bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uterine artery blood flow parameters in women with dysfunctional uterine bleeding and uterine fibroids: the effects of tranexamic acid
Authors: Lakhani K. P. , Marsh M. S. , Purcell W. , Hardiman P. 
Published: March 2003

AbstractThe objective of this study was to investigate the effects of tranexamic acid on uterine vascular resistance in women with dysfunctional uterine bleeding and in women with menorrhagia associated with fibroids.A longitudinal, prospective study was carried out in premenopausal women referred to a gynecological out‐patient department with a complaint of menorrhagia. We studied 24 women with dysfunctional uterine bleeding (mean age 38.8 years; normal ultrasound examination, hysteroscopy and endometrial biopsy) and 12 women (mean age 42.8 years) with at least one fibroid greater than 2.0 cm on ultrasound examination. None were on any form of oral contraception or other medication which could influence uterine vascular resistance. All women had normal coagulation and thyroid function tests.Transvaginal scanning was performed using an Aloka SSD 650 machine with a 5‐MHz probe and pulsed Doppler. Pulsatility index (PI) and resistance index (RI) were measured from the left and right uterine arteries before and during the second month of treatment with tranexamic acid (1 g orally three times a day). Menstrual blood loss was assessed using a validated pictorial blood chart.In women with dysfunctional uterine bleeding, the mean PI and RI fell significantly with treatment (PI 2.20–1.94, p = 0.0001; RI 0.81–0.77, p = 0.003). There was a reduction of approximately 30% in menstrual blood loss with treatment (210.0–137.6 ml, p = 0.0001). In women with uterine fibroids, there was no significant change in either the PI or the RI with treatment and there was no significant reduction in menstrual blood loss.We conclude that tranexamic acid significantly reduces uterine artery vascular resistance in women with dysfunctional uterine bleeding. This effect is unlikely to be a mechanism for the action of tranexamic acid in reducing menstrual blood loss but may have important implications for women taking this treatment in the long term. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
An evaluation of sonohysterography and diagnostic hysteroscopy for the assessment of intrauterine pathology
Authors: Schwärzler P. , Concin H. , Bösch H. , Berlinger A. , Wohlgenannt K. , Collins W.P. , Bourne T. H. 
Published: March 2003

AbstractThe availability of advanced hysteroscopic surgical techniques has changed the management of abnormal uterine bleeding. The aim of this study was to evaluate the use of transvaginal sonography (TVS), sonohysterography (SH) and diagnostic hysteroscopy (DH) for the preoperative assessment of the uterine cavity. The plan was to investigate 100 patients with abnormal uterine bleeding despite conventional medical treatment. The endpoints were uterine abnormalities detected by operative hysteroscopy and histology, and subjective estimates of discomfort during TVS and SH. A total of 104 patients (aged 26–79 years) were recruited and 98 (94%) underwent all three diagnostic procedures. Uterine abnormalities were present in 52 patients (53%). There were 25 cases with at least one endometrial polyp, 17 with submucous fibroids, seven with endometrial hyperplasia and three with an adenocarcinoma. The overall sensitivity of TVS improved after SH from 67 to 87% and the specificity from 89 to 91%. The positive predictive value increased from 88 to 92% and the negative predictive value from 71 to 86%. The use of SH also improved the quality of information about the location and size of polyps and submucous fibroids. Increased endometrial thickness associated with adenocarcinoma was detected in all cases (three of three) by TVS and in four of seven cases of hyperplasia (five of seven cases after SH). Most patients reported minor discomfort during TVS or SH and no side‐effects were apparent. The sensitivity of DH was 90% (92% for polyps, 88% for fibroids); two cases with a polyp, two with a submucous fibroid and one with endometrial hyperplasia were not detected. The use of saline infusion to enhance visualization of the endometrium increases the diagnostic accuracy of transvaginal sonography to approach that of diagnostic hysteroscopy and also provides some additional information. This development has implications for the management of uterine bleeding disorders. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Comparison of umbilical artery Doppler velocimetry between maternal supine position and complete left lateral position in predicting obstetric complications
Authors: Ryo E. , Okai T. , Takagi K. , Okuno S. , Sadatsuki M. , Kaneko M. , Taketani Y. 
Published: March 2003

AbstractThe aim of this study was to compare the predictive value of umbilical artery Doppler velocimetry in women in the supine position with that in women in the complete left lateral position as a screening test for abnormal obstetric outcomes. Umbilical artery resistance index (RI) was measured at 27–29 weeks and 35–37 weeks in 202 pregnant women. The measurements were performed with the mother in the supine position in 100 cases (supine group), and in the complete left lateral position in 102 cases (lateral group). Predictive values of the tests for abnormal outcomes (small for gestational age, fetal distress, pregnancy‐induced hypertension) were compared between both groups. When abnormal RIs were defined as being greater than the 90th centile in the supine group, the sensitivities for any of the abnormal outcomes at 27–29 weeks were 18% in the supine group and 6% in the lateral group; the positive predictive values were 30% and 25%, respectively. For measurement at 35–37 weeks, the sensitivity and positive predictive value were 29% and 45%, respectively in the supine group, and 0% in both cases in the lateral group. When abnormal RIs were defined as being greater than the 90th centile in the lateral group, the sensitivities at 27–29 weeks were 41% in the supine group and 6% in the lateral group; the positive predictive values were 44% and 8%, respectively. At 35–37 weeks, the sensitivity and positive predictive value were 53% and 43% in the supine group, and 6% and 8% in the lateral group. Umbilical artery Doppler velocimetry when the mother was in the complete left lateral position was of little value as a screening test. However, when the mother is in the supine position, it may serve as a kind of stress test and disclose latent obstetric abnormalities in certain cases. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Age‐adjusted ultrasound risk assessment for fetal Down's syndrome during the second trimester: description of the method and analysis of 142 cases
Authors: Nyberg D. A. , Luthy D. A. , Resta R. G. , Nyberg B. C. , Williams M. A. 
Published: March 2003

AbstractObjectiveTo describe and test a method of individual risk assessment for fetal Down's syndrome based on maternal age and second‐trimester ultrasound findings.DesignA case–control study of 142 fetuses with Down's syndrome was compared with 930 control fetuses with normal karyotype. All patients underwent second‐trimester ultrasound at a single institution with a standardized ultrasound protocol without knowledge of fetal karyotype. Age‐adjusted ultrasound risk assessment (AAURA) for Down's syndrome was performed by multiplying the a priori risk, based on maternal age, with likelihood ratios resulting from the presence or absence of specific ultrasound findings for each patient. Individual ultrasound findings were assigned likelihood ratios (LR) as follows: structural abnormality (LR 25), nuchal thickening (LR 18.6), echogenic bowel (LR 5.5), shortened humerus (LR 2.5), shortened femur (LR 2.2), echogenic intracardiac focus (LR 2), and renal pyelectasis (LR 1.6). A normal ultrasound was assigned a LR of 0.4.ResultsOne or more ultrasound markers were identified in 68.3% (97) of fetuses with Down's syndrome compared to 12.5% of fetuses with normal karyotype. Among fetuses with positive ultrasound, 31% of those with Down's syndrome and 80% of those with normal karyotype showed a single non‐structural finding. Using AAURA and a threshold of 1 : 200, 74% (105 of 142) of fetuses with Down's syndrome were identified, including 61.5% (24 of 39) from women aged less than 35 years, 67.2% (45 of 67) from women aged 35–39 years inclusively, and 100% (36 of 36) from women aged 40 years or older. AAURA of 930 fetuses with normal karyotype showed an overall false‐positive rate of 14.7%, including 4% (21 of 519) from women aged less than 35 years, 12.5% (42 of 337) from women aged 35–39 years inclusively, and 100% from women aged 40 years or older.ConclusionsAAURA permits improved individual counselling regarding the risk of fetal Down's syndrome following a second‐trimester sonogram. For low‐risk women under age 35 years, ultrasound assessment can identify over half of the affected fetuses with Down's syndrome with an acceptable false‐positive rate (4%). For women aged 35–39 years, a normal ultrasound can substantially reduce the risk of unnecessary amniocentesis (12.5% from 100%) but will also miss approximately one‐third of affected fetuses. Biochemical screening of maternal serum is also suggested for this group. Based on their high a priori risk, women aged 40 years or more should consider genetic amniocentesis regardless of a normal ultrasound. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Fetal cardiac measurements derived by transvaginal and transabdominal cross‐sectional echocardiography from 14 weeks of gestation to term
Authors: Shapiro I. , Degani S. , Leibovitz Z. , Ohel G. , Tal Y. , Abinader E. G. 
Published: March 2003

AbstractObjectiveMost of the routine ultrasound screening in our institution consists of early transvaginal examinations at 14–17 weeks. Complete fetal echocardiography is performed in every case. However, normal values for most fetal cardiac structures at this stage of gestation are not available. Our aim was to construct normal ranges for fetal cardiac structures, derived from cross‐sectional echocardiography, at 14–40 weeks of gestation.DesignA prospective study was performed. The study group consisted of 637 pregnant women referred for a routine sonographic examination. Women with abnormal prenatal or postnatal outcome were not included in the study. Transvaginal examinations were used for 14–17 weeks of gestation. More advanced pregnancies were examined transabdominally.ResultsWe constructed normal ranges for the left and right end‐diastolic transverse ventricular diameters (n = 637), left/right ventricular ratio (n = 637), aortic root diameter (n = 637), pulmonary artery diameter (n = 637), aortic/pulmonary ratio (n = 490), left and right transverse atrial diameters (n = 201) and left/right atrial ratio (n = 201).ConclusionsThe results provide the examiner with normal ranges for fetal cardiac structures for the early transvaginal examination. The continuity of all curves from 14 to 40 weeks of gestation allows follow‐up of any specific fetus to term. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasound measurement of the fetal cavum septi pellucidi
Authors: Jou H.‐J. , Shyu M.‐K. , Wu S.‐C. , Chen S.‐M. , Su C.‐H. , Hsieh F.‐J. 
Published: March 2003

AbstractObjectivesTo establish normative data for the width of the fetal cavum septi pellucidi at various gestational ages.Subjects and methods A total of 608 consecutive fetuses between 19 and 42 gestational weeks were included in this prospective study. The largest width of the cavum septi pellucidi was measured by two‐dimensional ultrasound. Piecewise regression analysis was used to study the relationships between the width of the fetal cavum septi pellucidi, gestational age and biparietal diameter.ResultsThe fetal cavum septi pellucidi width increased gradually between 19 and 27 weeks of gestation and then plateaued between 28 weeks and term. Regression analysis revealed significant associations between cavum septi pellucidi width and gestational age, and cavum septi pellucidi width and biparietal diameter.ConclusionsThe present study provides normative data for fetal cavum septi pellucidi width and useful information about the development of the midline brain structure in the fetus. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Fetal gallstones: sonographic and clinical observations
Authors: Suma V. , Marini A. , Bucci N. , Toffolutti T. , Talenti E. 
Published: March 2003

AbstractFetal gallstones were visualized sonographically in two cases at 30 and 37 weeks' gestation; follow‐up scans at 2 and 3 months, respectively, disclosed their spontaneous resolution. The hypotheses advanced to explain the formation of echogenic material in the fetal gallbladder are reviewed, and the clinical utility of postnatal long‐term sonographic follow‐up is stressed. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
The effectiveness of non‐surgical management of early interstitial pregnancy: a report of ten cases and review of the literature
Authors: Hafner T. , Aslam N. , Ross J. A. , Zosmer N. , Jurkovic D. 
Published: March 2003

AbstractObjectiveTo assess the effectiveness of non‐surgical management of interstitial pregnancy.DesignA prospective interventional study.SubjectsEleven women with the ultrasound diagnosis of interstitial ectopic pregnancy.MethodsWomen with suspected early pregnancy complications were examined by transvaginal ultrasound. Those with the diagnosis of interstitial pregnancy were offered non‐surgical treatment with methotrexate, which was administered systemically or by local injection. Follow‐up with regular measurements of ß‐human chorionic gonadoropin and ultrasound scans continued until the pregnancy had resolved completely.ResultsTen women were managed non‐surgically, and one woman opted for surgery. Five women received systemic and five local methotrexate. Local therapy was successful in all five cases (100%), whereas four out of five (80%) women receiving systemic methotrexate were cured. Significant side‐effects were noted in two women following systemic therapy. In comparison, there were no side‐effects in the group of women who received local therapy. There were no significant differences between the two treatment groups in the length of time taken for the pregnancy to resolve.ConclusionsNon‐surgical treatment of interstitial pregnancy with methotrexate appears to be safe and effective. Local administration appears to be more successful and better tolerated by patients and may be used as the first‐line therapy. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of fetal adrenal masses: differentiation between hemorrhage and solid tumor by color Doppler sonography
Authors: Schwärzler P. , Bernard J.‐P. , Senat M.‐V. , Ville Y. 
Published: March 2003

AbstractWe present four cases of fetal adrenal masses detected by routine prenatal ultrasound, of which three were adrenal hemorrhages and one was a fetal neuroblastoma. The differential diagnoses of fetal adrenal mass include adrenal hemorrhage, neuroblastoma, adrenal and cortical renal cysts, pulmonary sequestrations, duplication of the reno‐ureteral system and Beckwith‐Wiedemann syndrome. These can pose a diagnostic and therapeutic dilemma. A systematic comparison of the pre‐ and postnatal sonographic features including color Doppler imaging may help to differentiate adrenal hemorrhage from neuroblastoma prenatally. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Evaluation of the upper uterine cervix by the location of the vesicocervical fold of the urinary bladder to rule out cervical shortening during pregnancy with and without premature contractions
Authors: Shalev J. , Meizner I. , Orvieto R. , Mashiach R. , Vardimon D. , Hod M. , Ben‐Rafael Z. 
Published: March 2003

AbstractObjectivesTo measure the length of the upper and lower cervix, as demarcated anatomically by the lowermost edge of the urinary bladder, in second‐ and third‐trimester pregnancies with and without premature contractions. We hypothesized that patients with active premature contractions have a shorter upper cervix, placing them at greater risk of preterm delivery.MethodsThe lengths of the total cervix and of the upper and lower cervix, separately, and funnelling of the internalos, were assessed by endovaginal ultrasonography. In 120 women with normal pregnancy (43 of which with premature contractions), cervical dilatation and effacement were determined by digital examination. The correlation of cervical variables with the course of pregnancy was analyzed by the Wilcoxon test.ResultsThe mean lengths of the upper and lower cervix were 15.9 ± 1.7 mm (median 16.0 mm) and 26.4 ± 3.7 mm (median 27.0 mm), respectively, in patients without premature contractions and 6.9 ± 3.7 mm (median 6.0 mm) and 24.7 ± 4.7 mm (median 25.0 mm), respectively, in patients with premature contractions. In the latter subgroup, the upper cervix was significantly shorter (p = 0.0001) but the lower cervix remained almost unchanged. Digital palpation was less accurate than transvaginal sonography for evaluating total cervical length.ConclusionsTransvaginal sonography is the method of choice for assessing cervical changes during pregnancy. In this prospective study, upper cervical length was the best predictor of preterm labor of all cervical parameters studied. Its length could be accurately determined by the location of the lowermost edge of the urinary bladder (vesicocervical fold of the bladder). Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
A new photogrammetric method to measure fetal breathing movements
Authors: Florido J. , Cortés E. , Soto V. , Gutiérrez M. 
Published: March 2003

AbstractObjectivesIn most recent studies, fetal respiratory movements have been measured with real‐time and Doppler echography. We describe an alternative approach using photogrammetry that provides more objective measurements.MethodsRespiratory movements were studied in 28 women with uncomplicated pregnancies of 30–38 weeks' gestation. Fetal echographic images were recorded on videotape and digitized to obtain coordinates of the reference point (midpoint on the anterior abdominal wall of the fetus between the xiphoid process and the insertion of the umbilical vessels) and generate graphic representations of fetal movements in the anterior abdomen.ResultsThe mean duration of a complete respiratory cycle was 1.194 s, the mean distance representing the extent of movement was 2.92 mm, the mean inspiratory velocity was 5.52 mm/s and the mean expiratory velocity was 5.06 mm/s.ConclusionsPhotogrammetric analysis of images obtained with real‐time echography provided accurate measurements of fetal breathing movements. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Fetal cardiac development and hemodynamics in the first trimester
Authors: Leiva M. C. , Tolosa J. E. , Binotto C. N. , Weiner S. , Huppert L. , Denis A. L. , Huhta J. C. 
Published: March 2003

AbstractObjectiveTo describe fetal cardiac and hemodynamic development in the first trimester of pregnancy.Subjects and methods Forty‐eight pregnancies were prospectively studied with transvaginal ultrasound and color Doppler. Fetal heart rate and size were documented together with the presence of inflow and outflow waveforms and valve signals.ResultsHeart rate and size showed a positive correlation, with gestational age. At 6 weeks of gestation, 20% of the cardiac cycle was occupied by the isovolumic contraction time (ICT); the isovolumic relaxation time (IRT) occupied 16% and remained unchanged, while the ICT progressively shortened and was not measurable after 12 weeks. The peak inflow velocities had changed from monophasic to biphasic by 10 weeks of gestation. At 7 weeks of gestation, semilunar valves were detected in 10% of examinations and the atrioventricular valves in 3%. The detection rate for both valves at 12 weeks was ≥ 90%. In pregnancies that miscarried, the detection rate for both was < 25%.ConclusionsThe Doppler signals that characterize the heart during the first trimester suggest effective heart compliance by 12 weeks. Normal valve development can be inferred from non‐invasive Doppler recordings. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
P72Prenatal assessment of the thymus in detecting fetuses with del.22q
Authors: Chaoui R. , Körner H. , Bommer C. 
Published: March 2003

BackgroundSome congenital heart defects (CHD) were found to be associated with a deletion 22q11 and grouped as catch‐22 an acronym for Cardiac anomaly, Abnormal facies, Thymus hypo‐ or aplasia, Cleft palate and Hypothyreoidism with del.22q.11. It is still discussed whether all fetal CHD or only conotruncal anomalies (CTA) should get the targeted del.22q11 evaluation. Aim of the study was to find out the importance of thymus visualization in the prenatal detection of these affected fetuses.MethodDuring a period of 3 years only fetuses with CHD undergoing invasive procedure for determination of the karyotype and fish for del.22q11 were included in the study. Fetal thymus was visualized as the structure in front of the great vessels as seen in the three‐vessels‐trachea view.Results95 fetuses with different CHD were evaluated including 31 with conotruncal anomalies. Seven fetuses were found to have a del.22q11 (7.3% of all CHD, 22.5% of CTA). Six of these 7 (85.7%) had no or a hypoplastic thymus. A false positive result was found in two further cases.ConclusionsFetal thymus can be assessed on prenatal ultrasound. In fetuses with CHD especially in CTA the absence or hypoplasia of the thymus can be a hint in the targeted examination for del.22q11.
WS12‐08Pulmonary arterial and venous flow velocity waveforms in growth restricted fetuses
Authors: Rizzo G. , Capponi A. , Angelini E. , Muscatello A. , Grassi C. , Romanini C. 
Published: March 2003

ObjectiveTo measure peripheral pulmonary artery (PPA) and pulmonary vein (PV) velocity waveforms in growth restricted fetuses (IUGR) and to relate them to different Doppler indices fetal circulation and to pregnancy outcome.Design and methods108 IUGR fetuses from singleton pregnancies (gestational age median 28.4 range 25–32) were prospectively considered for this study. Entry criteria were an ultrasonographic extimated fetal weight < 5th centile, the absence of structural and chromosomal abnormalities, and a Pulsatility Index (PI) in umbilical artery > 95th centile of our reference limits for gestation. Velocity waveforms were recorded from the PPA and in one of the PV in proximity of the inflow in the left atrium. The PI from PPA and the Pulsatility Index for the vein from PV (PIV = [S − D]/m) were calculated. Values obtained were compared to our reference limits for gestation and related to other Doppler indices from arterial, cardiac and systemic venous circulation and to fetal outcome.ResultsIn IUGR fetuses both the PI from PPA (P < 0.001) and the PIV from the PV (P < 0.001) were increased when compared to control fetuses. An inverse relationship was found between PPA and middle cerebral artery PI. Changes in PV were present when abnormal velocity waveforms are present in the systemic venous circulation. Reverse flow during atrial contraction is present in pulmonary vein in the most severely compromised fetuses and are associated with fetal distress and imminent fetal death.ConclusionsAbnormalities in arterial and pulmonary flows are present in IUGR fetuses. Changes in arterial circulation occur at an early stage of the disease while modifications in venous flows occurs later and may be the expression of an impaired function of the left ventricle close to fetal jeopardize.