bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abnormal fetal aortic velocity waveform and intellectual function at 7 years of age
Authors: Ley D. , Tideman E. , 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 148 children (84%) an assessment of overall intellectual ability was performed at 6.5 years of age.Verbal and global IQ was lower in the group with an abnormal fetal aortic blood flow velocity waveform (mean ± SD 96.0 ± 17.7 and 95.9 ± 15.7, respectively; n = 41) compared to the group with a normal waveform (102.1 ± 12.2 and 102.9 ± 13.2, respectively; n = 105; p < 0.05). Logistic regression analysis revealed that abnormal fetal aortic velocity waveform, both independently and in combination with other factors, was a significant predictor of impaired intellectual outcome.The association found between abnormal fetal aortic velocity waveform and impaired intellectual outcome suggests that hemodynamic evaluation of the fetus has a predictive value regarding postnatal intellectual development. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Isolated fetal pyelectasis: assessment of risk for postnatal uropathy and Down syndrome
Authors: Wickstrom E. , Maizels M. , Sabbagha R. E. , Tamura R. K. , Cohen L. C. , Pergament E. 
Published: March 2003

AbstractEighty‐two consecutive fetuses with ultrasound evidence of isolated pyelectasis (defined as dilatation in the anteroposterior renal pelvic dimension of ≥ 4 mm) were prospectively followed to determine the risk for postnatal uropathy and Down syndrome. In 98 (60%) kidneys, isolated pyelectasis was shown to be the first manifestation of a pathophysiological process that evolved into a gamut of postnatal uropathies (defined as urological conditions requiring remedial surgery or extended medical surveillance). Data quantifying the risk for postnatal uropathy in fetuses with varying degrees of isolated pyelectasis, at different gestational ages, are presented in figure format to facilitate prenatal counselling. Bivariate analysis showed that the evolution of isolated pyelectasis to uropathy was statistically significant when in utero progression was noted or in conjunction with other findings including contralateral pyelectasis (p < 0.01), male gender (p < 0.01) and increased kidney length (p < 0.001). Importantly, 55% of the infants requiring corrective surgery demonstrated in utero progression of pyelectasis (p < 0.002). Serial ultrasound examinations were necessary to evaluate progression or regression in the extent of pyelectasis. Finally, isolated pyelectasis was associated with an increased risk for Down syndrome, beginning at maternal age of 31 years, in the interval of 16–20 weeks' gestation. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Doppler assessment of flow velocity in the uterine artery during pubertal maturation
Authors: Laursen E. Mosfeldt , Holm K. , Brocks V. , Jarden M. , Müller J. 
Published: March 2003

AbstractThe aim of this study was to investigate the possible changes in uterine artery flow velocity during puberty and young adulthood.In a cross‐sectional study, 133 healthy volunteers aged 6.7 to 25.4 years were investigated. Pubertal development according to the Tanner classification was recorded in each subject. Uterine arteries were visualized by transabominal color‐coded ultrasound. Maximum, minimum and time averaged maximum flow velocities were measured and the pulsatility index (PI) was calculated electronically.When flow velocity was compared between patients at different rates of pubertal development, we found that the average velocity increased from Tanner breast stages I and II to V, followed by a slight decrease in adults (p < 0.0001). The PI varied significantly from stage I to adult (p < 0.0001). The PI was similar in breast stage I, stage II and in adults, with median 4.7 (range 2.7–8.5), 6.1 (range 3.0–7.8) and 4.3 (range 1.9–8.1), respectively. The PI decreased in stages III and IV to 2.6 (1.8–8.4) and 2.8 (1.2–7.9), respectively, whereas stage V was intermediate, at 3.7 (1.1–6.3). The variance of PI was independent of age.In summary, we demonstrated a significant increase in the uterine artery flow velocity during puberty. Furthermore, a significant decline in vascular resistance expressed by the PI was observed in the mid‐pubertal period, reflecting increasing blood flow to the rapidly growing uterus. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
The reproductibility of the results of transvaginal sonography of the uterus in patients with abnormal uterine bleeding
Authors: Emanuel M. H. , Ankum W. M. , Verdel M. J. C. , Hart A. A. M. 
Published: March 2003

AbstractOur objectives were to determine the reproducibility, or interobserver agreement, of transvaginal sonographic imaging of the uterus in patients with abnormal uterine bleeding and to identify the effect of observer experience.Transvaginal ultrasound findings of 235 patients with abnormal uterine bleeding were recorded systematically on videotape. Recordings were reviewed by three observers who had different levels of experience, and who were asked to judge the endometrium/uterine cavity and myometrium separately as being normal, abnormal or inconclusive, according to predefined criteria. Reproducibility was expressed by the observed rates of interobserver agreement and by kappa statistics. The differences in agreement between observer pairs were analyzed by means of McNemar's χ2 test.The observed rates of agreement for the judgement of the endometrium/uterine cavity varied from 0.85 to 0.89, with a kappa value ranging from 0.70 to 0.78 between observers. The judgement of the myometrium resulted in agreement rates of 0.86–0.91 and kappa values of 0.67–0.80. Although the effect of experience was evident, the differences in agreement between observers were not significant (p > 0.01).The reproducibility of the results of transvaginal sonography of the uterus in patients with abnormal uterine bleeding was good. Observations of the endometrium/uterine cavity with a normal appearance were the most highly reproducible, with the smallest effect of observer experience. This may reduce the need for invasive diagnostic procedures in patients with abnormal uterine bleeding. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Successful transvaginal ultrasound‐guided puncture and injection of a cervical pregnancy in a patient with simultaneous intrauterine pregnancy and a history of a previous cervical pregnancy
Authors: Monteagudo A. , Tarricone N. J. , Timor‐Tritsch I. E. , Lerner J. P. 
Published: March 2003

AbstractCervical pregnancy is a rare type of ectopic pregnancy. A recurrent cervical pregnancy in conjunction with a viable intrauterine pregnancy is an even rarer event. We present a case in which a recurrent cervical pregnancy was treated by selective reduction using an injection of potassium chloride guided by transvaginal sonography. The intrauterine gestation was delivered at a gestation of 34 weeks and 4 days by Cesarean section. Subsequently, the patient was treated with intramuscular methotrexate with a prolonged, but complete, resolution of the cervical pregnancy. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal power Doppler angiography of the fetal brain
Authors: Pooh R. K. , Aono T. 
Published: March 2003

AbstractUsing transvaginal B‐mode sonography combined with power Doppler flow mapping on a total of 6.5 fetuses between 12 and 30 weeks of gestation, fetal intracerebral arteries and veins and blood flow were demonstrated in the coronal and sagittal planes. Clear images of the fetal brain and intracerebral vascular flow were obtained in 36 of the 65 cases. Bilateral vertebral arteries, the basilar artery and posterior cerebral arteries were imaged in the coronal plane at 12 weeks of gestation. Bilateral carotid and middle cerebral arteries were also depicted in the coronal plane at 13 weeks of gestation. The middle cerebral arteries and their branches were depicted via the anterior fontanelle in the coronal plane at 20 weeks of gestation. The anterior cerebral artery and its branches were demonstrated in the sagittal plane at 26 weeks of gestation. The fetal cerebral venous systems of the superior sagittal sinus, internal cerebral vein, vein of Galen and straight sinus were clearly imaged in the mid‐sagittal plane. Although we encountered several problems with this new technology of transvaginal power Doppler sonography, we were able to demonstrate its potential to assess fetal intracranial blood flow during pregnancy. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Early ultrasound diagnosis and follow‐up of molar pregnancies
Authors: Jauniaux E. , Nicolaides K. H. 
Published: March 2003

AbstractThe objective of this study was to investigate the role of ultrasound in the differential diagnosis and management of early pregnancies presenting with placental molar changes. Placental features were recorded over a 10‐month period in women undergoing ultrasound examination at 10–14 weeks of gestation. In cases of a molar pregnancy, the fetal karyotype was obtained in utero and, if tbe pregnancy continued, the maternal concentration of human chorionic gonadotropin (hCG) and uterine artery resistance to flow were measured serially. A histopathological examination of the placenta was performed in all cases after delivery. During the study period, 9425 women had an early scan and 11 molar pregnancies were identified including one classical mole, four hydatidiform moles coexisting with a normal pregnancy, three partial triploid moles and three partial moles associated in one case with a fetus presenting congenital anomalies diagnostic of Beckwith– Wiedemann syndrome. The hCG levels were high in all cases except one case of triploidy and remained high during the rest of the pregnancy in cases of hydatidiform moles coexisting with a fetus. In these cases, the uterine artery resistance was normal. The present data indicate that placental ultrasound examination can correctly identify molar changes in early pregnancy and together with hCG level and uterine Doppler measurements can establish the differential diagnosis in utero of the various forms of placental molar transformations. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Fetal heart volume assessment by three‐dimensional ultrasound
Authors: Chang F.‐M. , Hsu K.‐F. , Ko H.‐C. , Yao B.‐L. , Chang C.‐H. , Yu C.‐H. , Liang R.‐I. , Chen H.‐Y. 
Published: March 2003

AbstractHeart volume may provide important information on the status of fetal hemodynamics. However, traditionally fetal heart volume has been assessed with the erroneous assumption that the fetal heart is spherical or elliptical. With the advent of three‐dimensional ultrasound, accurate assessment of organ volume has become feasible. The objectives of this study were to compare the reproducibility of two‐dimensional ultrasound and three‐dimensional ultrasound in the assessment of heart volume, and to test whether heart volume assessed by the traditional method of two‐dimensional ultrasound equates to that assessed by three‐dimensional ultrasound. If it proved to be significantly different, we aimed to find a new constant which, if incorporated into the traditional formula used to determine heart volume, would enable us to achieve more accurate volumes with two‐dimensional ultrasound. In total, 50 normal singleton fetuses ranging from 20 to 30 weeks' gestation were included in the study. Both the traditional two‐dimensional and the new three‐dimensional volume measurements were compared. The results showed that three‐dimensional ultrasound has a better reproducibility than two‐dimensional ultrasound in heart volume assessment and that heart volume assessed by the traditional formula of two‐dimensional ultrasound is significantly larger than that measured by three‐dimensional ultrasound (p < 0.001). We therefore propose that, if the traditional two‐dimensional equation is to be used, the constant for heart volume could be modified to 0.4563 (SE = 0.0153, n = 50) to achieve more accurate results. With this new constant, the heart volume derived by two‐dimensional ultrasound was not found to differ from that measured by three‐dimensional ultrasound. From our series, we conclude that three‐dimensional ultrasound is theoretically the best method for the assessment of heart volume. However, because of the limitations of three‐dimensional ultrasound (i.e. it is not routinely available, it is more expensive and more time‐consuming) two‐dimensional ultrasound in practical terms should be the method of choice. Although we were able to improve the accuracy of the heart volume measurements using a new constant in the traditional two‐dimensional formula, the new constant will not improve variability, which can only be reduced by three‐dimensional ultrasound. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Placenta previa percreta with bladder involvement: new considerations and review of the literature
Authors: Silver L. E. , Hobel C. J. , Lagasse L. , Luttrull J. W. , Platt L. D. 
Published: March 2003

AbstractPlacenta previa percreta is a life‐threatening condition. Antenatal diagnosis is important to establish and to optimize a plan of management. When bladder invasion occurs, other potential complications can result, including massive hemorrhage and the development of disseminated intravascular coagulation. Numerous modalities have been used successfully to treat these patients, but hysterectomy at delivery is the treatment most commonly used.A case of placenta previa percreta with suspected bladder invasion was diagnosed in a 35‐year‐old woman by routine office ultrasound examination at 19 weeks 6 days' gestation. She was managed conservatively until 36 weeks 3 days' gestation, at which time she underwent a modified classical Cesarean section after amniocentesis to confirm fetal lung maturity. The placenta was left in situ immediately postpartum. The patient underwent a prophylactic embolization of her hypogastric arteries and received methotrexate chemotherapy. Eight weeks later, she developed a low‐grade coagulopathy and underwent a total abdominal hysterectomy.Conservative management intrapartum is thought to be appropriate, to avoid the risk of severe hemorrhage at the time of delivery. However, elective hysterectomy ought to be considered earlier (2–4 weeks postpartum) than the time suggested in the literature, to avoid the development of further complications, including coagulopathy. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
In vitro demonstration of inhibition of retrograde flow in the human umbilical vein
Authors: Potter P. L. 
Published: March 2003

AbstractThis study was designed to investigate the apparent inhibition of retrograde flow in umbilical veins. While flushing fluid through cord veins for another study it appeared that there existed an impedance to retrograde flow. Simple hydraulic flow and Doppler ultrasound were used to evaluate this observation. First, in vitrostudies were carried out on 100 normal umbilical cords to measure the time it took fluid to flow forward through a 30‐cm segment of umbilical vein. These data were then compared to the time required for flow in the opposite direction. The average time was 8.84 s in the antegrade direction and 9.97 s in the retrograde direction. This difference was statistically significant with a p‐value of < 0.001. To evaluate this observation under more controlled conditions the second phase of the study was conducted. During phase two, umbilical cords were collected from term uncomplicated pregnancies. Doppler test fluid was pumped through the cord at a rate based on newborn weight. The volume and velocity were measured in both directions by Doppler ultrasound. Average flow volume was 369.1 ml/min in the antegrade direction and 174.8 ml/min in the retrograde direction. The velocities were 9.1 cm/s and 5.5 cm/s, respectively. The difference in mean flow volume was 194.3 ml/min. The difference of the mean velocity was 3.58 cm/s. Both are statistically significant with p‐values of < 0.01. These data suggest there is an intrinsic inhibition of retrograde flow in the umbilical vein. The etiology and significance of this finding are discussed. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Reversal of diastolic flow in the middle cerebral artery of the fetus during the second half of pregnancy
Authors: Respondek M. , Woch A. , Kaczmarek P. , Borowski D. 
Published: March 2003

AbstractThis study obtained data on 22 fetuses in whom reversal of diastolic flow in the middle cerebral artery (MCA) was seen. In 59% of cases there was normal heart function and in 28% there was isolated tricuspid valve regurgitation. The majority (73%) of cases presented with normal fetal anatomy and most (82%) had a normal amniotic fluid index and normal fetal growth. In all cases, Doppler results of the umbilical artery and vein were normal. Of the women, 6.5% were on no medication and 73% did not smoke during pregnancy.The reversal of diastolic flow in the MCA was seen temporarily in the majority of cases (for 2–30 min); however, in one case with rhesus factor disease and a rim of ascites, it was observed for a longer period (about 2 h) and on the following day, intrauterine demise was recorded. In most of the cases without structural malformations, the neonatal outcome was normal.We conclude that reversed diastolic flow in the MCA is a rare and usually transient event. In one of our cases prolonged reversed flow preceded intrauterine demise. Therefore, this may be an ominous sign and careful fetal surveillance should be undertaken when this observation is made. There are a few possible pathomechanisms of reversed diastolic flow in the MCA. In the majority of cases the cause of the observed phenomenon remains unknown, but an increased pressure in the right ventricle and possible tricuspid regurgitation should be considered. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Receiver operating characteristic curves of sonographic estimated fetal weight for prediction of macrosomia in prolonged pregnancies
Authors: O'Reilly‐Green C. P. , Divon M. Y. 
Published: March 2003

AbstractWe evaluated areas under receiver operating characteristic curves for sonographic estimated fetal weight (EFW) as a predictor of macrosomia in prolonged pregnancies. These areas were 0.85 for birth weights of ≥ 4000 g and 0.95 for birth weights of ≥ 4.500 g. Both were significantly greater than 0.5, the area under curves for useless tests. Areas under curves before and after adjustment for time elapsed between measurement and delivery did not differ significantly. At the inflexion point cut‐off level of 3711 g, sensitivity, specificity and positive and negative predictive values of EFW for birth weight of ≥ 4000 g were 85, 72, 49 and 94%, respectively. At the inflexion point cut‐off level of 4192 g for birth weight of ≥ 4500 g: these values were 83, 92, 30 and 99%. The relative risk for birth weight of ≥ 4000 g was 7.99, and for birth weight of ≥ 4500 g, 39.50, both significant. In conclusion, sonographic EFW is a useful test for predicting macrosomia. Adjustment for time elapsed did not significantly improve either test, probably because of slow rates of fetal growth at this gestational age. Cut‐off values derived from this analysis result in high sensitivity but low positive predictive value. A randomized controlled trial of mode and timing of delivery for predicted macrosomia is needed. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Correlation of fetal frontal lobe and transcerebellar diameter measurements: the utility of a new prenatal sonographic technique
Authors: Persutte W. H. , Coury A. , Hobbins J. C. 
Published: March 2003

AbstractSeveral authors have reported the value of the sonographic assessment of both the fetal frontal lobe and the cerebellum. Both frontal lobe shortening and cerebellar hypoplasia have been associated with fetal aneuploidy. We anecdotally observed that the distance between the calvarium and the posterior cavum septum pellucidum (frontal lobe) closely approximated the transcerebellar diameter. This study was undertaken to investigate this relationship.Between 1 July 1994 and 1 January 1996, the frontal Lobe (posterior cavum septum pellucidum to the inner calvarium) and transcerebellar diameter were measured in patients referred to two prenatal ultrasound laboratories in Denver, Colorado., USA. All pregnancies had certain dates and were uncomplicated. Statistical comparison was completed using interval polynomial regression analysis. During the study period, we performed 221 detailed ultrasound examinations in which the frontal lobe and the transcerebellar diameter were measured. We found a correlation coefficient of 0.950 when comparing the two variables (p < 0.0001).Some conditions (Down's syndrome, lethal trisomies and pathological microcephaly) have differential effects on the frontal lobe and the transcerebellar diameter. Our preliminary judgement is that this new technique may prove to be a useful tool in assessing the relative effect of these conditions on structural neuroanatomy. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Effect of first‐trimester nuchal translucency on second‐trimester maternal serum biochemical screening for Down's syndrome
Authors: Thilaganathan B. , Slack A. , Wathen N. C. 
Published: March 2003

AbstractWe evaluated the effectiveness of 10–14 week nuchal translucency measurement in routine ultrasound screening for Down's syndrome, and its effect on the sensitivity of subsequent maternal serum biochemistry. This was an observational study, in which all women attending for antenatal care at a district general hospital were routinely offered a first‐trimester nuchal translucency scan and second‐trimester quadruple maternal serum biochemistry as screening tests for Down's syndrome, The main outcome measures were abnormal fetal karyotype and the performance of screening tests.A total of 3604 women were scanned in the first trimester of pregnancy. Excluding the cases that did not fit the entry criteria (n = 344, 9.6%) and in which nuchal translucency measurements were not possible (n = 340, 9.4%), a total of 2920 women were screened. A nuchal translucency‐derived risk of 2 : 200 for an aneuploid pregnancy resulted in a 5% (n = 147) screen‐positive rate. Screening using this risk enabled the first‐trimester detection of five of seven (71%) fetuses with trisomy 21 and 14 of 18 (78%) aneuploid fetuses. Second‐trimester maternal serum biochemistry testing was performed in 1904 of the women who had nuchal translucency screening, with a screen‐positive rate of 7.5% (n = 143). Only one extra case of Down's syndrome would have been detected by maternal serum biochemistry testing if nuchal translucency screening had been implemented at a risk level of 1 : 300.This study demonstrates that first‐trimester nuchal translucency measurement is effective in routine screening for fetal chromosomal abnormality. Furthermore, the implementation of a nuchal translucency screening program will significantly reduce the positive predictive value of second‐trimester maternal serum biochemistry testing. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology