bluuebunny/crossref_metadata_2025_split huggingface dataset:
WS01‐06Fetal obstructive uropathies: management and outcome
Authors: Sen C. 
Published: March 2003

BackgroundUrinary tract anomalies are among the most common sonographically identified anomalies in utero with the incidence about 1/250–1/1000 pregnancies. The obstruction can be unilateral or bilateral at the level of urethra, ureteropelvic junction (UPJ), ureterovesical junction (UVJ).MethodObstructive uropathy cases diagnosed antenatally have been retrospectively evaluated in terms of short and long‐term outcome. It is important to make early diagnosis and intervention in order to save organ function as possible.ResultsDuring last 7 years in our Department, 58 cases with fetal obstructive uropathy were examined and performed 12 interventions. They were diagnosed antenatally with different type of obstruction including posterior urethral valve syndrome, unilateral and bilateral hydronephrosis, ureteropelvic junction obstruction, multicystic kidney. Intervention was performed in 12 cases at different stage of gestation including needling, vesico‐amniotic shunting and pelvic shunting. Out of 12 procedures, there was mortality in 5 cases antenatally or neonatally.ConclusionEarly diagnosis of the obstruction is very important before the kidney becomes dysplastic. The type of anomalies, level and starting time of pathology and duration of severe obstruction are the main factors for prognosis. Early diagnosis and referral to tertiary center is to be encouraged in order to have early management and intervention in the case of severe obstruction and to save kidney function as early as possible.
WS11: Media WS11‐01The Croatian ultrasound safety law
Authors: Breyer B. 
Published: March 2003

Legal regulation of the safety of medical applications of ultrasound is important for protection of the patients and physicians.The matter of ultrasound safety has recently been regulated in Croatia within the framework of the law on nonionising radiation protection. The law as approved by the parliament regulates the general principles and material cornerstones while the details are defined by rules and regulations issued by the Ministry of Health.Apart from medical applications ultrasound is used in plastic and metal welding, food processing, cleaning, electroplating, drilling and metal flaw detection, to mention but some. The law had to be general and sufficiently cover the whole spectrum allowing for the special medical exception. Namely, the medical professional may breach the integrity of human body and even harm the patient if the expected net final result of the whole proceeding is expected to help the person who seeks help.The law in Croatia states that ultrasound may not increase the temperature of the human body to more than 38.5 °C and may not induce cavitation there. However medical applications of ultrasound are specifically excluded from this limitation. The requirement is the application of the ALARA principle.The specifics of the regulation of the total field of medical applications of ultrasound are now being prepared under consideration of the existing and the presently processed IEC from IEC committees TC 62 and TC 87 documents and taking into account the present regulation in the USA.
WS12: Second and third trimester Doppler I WS12‐01Uterine artery velocimetry in the third trimester
Authors: Marsal K. , Hernandez‐Andrade E. , Lingman G. , Gudmundsson S. 
Published: March 2003

Spectral Doppler velocimetry supported by directional color Doppler imaging became the method of choice for recording blood velocity signals from the maternal uterine arteries during the third trimester of gestation. Normally, the uterine artery waveforms show a high proportion of diastolic flow without any early diastolic notch and with a low resistance (RI) or pulsatility (PI) index. With increasing gestation, there is a slight decrease in the resistance to flow in the placental circulation. The placental side of the uterus shows lower values of the waveform indices than the nonplacental. In high‐risk pregnancies, the abnormally high PI or the presence of notch is predictive of the adverse outcome of pregnancy. Recently, a Uterine Artery Score (UAS) has been presented based on a combined evaluation of RI and notch (Sekizuka et al., J Mat Fet Invest 1997; 7: 197). We have modified this approach, using PI and a uniform cut‐off value for definition of the abnormal PI, disregarding the placenta location. The modified UAS in combination with the umbilical artery Blood Flow Classes possess a high predictive value with regard to the perinatal outcome in high‐risk pregnancies, especially in those with placental hemodynamic dysfunction. In cases of intrauterine growth restriction, the combined examination of the uterine and umbilical circulation improves the clinical value of the third trimester Doppler velocimetry.
WS12‐03Uteroplacental resistances and maternal cardiac function in normal and hypertensive pregnancy: a Doppler and echocardiographic study
Authors: Valensise H. , Vasapollo B. , Novelli G. P. , Larciprete G. , Arduini D. , Galante A. , Romanini C. 
Published: March 2003

ObjectiveTo verify the existence of a relationship between maternal cardiac function and peripheral hemodynamic parameters in normal and gestational hypertensive women.Methods43 normotensive primigravidae were evaluated at 12 ± 1, 21 ± 1, and 33 ± 1 weeks of gestation with uterine artery color Doppler and maternal echocardiographic examination comparing data of the third trimester with those of 21 gestational hypertensive women.ResultsThe 43 healthy women showed a decrease in Uterine Resistance Index (RI) from I° to II° trimester (0.72 ± 0.10 vs. 0.54 ± 0.09, P < 0.001) and modifications in Diastolic function parameters: E wave velocity and E/A ratio decreased; A wave velocity and deceleration time of the E wave increased; the left ventricular isovolumetric relaxation time (IVRT) decreased significantly (88.7 ± 6.7, 75.6 ± 7.7, 71.1 ± 5.0 msec, P < 0.001) showing a correlation with left atrial dimensions and RI (r = −0.38, r = 0.47, P < 0.001). In the third trimester the comparison between normal and hypertensive women showed a significant reduction in (TVR) total vascular resistances (1006 ± 212 vs. 1620 ± 469, P = 0.000) and IVRT (71 ± 5.0 vs. 92.0 ± 7.6 msec, P = 0.000). Regression analysis showed a linear correlation between IVRT and TVR (r = 0.68; P < 0.01), Uterine RI and TVR were directly related (r = 0.59, P < 0.001).ConclusionsMaternal diastolic function analysis may be useful to identify women who fully adapt to pregnancy and at risk for development of gestational hypertension.
WS13‐08Multifetal pregnancy reduction: clinical and pathophisiological aspects
Authors: Mikhailov A. , Koroteev A. 
Published: March 2003

BackgroundTo decrease perinatal mortality and morbidity rate in case of multifetal pregnancy fetal reduction (MFPR) in the first trimester was introduced.MethodsCombine ultrasound and Doppler evaluation of fetal chromosomal abnormality markers, fetal structure and biometry, chorionicity and amnionicity, arterial and venous circulation in fetal‐placental‐maternal functional system were introduced as an algorithm before MFPR.Results355 fetuses in 112 women were examined before 141 MFPR. NT thickness was above 2.5 mm in 1,7% of fetuses and one fetus had reverse DV flow. But no fetal chromosomal defects were detected after CVS. No specific severe complications for multifetal pregnancy were registered in completed pregnancies. Average gestational age at birth was 35,5 w that was less then in essential twins but perinatal mortality rate was 5.8‰ and 12.8‰ correspondingly.ConclusionMFPR with combine fetal examination seems to be the way to improve multifetal pregnancy outcome.
WS14‐08Three dimensions in neonatal period
Authors: Stanojevic M. 
Published: March 2003

BackgroundThe aim of this study was to compare the application of 2D neurosonography (USG) and 3D USG in newborns with respect to the time required to obtain the data for analysis.MethodAll newborns in whom neurosonography was indicated underwent 2D USG and 3D USG by the same investigator. The Voluson 530 D Color System was used with vaginal 5–8 MHz 3D probe for 3D imaging. 2D real‐time imaging was performed with Aloka SSD 121 device using 5 MHz sector probe. The time needed to perform the examination was determined. Non‐parametric Kruskal–Wallis rank sum test was used in statistical analysis.ResultsA total of 30 newborn infants of different gestational ages (ranging from 25 to 40 weeks) underwent USG after delivery at different postnatal ages (ranging from 2 to 60 days). The median time required to perform the 2D USG was 14 min (10–21). The median time required to perform the investigation by 3D USG was 5 min (ranging from 3 to 10). The difference was statistically significant (H = 24.88; P = 0.0031). The median time of data interpretation for 2D USG was 25 min (15–35), and for 3D USG it was 45 min (30–63). The difference was not statistically significant (H = 13.22; P = 0.1531).ConclusionThe time necessary to obtain 3D USG compared to 2D USG images was shorter, which made it less stressful for the newborns. 3D USG provides more reliable information than 2D USG performed in the same patient at the same age. The time needed to interpret the data is longer for 3D USG but it can be performed after the imaging was terminated.
F10The sonographic diagnosis of uterine venous plexus thrombosis made by transvaginal B‐mode and color Doppler scanning: two case reports
Authors: Leibovitz Z. , Degani S. , Shapiro I. , Tal J. , Paz B. , Levitan Z. , Schliamser L. M. , Toubi A. , Ohel G. 
Published: March 2003

BackgroundTransvaginal sonography (TVS) enables a close imaging of the pelvic organs providing a clear imaging of the pelvic vessels. To the best of our knowledge – this is the first report of the diagnosis of uterine venous plexus thrombosis using this technique.Case reports 1st case: 38‐year‐old patient diagnosed as having a left tubal ectopic pregnancy in the 7th week of gestation. On TVS examination the ipsilateral uterine plexus thrombosis was found. The blood clots were demonstrated as elongated echogenic structures within the dilated veins. The thrombi showed swinging movements caused by the surrounding blood flow. This effect could also be provoked by gentle transducer pressure. On the transverse view of the affected veins the thrombi appeared as free round structures in the lumen. The blood flow around the thrombi was seen on color Doppler. 2nd case: 36‐year‐old patient with fetal death in the 19th week of gestation. Two days after the induced labor the patient experienced excessive vaginal bleeding. A placental residue was confirmed by TVS. Upon examination the engorged uterine venous plexuses were seen with a thrombus on the right side. The sonographic description of the clot was as in the first case.There were no signs of thromboembolic disease in both cases. The deep leg veins and iliac veins were studied and found to be normal. The uterine plexus thrombi could not be detected by transabdominal sonography and were only seen by TVS. Over 3 months of anticoagulation therapy the clots gradually disappeared in both cases.ConclusionsIn both patients the transvaginal sonographic diagnosis of uterine venous plexus thrombosis was accidental. There is not enough data in the medical literature to determine the evidence based approach to such cases. Nevertheless, focusing on the pelvic veins may reveal important findings with significant clinical implications.
F110Human fetal gallbladder contractility exists in utero
Authors: Tanaka Y. , Senoh D. , Hata T. 
Published: March 2003

ObjectiveThe purpose of this study was to evaluate whether human fetal gallbladder contractility exists in the second half of pregnancy.MethodUltrasound examinations were performed on 54 normal pregnant women from 20 to 40 weeks of gestation. Fetal gallbladder volume was monitored every 30 min from 8 to 18 o'clock in each patient.ResultsMaximum gallbladder volume (Max) had a linear relationship with gestational age between 20 and 32 and 35 weeks of gestation, after which a plateau was observed. Minimum gallbladder volume (Min) was not changed throughout gestation. Functional capacity (Max – Min) of the fetal gallbladder increased linearly with advancing gestation until 32–35 weeks' gestation, thenafter became constant. Contractility rate [(Max – Min/Max) × 100] increased curvilinearly with advancing gestation. The change of fetal gallbladder volume in a day showed a typical sinusoidal pattern, and the contractility cycle of gallbladder volume was not changed during pregnancy.ConclusionWe suggest that there is an gallbladder contractility in human fetuses in utero, and that maternal meals seem not to affect the volume of fetal gallbladder.
F113The diagnosis and therapy in pregnancies complicated by acute hydramnios
Authors: Szaflik K. , Borowski D. , Oszukowski P. , Wyrwas D. , Kunert A. , Hincz P. , Ciesielski A. 
Published: March 2003

BackgroundThe aim of the study was an analysis of frequency of hydramnios and its etiology, and assessment of therapeutic modalities.MethodThe study group consisted of 77 pregnant women with detected hydramnios. The entry criteria were amniotic fluid index (by Phellan) > 28 cm.ResultsThe mean gestational age was 29 ± 4.5 weeks. The mean AFI was 35 ± 7.9 cm. In 30 cases of hydramnios the congenital malformation was diagnosed. The most frequent were anomalies of gastrointestinal tract, lesions of central nervous system and teratomas. In 23 cases viral infections were diagnosed. Another group of pregnancies with the acute hydramnios constitute 13 twin gestations with TTS. In 16 cases, no etiologic factor was found. In all cases, the therapy of acute hydramnios was based on serial amnioreductions. In two cases maternal treatment with indomethacin was introduced beside amniocentesis. In 13 cases there were performed additional intrauterine drainage procedures. The mean gestational age during delivery was 33.6 ± 4.6 weeks. The mean interval between the diagnosis and delivery was 4.6 weeks. The mean birth weight was 2055 ± 1060g. 5th min Apgar score was 4pt. In 13 cases intrauterine demise of fetus occurred.ConclusionThe most frequent causes of acute hydramnios include fetal anomalies, the TTS in twin pregnancies and congenital infections. Amnioreductions are the therapeutic approach with a significant effect on the prolongation of pregnancy.
F116Wharton's jelly quantification during gestation and its correlation with fetal biometry
Authors: Ghezzi F. , Raio L. , Di Naro E. , Franchi M. , Ferronato R. , Brühwiler H. , Triacca P. , Bolla D. , Schneider H. 
Published: March 2003

BackgroundAbnormalities of the umbilical cord size have been associated with the growth of the fetus (Raio et al. Ultrasound Obstet Gynecol 1999; 13: 176). Therefore, this study was undertaken to generate a nomogram for the amount of Wharton's jelly (WJA) during gestation and to investigate whether it is related to fetal biometric parameters.MethodThe sonographic cross‐sectional area of the umbilical cord and of its vessels was measured in 627 healthy fetuses between 15 and 42 weeks of gestation. The WJA was calculated subtracting the vascular area from the umbilical cord area. The conventional biometric parameters were measured.ResultsThe WJA increases as a function of gestational age (r = 0.63, P < 0.001). A stron correlation was present between the WJA and the umbilical cord area (r = 0.97, P < 0.001). A significant correlation was found between the WJA and fetal biometric parameters (with BPD, r = 0.66, P < 0.001; with AC, r = 0.65, P < 0.001; with FL r = 0.64, P < 0.001) and between WJA and estimated fetal weight (r = 0.63, P < 0.001).ConclusionA nomogram for the WJ amount has been generated. The WJA increases as a function of gestational age and it is related either with fetal size and with umbilical cord diameter.
F121The routine use of the three vessels and trachea (‘3VT’) view in fetal echocardiography
Authors: Yagel S. 
Published: March 2003

Detailed fetal echocardiography potentially detects most congenital heart defects. In the last decade, screening programs have been established in numerous institutions in an attempt to rule out fetal heart anomalies in all pregnancies. However, fetal heart examination is time‐consuming and requires special skills. The ‘four chamber view’ and identification of ventricular outflow tracks became standard tests in screening programs. Examination of the aortic arch and superior vena cava, the location of the trachea in the mediastinum, the size of the aortic arch, main pulmonary artery, and the ductus arteriousus, and the direction of flow in these vessels, demands special attention and increases significantly the time required for routine fetal heart examinations.We introduced the identification of the main pulmonary artery, ductus arteriosus, aortic arch, transverse section of the superior vena cava, and transverse section of the trachea into our routine fetal heart study. This ‘three vessel view’ is obtained by sliding the transducer upward from the four‐chamber plane toward the fetal upper mediastimun. In more than 2500 cases this maneuver significantly reduced the time required to examine these structures. Moreover, this approach facilitated detection of pathologies such as abnormal vessel size, abnormal vessel alignment or arrangement, and was shown to be superior in detecting anomalies such as persistent left superior vena cava, right aortic arch, vascular ring, and others.We believe that this view should be introduced into the routine examination of the fetal heart.
F128The sonographic detection of fetal cardiac rhabdomyomas
Authors: Pinto V. , Selvaggio S. , Volpe P. , D’Addario V. 
Published: March 2003

ObjectiveTo compare the sonographic appearance of suspected cardiac tumors with the postnatal results and to assess the influence of antenatal ultrasound on the management of these lesions.Study designThe study group consisted of 6 patients at 28–37 weeks of gestation referred to our Ultrasonic Unit, between March 1992 and December 1998, for suspected fetal cardiac masses.ResultsAll the 6 cases of suspected rhabdomyomas have been confirmed in the neonatal period. The tumors were single in three cases and multiple in the other cases. The size ranged from 11 to 47 mm. In two cases the tumors arose from the right ventricle, in one case from the interventricular septum and in three cases from the left ventricle. Five infants are alive and in a satisfactory hemodynamic compensation. In two patients a regression in the maximum diameter of the tumor masses has been observed. One case underwent a surgical treatment at the age of six months and the baby died after surgery. In 3 out of 6 cases an association with tuberous sclerosis has been detected.ConclusionsTwo‐dimensional and Doppler echocardiography are accurate non invasive methods to evaluate fetal cardiac masses. They allow an immediate diagnosis and a reliable follow‐up of fetal and neonatal cardiac tumors. In our cases prenatal diagnosis did not appear to influence the outcome.
F24Assessment of endometrial volume by virtual organ computer aided analysis (VOCALTM) with three‐dimensionnal ultrasound prior to embryo transfer
Authors: Rudigoz R. C. , Bory A. M. , Affif A. , Salle B. 
Published: March 2003

BackgroundThe aim of this study was to obtain quantitative data on endometrial volume at the time of the oocyte retrieval in IVF patientsMaterials and methods110 consecutive patients undergoing IVF were included. The day of oocyte retrieval, patients were scanned by 3D ultrasound with Voluson 530 D (Kretztechnik AG, Zipf, Austria). Once the uterus was centred in longitudinal section, the volume box was superimposed. The volume was captured and stored on a 540 Mbyte with an integrated magneto optical drive. Endometrial volume was calculated with Virtual Organ Computer Aided Analysis (VOCALTM).ResultsPregnancy rate was 25.45% (28/110). There was no statistical difference in age, ampoule of rec FSH, E2 level at the time of the oocyte retrieval, number of oocyte, number of mature oocyte, embryos and embryos transferred between pregnant and non pregnant women. Mean endometrial thickness was 10.29 mm in the pregnant group and 9.54 mm in the non pregnant group. Mean endometrial volume was 5.10 cm3in the pregnant group and 4.31 cm3 in the non pregnant group. A paired t‐test showed no statistical difference in endometrial thickness (P = 0.4) and volume (P = 0.08) between the two groups of patients.Conclusion3D‐ultrasound enables easy calculation of the endometrial volume. Although there is a statistical tendency endometrial volume cannot be use to appreciate uterine receptivity during IVF.
F29Vascular network in LUF syndrome
Authors: Marton U. , Kupešić S. , Kurjak A. 
Published: March 2003

BackgroundThe principal aim was to reveal additional information and comprehension's on physiology of the normal and pathophsysiology of disturbed cycles, that may lead towards the new diagnostic approaches and treatments in infertile patients.MethodThe group of 22 patients included women with LUF syndrome. The emphasis was put on the intraovarian vascularity and especially on vascularity from inner vessels of ring of the follicle. Scans were performed on 5th, 10th, 12th, 21st and 24th day of menstrual cycle. A control group of 38 patients with regular menstrual cycles was selected on the basis of the normal gynecological, sonographical and hormonal findings. These patients had normal ovulatory cycles but were investigated for infertility due to the male factor.ResultsDoppler studies of the uterine artery and its evaluated branches have suggested significant decrease of the velocities at 12th and 15 h day of MC compared to control group. The RI of ovarian artery were around 0.84 ± 0.016 during the MC and excepted lowering of the RI has not occurred during the preovulatory period as in the control group. Velocity of ovarian artery of the dominant side showed significantly lower values, with the mean values of 34 cm/s ± 1.1 in the patients with LUF sy. compared to controls. The development of the RI of the intraovarian stromal vessels in LUF sy. were similar to that of anovulatory cycles, showing the loss in the cycling rhythm and post peak LH values similar to those of the follicular growth phase.ConclusionThe results of this study showed again that there is clear relationship between hormone mediators, primarily the steroids and velocimetric indices taken during the observed cycles. It also would seem that the hormones, with its mediators and hemodynamic factors play an important role through systemic and local action, in regulating uterine and ovarian blood flow.
F37Serial measurements of ductus venosus flow velocity waveforms and nuchal translucency thickness: relationship with fetal outcome
Authors: Bilardo C. M. , Müller M. A. , Pajkrt E. , Bleker O.P. 
Published: March 2003

BackgroundIn a previous study we have demonstrated that a statistically significant relationship exist between nuchal translucency (NT) thickness and ductus venosus flow measurements. Moreover we have shown that a decrease in NT thickness at a subsequent examinationl reduces the chance of an abnormal outcome. The aim of this study was to investigate the interrelationship between NT thickness and ductus venosus Doppler measurement (a‐wave, pulsatility index PI) at repeated examinations and their relationship with fetal outcome.MethodDuctus venosus flow velocity waveforms and NT thickness were measured twice (median 4 days range 2–7) in 36 fetuses with increased nuchal thickness.ResultsAccording to the behaviour in the two parameters the fetuses were divided into three categories: unchanged both abnormal (1), unchanged only NT persistently abnormal (2) and changed NT decreased. The fetuses in group 1 had a 20 fold increase chance of an abnormal outcome (chromosomal anomalies, unexplained intrauterine death, congenital anomalies, cardiac defects n.). Conversely fetuses in group 3 had a lower chance of an abnormal outcome than group 1 and 2.ConclusionIn fetuses with normal karyotype the finding of persistently increased NT and ductus venosus flow represents a poor prognostic factor, more than when nuchal translucency alone is persistently abnormal.