal, urogenital and other severe major anomalies occurred: 317 were detected at 18–20 weeks (sensitivity 63.1%; specificity 100.0%; positive predictive vulue 100.0%). The sensitivity of ultrasound scanning was significantly higher (p < 0.05) than that of the MSAFP screening. (At the time of ultrasound scanning the MSAFP value was known.)In this study, the less serious anomalies such as hydrocele, hypospadius and undescended testicle were not systematically searched for, but the birth prevalences were calculated. The overall mid‐trimester prevalence of severe plus less severe major anomalies was 2.26%.The birth prevalences of severe major anomalies were 0.57 (craniospinal), 4.36 (thoracoabdominal and urogenital) and 1.21 (other severe) per 1000. These values were lower than the mid‐trimester prevalences which were 2.94, 5.20 and 2.06 per 1000, respectively. The prevalence values at the age of 1 year were also calculated (0.36, 2.21, 0.54 per 1000, respectively).We conclude that our screening program with availability of termination of, pregnancy could significantly (p < 0.05) reduce the prevalence of severe major abnormalities at birth. Training programs in cardiac scanning are required. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Assessment of myometrial infiltration and preoperative staging by transvaginal ultrasound in patients with endometrial carcinoma
Authors: Weber G. , Merz E. , Bahlmann F. , Mitze M. , Weikel W. , Knapstein P. G. 
Published: March 2003

AbstractIn recent years, the incidence of carcinoma of the endometrium has shown an upward trend, such that it is currently the most frequently encountered malignant tumor of the female genital tract. An accurate preoperative diagnosis of the extent and spread of such carcinomas is of crucial importance for the selection of a therapeutic approach appropriate to the stage and infiltration of each particular tumor.In a prospective study of 80 patients with a carcinoma of the endometrium, performed at the Department of Obstetrics and Gynecology of the University of Mainz, we compared the preoperative findings of transvaginal sonography with the postoperative histological results with respect to the following parameters: endometrial thickness, demarcation of the boundary of the endometrium, myometrial infiltration depth and staging.In all of these patients, sonography revealed a distinct increase in the thickness of the endometrium. In all cases, the structure of the endometrium was found to be heterogeneous, with an irregular and poorly delineated boundary. Assessments of the depth of tumor infiltration and the tumor staging obtained by transvaginal sonography were found to correlate with the histological findings in 85% and 87.5% of the cases, respectively. Thus, in cases of endometrial carcinoma, transvaginal sonography has an essential role to play in devising an individualized operative treatment program that takes into account the extent, spread and stage of the tumor. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Extrauterine twin‐twin transfusion syndrome after birth in conjoined twins
Authors: Shyu M.‐K. , Shih J.‐C. , Lee C.‐N. , Wu C.‐C. , Jou H.‐J. , Hsieh F.‐J. , Chang M.‐H. , Tsou Yau K.‐I. , Teng R.‐J. , Lin G.‐J. , Li Y.‐W. 
Published: March 2003

AbstractCross‐circulation of conjoined twins in utero has been demonstrated and the extent of its severity has varied. Significant ‘extrauterine’ twin‐twin transfusion syndrome after birth, however, caused by an unbalanced shunting within the circulation has not been reported. In a case of omphalopagus conjoined twins complicated by hypovolemia in one twin and hypervolemia in the other, we demonstrated by color Doppler imaging an aberrant vessel from the hepatic artery of one twin to the hepatic vein of the other. Unbalanced shunting through this aberrant vessel was suspected and urgent separation of the conjoined twins was undertaken. Circulatory changes after birth leading to ‘extrauterine twin‐twin transfusion syndrome’ are discussed. A possible explanation of the pathophysiology of intrauterine twin‐twin transfusion syndrome is also given. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of a chest wall hamartoma and sternal cleft
Authors: Rose N. C. , Coleman B. G. , Wallace D. , Gaupman K. , Ruchelli E. 
Published: March 2003

AbstractWe present the prenatal evaluation and diagnosis of a disorganized chest wall hamartoma (with underlying sternal cleft in a family with a prior offspring with the VATER association. The possibility that these conditions are linked to mesodermal defects with a common pathogenic etiology is suggested. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
The significance of non‐visualization of the fetal bladder during an ultrasound examination to evaluate second‐trimester oligohydramnios
Authors: Brumfield C. G. , Guinn D. , Davis R. , Owen J. , Wenstrom K. , Mize P. 
Published: March 2003

AbstractOur objective was to determine the pregnancy outcome after targeted sonography performed for the evaluation of second‐trimester oligohydramnios fails to visualize the fetal bladder. A retrospective review identified patients in 1990–94 who were referred for targeted sonography from 16 to 24 weeks to evaluate oligohydramnios. The ultrasound records and photographs from the initial examination were reviewed and compared to later pregnancy outcome data obtained by reviewing delivery and neonatal records, neonatal renal ultrasound reports or autopsy information.Complete outcome data were available in 98 patients. The fetal bladder was not visualized in 29 patients (30%). Post‐delivery analysis of the fetal urinary tract was performed in 25 patients either by autopsy or by neonatal renal ultrasound scanning. A severe anatomic malformation of the urinary system was present and had been detected by targeted sonography in 23 of 25 cases (92%). The remaining two fetuses were found to have anatomically normal urinary tracts at autopsy, but other pathological findings suggested that a functional derangement of the urinary system had led to non‐visualization of the bladder at ultrasound examination.Non‐visualization of the fetal bladder during targeted sonography to evaluate oligohydramnios indicates a severe anatomic or functional problem of the fetal urinary tract. In our study, this ultrasound finding was associated with universal fetal or neonatal death. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
The effect of amniotic sheet orientation on subsequent maternal and fetal complications
Authors: Lazebnik N. , Hill L. M. , Many A. , Martin J. G. 
Published: March 2003

AbstractThe purpose of this investigation was two‐fold, first, to determine the incidence of amniotic sheets in our obstetric population; and, second, to elucidate the maternal and fetal complications associated with this particular finding.In this retrospective study, we searched the computerized records of the ultrasound department for the presence of amniotic sheets, in singleton pregnancies from 1 March 1991 to 17 September 1993. Sonograpbic criteria for an amniotic sheet included the findings that (1) a reflective membrane attached to the placenta at one end or the other, with measurable thickness, was identified traversing the amniotic fluid; and (2) the fetus was not attached to the membrane, and fetal ability to move without restriction was ascertained.An amniotic sheet was identified in 79 of 17 553 examinations (0.45%) performed between 12 and 28 weeks' gestation. Two subsets of amniotic sheets were identified: perpendicular and not perpendicular. The sheets in the first subset were orientated perpendicular to the placental surface and were more likely to be associated with an abnormal presentation at delivery (p < 0.001) and a history of pelvic inflammatory disease, but not with a history of prior Cesarean section, or previous dilatation and curettage. The second subset of amniotic sheets were non‐perpendicular, either oblique or parallel, in orientation to the placental surface and were associated with fewer maternal complications. Of the study group, 40.7% had a history of vaginal bleeding. The incidence of vaginal bleeding was not significantly different between those patients with perpendicular or those with non‐perpendicular amniotic sheets.We conclude that perpendicular, in contrast to non‐perpendicular, amniotic sheets are more commonly associated with breech presentation art term and a past history of pelvic inflammatory disease. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Is the fetal brain‐sparing effect a risk factor for the development of intraventricular hemorrhage in the preterm infant?
Authors: Mari G. , Abuhamad A. Z. , Keller M. , Verpairojkit B. , Ment L. , Copel J. A. 
Published: March 2003

AbstractThe intrauterine identification of fetuses at risk of developing intraventricular hemorrhage would be helpful to the perinatologist, in light of the recent results which suggest that indomethacin given to the infant reduces the risk of developing intraventricular hemorrhage. We hypothesized that fetuses undergoing brain sparing, as identified by a lowered pulsatility index (PI) in the middle cerebral artery, and delivered prior to 34 weeks may differ in terms of being at risk for intraventricular hemorrhage from those fetuses without the brain‐sparing effect.The middle cerebral artery PI was studied in 43 fetuses between 25 and 33.6 weeks' gestation. The pregnancies were complicated by pre‐eclampsia, intrauterine growth restriction (IUGR) and preterm labor. A cranial sonogram was performed during the first postnatal week in all the neonates.Intraventricular hemorrhage was present in 6/22 infants with a normal middle cerebral artery PI (group A) and 0/21 with an abnormal middle cerebral artery PI (group B) (p < 0.05). The mothers of the six fetuses who developed intraventricular hemorrhage underwent preterm labor. IUGR fetuses and pre‐eclampsia were more common in group B. No difference was found between the two groups when the following variables were compared: (1) gestational age at the time of the Doppler study; (2) gestational age at delivery; (3) antenatal exposure to steroids; (4) antenatal exposure to magnesium; (5) Apgar score greater than 6 at 5 min; (6) respiratory distress syndrome in the newborn; (7) necrotizing enterocolitis; (8) Cesarean section; and (9) sepsis in the infant.Although the mean birth weight was significantly lower in group B than group A, no fetus in this group developed intraventricular hemorrhage. The fetal brain‐sparing effect, pre‐eclampsia and IUGR were associated with a lower risk of neonatal intraventricular hemorrhage than was preterm labor. Preterm labor appears to be a key factor in the development of intraventicular hemorrhage and must be included when testing associations with intraventricular hemorrhage. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
The relationship between preoperative endometrial thickness, the anteroposterior diameter of the uterus and clinical outcome following transcervical resection of the endometrium
Authors: Istre O. , Forman A. , Bourne T. H. 
Published: March 2003

AbstractThe objective of this study was to identify whether the endometrial thickness, or the anteroposterior diameter of the uterus as assessed by transvaginal ultrasonography (TVS), could be used to predict the clinical outcome following transcervical resection of the endometrium (TCRE).An open observational trial was carried out, involving 195 consecutive patients undergoing TCRE, 188 of whom completed follow‐up. The patients were examined by TVS preoperatively, and then 6 weeks, 6 months and 1 year following TCRE. In all examinations, endometrial thickness, the anteroposterior diameter and residual endometrium, uterine morphology and the clinical outcome as measured by pain reduction, bleeding index and amenorrhea were assessed.Patients with a preoperative endometrial thickness of 8 mm or less had a higher rate of amenorrhea after 1 year than patients with an endometrial thickness exceeding 8 mm. Outcome did not relate to the histological phase of the endometrium obtained during resection. Neither the uterine anteroposterior diameter, or the presence of submucous fibroids, had any influence on the clinical outcome. Cavity fluid was observed in some cases but was not always associated with symptoms. Residual endometrium could be detected by TVS in 38% of the women after 1 year, but the vast majority of these patients reported a satisfactory outcome from the procedure.We conclude that the size of the anteroposterior diameter does not affect the clinical outcome of TCRE, whilst the preoperative endometrial thickness does have a significant impact on the likelihood of achieving amenorrhea after 1 year. The data suggest that TCRE should preferably be performed when the endometrium is at its thinnest and that there may be a useful role for agents that produce endometrial atrophy prior to surgery. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal color Doppler sonography in predicting the response to chemotherapy in advanced cervical cancer
Authors: Greco P. , Cormio G. , Vimercati A. , Loverro G. , Selvaggi L. 
Published: March 2003

AbstractThe role of Doppler ultrasonography in the diagnosis of advanced cervical cancer continues to be controversial. This study was designed to assess the clinical value of the technique in terms of predicting the response to chemotherapy in patients with advanced cervical cancer.Twenty‐three patients with cancer of the cervix (FIGO stages Ib bulky‐IIIb) and 20 healthy women underwent transvaginal color Doppler assessment of the uterine arteries (both ascending and descending branches) and the intracervical vessels. Statistical analysis was performed by Student's t test for paired and unpaired data.The intracervical vessels were the only site to show significant differences both in the resistance and in velocity parameters. A subgroup of 14 patients, scheduled for neoadjuvant chemotherapy, were evaluated before and at the completion of treatment. A significant increase in resistance and pulsatility index values and a decrease in peak systolic velocity were observed in the ten patients who responded to chemotherapy.Preliminary results of our study suggest that Doppler parameters can be clinically useful in the evaluation of the response to neoadjuvant chemotherapy. More patients, sampled in a prospective way in order to increase the number of non‐responders, would be necessary to assess the possible role of Doppler ultrasound in predicting which patients will respond to chemotherapy. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology