bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transvaginal ultrasonography in detection of cervical incompetence
Authors: Podobnik M. , Podgajski M. , Gebauer B. , Ciglar S. 
Published: March 2003

Background:  To examine the relationship between transvaginal ultrasound cervical changes and pregnancy outcome in women at risk of cervical incompetence and preterm delivery.Methods:  In 100 pregnancies with clinical and ultrasonic signs of cervical incompetence, the length of the cervix, the thickness of the anterior wall of a lower uterine segment and the width of the endo‐cervical canal have been evaluated ultrasonically. These parameters were followed longitudinally from the 10 to 36 week gestation in the healthy pregnancies and pregnancies at risk for cervical incompetence and preterm delivery.Results:  In patients from 10 to 14 weeks, the cervix is significantly longer than in the 25–36 week group and the anterior wall of the lower uterine segment in the 10–14 week group is significantly thicker than in the 20–36 week group. In pregnancies at risk for cervical incompetence, cervical lengths and wall thickness, were significantly different from those in comparable controls. Forty‐five percent of the patients in the at‐risk group, with cervical cerclage, delivered at 37.5 weeks and 8.5% of pregnancies ended in abortion when the amniotic membrane herniated into the cervical canal. The frequency of preterm delivery was 60, 38 and 15% for cervical length of <10, 10–20, and 20–30 mm.Conclusions:  A shortened cervix with decreased thickness of the anterior wall of lower uterine segment and dilated endo‐cervical canal shows a strong association with cervical incompetence and preterm birth.
Ultrasound assessment of the cervix in recognizing preterm delivery
Authors: Brazert J. , Wender‐Ozegowska E. , Persona‐Sliwinska A. , Biczysko R. 
Published: March 2003

Background:  Cervix is very important structure that separates the fetus from external environment, which we can visualize very precisely transvaginal ultrasonography. Sonographic examination allows visualization of the internal cervical os and the portion of the cervix that lies above the vaginal fornices, providing information that is inaccessible to digital examination. Cervical length in the pregnancy is one of the predictors of preterm delivery and diagnosis of cervical incompetence.Materials and methods:  We have investigated 57 pregnant women: 20 diabetic pregnant women, 8 with hypertension, 14 with cervical incompetence, and 15 in uncomplicated pregnancy. Transvaginal sonography was used to measure cervical length between 20 and 30 weeks gestation. Ultrasound examination was performed using 2000 with 5.0 MHz transvaginal transducer. Maternal age ranged from 19 to 39 years (mean 27.2 ± 8.3). The following measurements were obtained: endo‐cervical canal length between the internal and external os, funneling of the cervix, funnel width, funnel length.Results:  The mean endo‐cervical length measured in ultrasonography was 17.3 ± 5.2 mm in pregnancies delivered preterm (n = 7) and 33.4 ± 9.6 mm in pregnancies delivered at term (nP). The 11 pregnant women with cervical incompetence were treated with cervical cerclage, eight of them delivered at term and three preterm. The mean endo‐cervical length was 10.4 mm ± 3.0 and in all cases we observed funneling of the cervix in this group. Endo‐cervical length was 25 mm in 75% pregnant women, who delivered after 37 weeks of pregnancy. No significant relationships were shown between length of the cervix in pregnancy complicated by diabetes mellitus, hypertension and uncomplicated pregnancy. The mean endocervical length in diabetic pregnancy was 34.7 ± 4.7 mm; pregnancy with hypertension 32.9 ± 5.8 mm and uncomplicated pregnancy 35.6 ± 3.8 mm.Conclusion:  Cervical length measured by ultrasonography between 20 and 30 week of pregnancy is very important predictor of preterm delivery. No significant relationships were shown between the length of the cervix and investigated pregnancy complications.
The Significance of non‐visualization of the fetal gallbladder in early pregnancy
Authors: Blazer S. , Zimmer E. Z. , Bronshtein M. 
Published: March 2003

Purpose:  To assess the incidence of a non‐visualized gallbladder in early pregnancy and to determine its prognostic significance.Material and methods:  Transvaginal ultrasound examination was performed in 29 749 consecutive pregnant women at 14–16 weeks gestation. All women underwent a detailed fetal survey prospectively. The incidence and associated risk in cases of a non‐visualized fetal gallbladder was determined.Results:  The gallbladder was not visualized in early pregnancy in 34 fetuses, giving an incidence of 0.11% (1 in 875 pregnancies). Associated malformations were detected in 14 fetuses (41%), and in 20 fetuses non‐visualization of the gallbladder was an isolated finding. All fetuses with an isolated finding had a normal outcome, in 13 fetuses the gallbladder was detected later on in pregnancy, in five no gallbladder was found after delivery, and two patients were lost in follow up. Of the 14 fetuses with associated anomalies, five had also an abnormal karyotype. Termination of pregnancy was performed in nine of these fetuses. Of the cases which continued pregnancy there was one case of neonatal death, two cases of developmental delay and only one normal child.Conclusion:  Non‐visualization of the fetal gallbladder in the early pregnancy is uncommon but is associated with a high incidence of associated anomalies. Fetuses with an isolated finding of a non‐visualized gallbladder have usually a favorable outcome.
Ultrasonographic findings of VATER association
Authors: Tanemura M. , Tsukishiro S. , Suzumori K. 
Published: March 2003

Purpose:  VATER association is a combination of congenital anomalies including vertebral defects (V), anal atresia (A), tracheoesophageal fistula (TE), esophageal atresia (E), and radial and renal anomalies (R). This report describes the prenatal progress of four such cases and the features of ultrasonographic findings.Methods:  Case (1): the mother was referred at 12 weeks gestation because of a fetal abdominal cyst. Bilateral hydronephroses and an expansive bladder were detected by ultrasonography. At 36 weeks polyhydramnios appeared, and soon she delivered. V, A, TE, E and R were confirmed. Case (2): the mother was referred at 14 weeks because of a fetal abdominal cyst and oligohydramnios. Ultrasonography suggested megalocystis based on urethral atresia. An infant was delivered at 27 weeks and died right thereafter. Autopsy confirmed V, A, R, tracheal atresia, genital anomaly and megalocystis. Case (3): the mother was transported at 37 weeks because of fetal distress. Polyhydamnios had been suspected on a routine office visit. The infant was delivered by cesarean section. TE, E and limb defects were detected. Case (4): the mother was referred at 26 weeks because of anhydramnios and mediastinal shift. Ultrasonography and fetal MRI indicated renal agenesis and congenital diaphragmatic hernia. Autopsy on a stillborn infant revealed V, A, TE, E, R and diaphragmatic hernia.Results and conclusions:  The features of ultrasonographic findings of VATER association were abnormality of urinary organs and amniotic fluid volume. However, in the cases with esophageal atresia, estimation of renal function was difficult.
Ultrasonographic normograms of the fetal chin and filtrum during pregnancy
Authors: Jaffa A. J. , Wolman I. , Har‐Toov J. , Fait G. , Amster R. , Lessing J. B. , Gull I. , Jaffa A. J. 
Published: March 2003

Introduction:  Abnormal sizes of the chin and of the filtrum or their proportions are morphological features in certain syndromes. Both chin and filtrum can be visualized and measured from the early second trimester until term. As of today there are no normograms of the chin and of the filtrum during pregnancy, and dysmorphism is evaluated only by subjective criteria.Purpose:  To establish normograms of the fetal chin and filtrum.Methods:  We studied cross‐sectioned the size of the chin and length of the filtrum in 153 fetuses from the 13th to the 42nd week of gestation. The chin was measured from the lower lip to the skin under the mandibular edge. The filtrum was measured from the nose to the upper lip.Results:  The growth normograms for the chin was best described by the regression equation: Y = − 9.799 + 1.312X − 0.013 × 2; R2 = 0.87 (Y = chin size in mm, X = gestational week). The growth normograms for the filtrum was best described by the regression equation: Y = − 2.672 + 0.477X − 0.005 × 2, R2 = 0.82 (Y = filtrum size in mm, X = gestational week). The ratio chin/filtrum tends to increase from 2 at the beginning of the second trimester to 2.8 at term.Conclusions:  We present the first normograms of fetal chin and filtrum along the pregnancy. One of the fetuses was found to have micrognatia at 32 weeks and both his chin and filtrum were abnormal. We used the normograms to evaluate another two past cases of face dysmorphism, which were evaluated by subjective criteria and found abnormal chin and filtrum sizes. These normograms can be used in consulting genetic disorders.
First‐trimester umbilical cord diameter: a novel marker of fetal aneuploidy
Authors: Ghezzi F. , Raio L. , Di Naro E. , Franchi M. , Buttarelli M. , Schneider H. 
Published: March 2003

AbstractObjectiveTo compare the umbilical cord diameter at 10–14 weeks of gestation of chromosomally normal and abnormal fetuses.MethodsIn a consecutive series of women, who were undergoing routine sonographic evaluation at 10–14 weeks of gestation, umbilical cord diameter and nuchal translucency were measured. Reference ranges for umbilical cord diameter according to gestational age and crown–rump length were constructed. Fetal karyotype was obtained at chorionic villus sampling, amniocentesis or at delivery in newborns with features suspicious for chromosomal abnormalities.ResultsDuring the study period, 784 patients met the inclusion criteria. Of these, a fetal or placental chromosomal abnormality was present in 17 cases. The mean umbilical cord diameter increased with gestational age (r = 0.41,P < 0.001). The proportion of fetuses with an umbilical cord diameter above the 95th centile was higher in the presence of fetal or placental chromosomal abnormalities than in normal fetuses (5/17 vs. 39/767, P < 0.01). Among fetuses with an abnormal fetal or placental karyotype, nuchal translucency was above the 95th centile for gestational age in 10 cases. When only fetal chromosomal abnormalities were considered (n = 14), the combined detection rate was 85.7% (12/14).ConclusionsSonographic assessment of the umbilical cord in early gestation appears to identify a subset of fetuses at increased risk of chromosomal abnormalities. Copyright © 2002 ISUOG
Pelvic sonography and uterine artery color Doppler analysis in the diagnosis of female precocious puberty
Authors: Battaglia C. , Regnani G. , Mancini F. , Iughetti L. , Venturoli S. , Flamigni C. 
Published: March 2003

AbstractObjectivesTo evaluate the role of ultrasound and color Doppler analyses in the diagnosis of precocious puberty.MethodsGray‐scale sonographic uterine and ovarian evaluation together with color Doppler analysis of the uterine artery were prospectively performed in 29 girls presenting with premature breast development and pubic hair growth. The values were compared with results obtained from the gonodotrophin releasing hormone stimulation test. Excluded from the study were patients with isolated thelarche or isolated pubarche and those patients with gonodotrophin releasing hormone‐independent puberty and with polycystic ovaries.ResultsAccording to the Tanner scale, all the girls presented a breast stage of 2–3 and pubic hair stage 2–3. The uterine size was greater in those girls who presented a pubertal response to the gonodotrophin releasing hormone test (Group II; n = 20) (8.07 ± 4.47 mL) than in those who did not (Group I; n = 9) (3.07 ± 1.18 mL; P = 0.001). The ovarian volume and the number of small follicles was not significantly different between the groups. On Doppler analysis, more elevated impedances were observed in Group I (pulsatility index = 3.28 ± 0.37) than in Group II (pulsatility index = 2.29 ± 0.19; P = 0.001) girls. The presence of a low pulsatility index (<2.5) at the level of the uterine arteries had a high diagnostic value for precocious puberty (sensitivity 86%, specificity 100%).ConclusionsUterine artery Doppler analysis may assist the diagnosis of gonodotrophin releasing hormone‐dependent precocious puberty, may be useful for the selection of those girls needing treatment, and may simplify the follow‐up of girls treated for precocities. Copyright © 2002 ISUOG
The sonographic approach to the detection of fetal cardiac anomalies in early pregnancy
Authors: Bronshtein M. , Zimmer E. Z. 
Published: March 2003

AbstractBackgroundTransvaginal sonography enables imaging of the fetal heart in various planes and directions in early pregnancy. This study summarizes our experience in early detection of fetal cardiac anomalies.MethodsTransvaginal sonographic examination was performed in 36 323 consecutive fetuses in both high‐ and low‐risk pregnancies. More than 99% of cases were evaluated at 14–16 weeks' gestation. Examination of the cardiovascular system did not rely on still images of the classic views but instead was performed in a dynamic mode visualizing the heart and great vessels from different directions and in various scanning planes.ResultsCardiac anomalies were detected in 173 fetuses, giving an overall incidence of 1 in 210 pregnancies. In 44% of these, the cardiac anomaly was isolated. An abnormal karyotype was detected in 27 of the 72 cases that underwent chromosomal analysis. An abnormal nuchal translucency finding was observed in 59 fetuses. The sonographic diagnosis was confirmed after delivery or at postmortem in 90 cases. Ten fetuses had a cardiac anomaly which differed from the anomaly suggested by sonography. In the remaining cases, a postmortem examination was not possible because termination of pregnancy was performed by dilatation and curettage. In four cases we did not detect the cardiac anomaly in early pregnancy. Two of them were detected at rescanning in mid‐pregnancy.ConclusionEarly detection of fetal cardiac anomalies is now possible. Most anomalies occur in low‐risk pregnancies. We suggest performing a detailed early multidirectional dynamic continuous sweep ultrasound examination of the fetal cardiovascular system in all pregnancies. Copyright © 2002 ISUOG
Evaluation of cycle‐to‐cycle variation of endometrial responsiveness using transvaginal sonography in women undergoing assisted reproduction
Authors: Basir G. S. , O W.‐S. , So W. W. K. , Ng E. H. Y. , Ho P. C. 
Published: March 2003

AbstractObjectivesTo investigate the variation of endometrial responsiveness between cycles within the same women undergoing assisted reproduction.MethodsThe sonographic endometrial thickness in ovarian stimulation cycles was compared with that of subsequent natural cycles. One hundred and thirty‐six ovarian stimulation cycles of in‐vitro fertilization and embryo transfer were evaluated. Women who did not conceive in in‐vitro fertilization cycles were subsequently seen in natural cycles (n = 97) or the next in‐vitro fertilization cycle (n = 39). Based on a receiver–operating characteristics (ROC) curve using endometrial thickness to predict pregnancy, the first in‐vitro fertilization cycles were classified according to the endometrial thickness as optimal (>8 mm) in 98 cycles, or suboptimal (≤8 mm) in 29 cycles. Similarly, spontaneous cycles were classified as suboptimal (≤7 mm) in 28 cycles and optimal (>7 mm) in 69 cycles.ResultsThe pregnancy rates were significantly lower (P < 0.05; Fisher's Exact test) in the suboptimal group in both the in‐vitro fertilization and frozen embryo transfer cycles. There was a strong correlation (r
2 = 0.745) and a significant difference (P < 0.001; Wilcoxon signed rank sum test) between the endometrial thickness of stimulation and natural cycles.ConclusionIt is possible to predict the occurrence of optimal or suboptimal endometrial response in natural cycles of women, after evaluation in stimulated cycles, with a high degree of reliability. Risk of implantation failure can be identified before subsequent treatment cycles and adjuvant therapeutic strategies may be planned to improve the endometrial response before embryo transfer. Copyright © 2002 ISUOG
Antenatal diagnosis of placenta percreta with planned in situ retention and methotrexate therapy in a woman infected with HIV
Authors: Henrich W. , Fuchs I. , Ehrenstein T. , Kjos S. , Schmider A. , Dudenhausen J. W. 
Published: March 2003

AbstractPlacenta percreta is a rare obstetric condition associated with potentially life‐threatening hemorrhage. Diagnosis in advance of delivery permits a planned delivery and preparation for blood transfusions and planned Cesarean hysterectomy, which is the common treatment. We report a case of placenta percreta in an HIV‐positive patient which was diagnosed in the second trimester using conventional and extended field of view ultrasound imaging and color Doppler. At 36 weeks the infant was delivered by Cesarean section and the placenta was left in situ. Postoperatively the patient was treated with methotrexate. Four weeks later, the patient delivered the placenta spontaneously. Early or late postpartum hemorrhage did not occur and postoperative recovery was uneventful. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
First‐trimester, three‐dimensional transvaginal ultrasound volumetry in normal pregnancies and spontaneous miscarriages
Authors: Acharya G. , Morgan H. 
Published: March 2003

AbstractObjectiveThe aim of this study was to perform three‐dimensional ultrasound volumetry of intrauterine contents in cases of normal and failed pregnancies and correlate these with conventional two‐dimensional measurements.MethodsThis was a cross‐sectional observational study. Three‐dimensional volumetric data were collected from a total of 111 patients with first‐trimester singleton pregnancies together with conventional two‐dimensional measurements. A single investigator performed all ultrasound scans and volume measurements.ResultsAmong 111 participants, 30 had an ongoing pregnancy and 81 had a miscarriage (anembryonic pregnancy 30, missed miscarriage 30, and incomplete miscarriage 21). There were no significant differences in age, parity, or gestational age between groups. A positive linear correlation was demonstrable between the crown–rump length and gestational sac volume in normal pregnancies (r = 0.962) and between gestational sac volume and gestational age, but the correlation was weaker in cases of missed miscarriage (r = 0.561). The volume of the retained products of conception as measured by three‐dimensional ultrasound volumetry in cases of incomplete miscarriage also showed a strong linear correlation (r = 0.938) to their maximum anterior–posterior diameter. There was an exponential correlation between the mean gestational sac diameter and gestational sac volume and the crown–rump length and embryonic volume in cases of both normal and failed pregnancies. The mean gestational sac diameter:crown–rump length ratio (P = 0.008) and gestational sac volume:embryonic volume ratio (P = 0.023) in missed miscarriages were significantly higher than those in ongoing pregnancies.ConclusionThree‐dimensional ultrasound volumetry of intrauterine contents in normal and failed pregnancies correlates well with conventional two‐dimensional measurements. Volumetric assessment does not seem to improve the diagnosis of miscarriage. However, its potential to predict pregnancies that will fail and determine the appropriate management regime for individual patients merits further research. Copyright © 2002 ISUOG
Sonographic features of phyllodes tumors of the breast
Authors: Chao T.‐C. , Lo Y.‐F. , Chen S.‐C. , Chen M.‐F. 
Published: March 2003

AbstractObjectiveThe aim of this study was to examine the sonographic features of phyllodes tumors of the breast.MethodsRetrospective analysis of prospectively recorded sonographic features was performed on 2268 patients with phyllodes tumors or fibroadenomas during 1995–98. Data from 110 phyllodes tumors (76 benign, 11 borderline, 23 malignant) and 2204 fibroadenomas were analyzed.ResultsThe patients with phyllodes tumors were older than the patients with fibroadenoma (mean ± standard error, 39.7 ± 1.1 years vs. 33.4 ± 0.3 years; P < 0.0001). Sixty‐four percent of patients with phyllodes tumors were aged 31–50 years, while 68.5% of those with fibroadenoma were aged 21–40 years. Phyllodes tumors were larger than fibroadenomas (5.90 ± 0.43 cm vs. 1.95 ± 0.03 cm; P < 0.0001). The ratio of length to anteroposterior diameter of phyllodes tumors was smaller than the ratio of length to anteroposterior diameter of fibroadenomas (1.72 ± 0.06 vs. 1.89 ± 0.02; P = 0.0105). Seventy‐seven percent of phyllodes tumors were lobulated and 79.5% of fibroadenomas were oval. Lobulated shape of the tumor, heterogeneous echo pattern and absence of microcalcification are significant independent sonographic features in multiple logistic regression analysis to distinguish between phyllodes tumors and fibroadenoma. Benign, borderline and malignant phyllodes tumors displayed no significant differences in tumor size or the ratio of length to anteroposterior diameter.ConclusionsThere is a substantial overlap in the sonographic characteristics between phyllodes tumors and fibroadenoma of the breast. If lobulation and heterogeneous hypoechoic internal echoes are observed and calcifications are absent, a diagnosis of phyllodes tumors should be considered. Sonography cannot distinguish between malignant, borderline and benign phyllodes tumors. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
The development and evolution of the pharyngeal arches
Authors: GRAHAM ANTHONY 
Published: March 2003

abstractA muscularised pharynx, with skeletal support, serving the dual functions of feeding and respiration, is a fundamental vertebrate characteristic. Embryologically, the pharyngeal apparatus has its origin in a series of bulges that form on the lateral surface of the embryonic head, the pharyngeal arches, whose development is complex. These structures are composed of a number of disparate embryonic cell types: ectoderm, endoderm, neural crest and mesoderm, whose development must be coordinated to generate the functional adult apparatus. In the past, most studies have emphasised the role played by the neural crest, which generates the skeletal elements of the arches, in directing pharyngeal arch development, but it has also become apparent that the endoderm plays a prominent role in directing arch development. Neural crest cells are not required for arch formation, their regionalisation nor to some extent their sense of identity. Furthermore, the endoderm is the major site of expression of a number of important signalling molecules, and this tissue has been shown to be responsible for promoting the formation of particular components of the arches. Thus vertebrate pharyngeal morphogenesis can now be seen to be a more complex process than was previously believed, and must result from an integration of both neural crest and endodermal patterning mechanisms. Interestingly, this also mirrors the fact that the evolutionary origin of pharyngeal segmentation predates that of the neural crest, which is an exclusively vertebrate characteristic. As such, the evolution of the vertebrate pharynx is also likely to have resulted from an integration between these 2 patterning systems. Alterations in the interplay between neural crest and endodermal patterning are also likely to be responsible for the evolutionary that occurred to the pharyngeal region during subsequent vertebrate evolution.