bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation between karyotype and ultrasound findings in patients with failed early pregnancy
Authors: Goldstein S. R. , Kerenyi T. , Scher J. , Papp C. 
Published: March 2003

AbstractThe aim of this retrospective study was to identify any consistent patterns between ultrasound findings in failed pregnancies and either normal or abnormal karyotypes. The study involved 102 women, in whom the diagnosis of early pregnancy failure was made sonographically. The criteria for a failed pregnancy were: a gestational sac with a mean diameter of > 12 mm without a yolk sac; a yolk sac of > 6 mm mean diameter with or without abnormal morphology that ultimately failed to develop an embryonic structure; and an embryo with a crown‐rump length (CRL) of > 5 mm without cardiac activity, or the loss of previously identified cardiac activity. All patients underwent elective dilatation and curettage (D & C) and products of conception were sent for karyotyping.Forty‐four pregnancies (43%) had abnormal karyotypes. Of these, 33 (75%) were trisomies. The other 11 included four triploidies, one tetraploidy, two with monosomy X, and four others (unbalanced complement, isochromosome, terminal deletion and translocation). Fifty‐eight pregnancies (57%) had normal karyotypes, of which 52 were 46,XX and six were 46,XY. The furthest sonographic anatomic landmark achieved did not differ with respect to karyotypic findings. An abnormal yolk sac was found in 10/58 cases (17.2%) with normal karyotypes and 8/44 cases (18.2%) with abnormal karyotypes. There were eight cases of trisomy 16, of which only two manifested an embryonic structure, but neither of which had cardiac activity; the largest was 4 mm. There were four cases of trisomy 22, of which three developed embryos with a CRL of > 10 mm with cardiac activity (11, 11 and 18 mm, respectively). In three cases of mosaicism, embryos developed cardiac activity, and were 9, 19 and 16 mm. Two cases of monosomy X had embryos of 14 and 24 mm. Only one out of five cases with multiple trisomies developed to a point at which any embryonic structure was identifiable on ultrasound examination.The ultrasound appearance of early pregnancy failure in terms of furthest anatomic landmark reached was not significantly different in cases with normal or abnormal karyotype. An abnormally enlarged yolk sac, presumably secondary to hydropic change, is a non‐specific finding of failed pregnancy, and did not correlate with karyotypic status. It appears from these preliminary data that pregnancies with certain types of karyotypic abnormality (trisomy 22, mosaics, monosomy X) seem (to develop further prior to embryonic demise than hose with certain others (trisomy 16, multiple trisomies and unusual other variants). Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Standards for the quantification of serial changes in the amniotic fluid index
Authors: Owen P. , Ogston S. 
Published: March 2003

AbstractA total of 274 low‐risk pregnancies underwent predetermined scheduled serial ultrasound examinations and measurements of the amniotic fluid index (AFI). As expected from previous cross‐sectional studies, there is a gradual decline in the AFI from mid‐trimester until term. The longitudinal nature of this data set permits the construction of conditional Gentiles for AFI whereby the AFI of an individual fetus at a given gestational age can be extrapolated to give a range of expected values for AFI (expressed as centiles) at a later gestational age. Examples of conditional centiles based upon 4‐week measurement separations are presented. These conditional centiles permit the appropriate evaluation and quantification of time‐dependent changes in AFI to be made. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Comparison between two methods of standardization for gestational age differences in fetal nuchal translucency measurement in first‐trimester screening for trisomy 21
Authors: Biagiotti R. , Periti E. , Brizzi L. , Vanzi E. , Cariati E. 
Published: March 2003

AbstractOur purpose was to compare two different methods of expressing nuchal translucency (NT) measurements in first‐trimester screening for trisomy 21: the difference in millimeters from the median of nuchal translucency (delta value: δNT) and the multiple of the expected median (MoM). Fetal nuchal translucency was measured in 32 fetuses with trisomy 21 and in 3180 normal fetuses at 9–13 weeks' gestation. For each fetus, the measured nuchal translucency was expressed both as a delta value and MoM. The effectiveness of the MoM‐Gaussian vs. the delta value method in modifying the age‐specific risk for trisomy 21 was compared by using both the maternal age distribution of our study population and the age distribution of a general obstetric population. The use of the MoM‐Gaussian approach led to a reduction in the false‐positive rate at a given detection rate, both in the study population (by 1.2–15.2%) and in the general population (by 0.4–2.4%). Our results suggest that the use of the MoM‐Gaussian method might confer a potential advantage on the screening performance of nuchal translucency in combination with maternal age by decreasing the false‐positive rate. Further studies in larger unselected populations will be needed to confirm the effectiveness of this approach. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Doppler velocimetry of the aortic isthmus in human fetuses with abnormal velocity waveforms in the umbilical artery
Authors: Sonesson S‐E. , Fouron J.‐C. 
Published: March 2003

AbstractExperimental studies in animals using Doppler ultrasound suggest that hemodynamic disturbances during fetoplacental circulatory insufficiency will be detected at an earlier and less severe stage in the aortic isthmus compared to the umbilical artery. In cases in which more severe impairment of the placental circulation was achieved, reverse flow was recorded in the aortic isthmus before its appearance in the umbilical artery. The present study was undertaken to investigate whether the same findings could be demonstrated in the aortic isthmus of the human fetus. The video recordings of 100 fetuses with abnormal umbilical artery pulsatility index were reviewed. Qualitative abnormalities of the Doppler waveform, i.e. absence or reversal of end‐diastolic velocities, were more frequently found in the aortic isthmus (absent 28%, reversed 41%) compared to the fetal end of the umbilical artery (absent 20%, reversed 19%; p < 0.0001) and also more frequently found in the fetal end compared to the placental end (absent 13%, reversed 2%; p < 0.0001). This study confirms our previous observations of the aortic isthmus as a site for early detection of fetoplacental hemodynamic disturbances. Reverse diastolic flow in the isthmus could direct poorly oxygenated blood from the descending aorta towards the carotid arteries and the brain. Further prospective studies are needed to establish the clinical value of these findings in terms of perinatal morbidity and, more importantly, of long‐term neurological impairment. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
In utero lysis of amniotic bands
Authors: Quintero R. A. , Morales W. J. , Phillips J. , Kalter C. S. , Angel J. L. 
Published: March 2003

AbstractAmniotic band syndrome is a sporadic condition that occurs in approximately 1 : 1200 to 1 : 15 000 live births and that may result in amputations, constrictions and other deformities of the fetus. Although some cases present with congenital anomalies that are beyond surgical repair, a selected group of fetuses may show isolated limb constriction. It has been speculated that, without treatment, amputation or severe dysfunction of the limb may occur. Despite these potential complications, surgical treatment for this selected group of fetuses has not been previously performed. We report two cases that were successfully treated using novel minimally invasive surgical techniques. The cases involved fetuses with amniotic band syndrome with associated limb constriction in which the amniotic band was surgically interrupted to avoid spontaneous amputation of the extremity. Adequate blood flow distal to the obstruction was preserved and significant functional improvement of the extremity occurred in both cases, preserving the limbs. These cases represent the first prenatal surgical intervention successfully used to treat constricting amniotic bands in humans. In addition, these cases represent the first time that a non‐lethal fetal entity has been surgically treated in utero. The results of this innovative therapy will encourage the efforts to continue developing minimally invasive techniques for the correction of birth defects. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
The effect of intravascular blood transfusion on the flow velocity waveform of the portal venous system of the anemic fetus
Authors: d'Ancona R. L. , Rahman F. , Ozcan T. , Copel J. A. , Mari G. 
Published: March 2003

AbstractOur objective was to assess flow velocity waveforms of the portal venous system of the anemic fetus prior to and immediately following intravascular transfusion.Color‐guided pulsed Doppler was used to obtain flow velocity waveforms from the fetal portal vein in 14 anemic fetuses that were transfused in utero for rhesus alloimmunization. The portal vein velocity pattern was defined as continuous when no change in velocity during the cardiac cycle was noted. It was defined as pulsatile when a deflection of the wave was present. The flow velocity waveforms were quantified by using the ratio between the peak (highest, H) and the nadir (lowest, L) velocities (H/L ratio).Fourteen intravascular transfusions were performed. Gestational age ranged from 19.5 to 35 weeks (mean ± SD, 24.7 ± 5.3 weeks). The hematocrit ranged from 5.9 to 31.2% (mean ± SD, 20.3 ± 9%) prior to transfusion; after transfusion it was between 24.8 and 56.7% (mean ± SD, 42 ± 10.4%). In six cases (43%) the waveforms were pulsatile prior to transfusion; in the other eight (57%) they were continuous. The pulsatile pattern was present following transfusion in 23 cases (93%, p < 0.05). The mean of the H/L ratio was 1.3 ± 0.38 prior to transfusion and 2.0 ± 0.86 after transfusion (p < 0.0s).Because the portal vein has continuous non‐pulsatile flow in the normal fetus, the presence of pulsatility in the waves of six anemic fetuses (43%) may suggest portal hypertension. Compared to normal fetuses, there was an increased number of cases with pulsation, and even more so after transfusion. The pattern corresponds to findings in children with portal hypertension. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Sirenomelia sequence versus renal agenesis: prenatal differentiation with power Doppler ultrasound
Authors: Sepulveda W. , Corral E. , Sanchez J. , Carstens E. , Schnapp C. 
Published: March 2003

AbstractIn order to assess the role of power Doppler ultrasound in the prenatal diagnosis of sirenomelia, prenatal findings in two fetuses with the sirenomelia sequence and in seven with bilateral renal agenesis were reviewed and compared. Both conditions were characterized by absence of renal vessels. However, the two common iliac arteries were always visualized in fetuses with renal agenesis, whereas absence of distal branching of the main abdominal vessel was a characteristic feature of sirenomelia. Power Doppler ultrasound allows expeditious identification of absent or non‐functional renal arteries in fetuses with severe oligo‐hydramnios. In addition, incorporation of power Doppler imaging to identify the aortic bifurcation could provide a diagnostic feature that could assist in the prenatal diagnosis of sirenomelia and in the differential diagnosis with other causes of bilateral renal agenesis. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Assessment of left ventricular filling in normally grown fetuses, growth‐restricted fetuses and fetuses of diabetic mothers
Authors: Tsyvian P. , Malkin K. , Artemieva O. , Wladimiroff J. W. 
Published: March 2003

AbstractObjectiveTo determine fetal left ventricular diastolic function as expressed by normalized left ventricular filling rate integral as well as conventional indices of transmitral blood flow in appropriate‐for‐gestational‐age (AGA), small‐for‐gestational‐age (SGA) and IDDM (insulin‐dependent diabetes mellitus) fetuses during the third trimester of pregnancy.DesignA cross‐sectional study of fetal left ventricular filling using conventional parameters of transmitral blood flow.SubjectsTwenty‐five AGA fetuses (mean 32 weeks), 18 SGA fetuses (mean 32 weeks) and 15 fetuses associated with IDDM (mean 31 weeks).MethodsDoppler measurements of mitral inflow velocity were converted to relative cumulative volume flow by integration at sequential time points along the velocity contour, producing a relative filling curve of the ventricle. The area under this curve was calculated to obtain the left ventricular filling rate integral.ResultsThe left ventricular filling rate integral (I) for the complete diastole (E + A wave) was not significantly different between AGA and SGA fetuses but significantly lower in the IDDM fetus (p < 0.05) compared with the AGA fetus. Ie (E wave) was significantly lower and Ia (A wave) significantly higher in both SGA fetuses (p < 0.05) and IDDM fetuses (p < 0.01) compared with AGA fetuses.ConclusionsThere is a delay in left ventricular filling which may reflect changes in myocardial relaxation and possible reduction in passive ventricular filling as a result of chronic hypoxemia in the SGA fetus and altered in utero metabolic environment in the IDDM fetus. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Imaging of placental vasculature using three‐dimensional ultrasound and color power Doppler: a preliminary study
Authors: Pretorius D. H. , Nelson T. R. , Baergen R. N. , Pai E. , Cantrell C. 
Published: March 2003

AbstractObjectiveTo assess placental vasculature using color power Doppler and three‐dimensional ultrasound techniques.DesignA prospective study was performed in patients to correlate visualization of placental vessels in vivo with known anatomy.SubjectsFourteen normal patients and one patient with intrauterine growth restriction were recruited to the study.MethodsVessels were assessed with regard to, first, the number of vessels seen within the placenta, second, the branching pattern of the vessels within the placenta, third, the number of vessels seen along the surface of the placenta, and, last, the number of vessels seen in the maternal circulation.ResultsOur results show that the placental vessels seen with this technique correlate well with known anatomy. A progressive increase in the number of intraplacental vessels and the number of vascular branches observed was seen with increasing gestational age. Volume data review using three orthogonal planar images had two distinct advantages. First, they could be obtained from orientations not possible using two‐dimensional ultrasound alone, and, second, they could be viewed in conjunction with volume‐rendered images to allow for referencing and identification of specific vessels. Volume‐rendered images were valuable in allowing the observer to acquire an improved overall understanding of placental anatomy. They also assisted the observer in following the continuity of vessels as they wrapped around and twisted through three‐dimensional space. Stereo viewing was helpful in distinguishing overlapping vessels.ConclusionsOur study showed that sonographic volume imaging combined with color power Doppler imaging methods allowed for individual vessels in the placenta to be identified, both in the fetal and maternal circulations. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Cervical length at 23 weeks of gestation: relation to demographic characteristics and previous obstetric history
Authors: Heath V. C. F. , Southall T. R. , Souka A. P. , Novakov A. , Nicolaides K. H. 
Published: March 2003

AbstractObjectivesTo examine the feasibility of introducing routine measurement of cervical length at 23 weeks of gestation, to establish the distribution of cervical lengths in a routine population of singleton pregnancies and to examine the relation between cervical length and demographic characteristics and previous obstetric history.MethodsCervical length was measured by transvaginal sonography at 23 weeks of gestation in women with singleton pregnancies attending for routine antenatal care. The distribution of cervical lengths was established and the significance of differences in median cervical length between subgroups according to maternal age, ethnic origin, maternal ponderal index, cigarette smoking, alcohol drinking, drug abuse and previous obstetric history was calculated. In addition, 100 women were asked to complete a questionnaire aimed to assess the degree of discomfort, pain or embarrassment caused by the scan. In 100 pregnancies, cervical length was measured in each patient by two of four operators to determine intraobserver and inter‐observer variabilities.ResultsDuring the study period, 2702 (80%) of the 3358 women attending for a 23‐week scan agreed to participate in the study and, in all cases, the cervical length was measured successfully. The median cervical length was 38 mm and in 1.6% of cases the length was 15 mm or less. More than 90% of the women reported that the procedure was associated with no or only mild discomfort and embarrassment, whilst 85% found the ultrasound scan to be equally or less uncomfortable than a speculum examination. Measurement of cervical length was highly reproducible and, on 95% of occasions, the difference between two measurements by the same observer and by two observers was ≤ 3.5 mm and ≤ 4.2 mm, respectively. Cervical length was significantly shorter in women of Afro‐Caribbean origin compared to Caucasians, those aged less than 20 years, those with a low ponderal index, those with a history of previous miscarriage or preterm delivery and in drug abusers.ConclusionsTransvaginal sonographic measurement of cervical length is highly reproducible and it is associated with a minimal degree of discomfort to the patients. At 23 weeks, the median cervical length is 38 mm and, in 1.6% of the population, the length is 15 mm or less. There is an association between cervical length and demographic characteristics and previous obstetric history. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Nuchal translucency audit: a novel image‐scoring method
Authors: Herman A. , Maymon R. , Dreazen E. , Caspi E. , Bukovsky I. , Weinraub Z. 
Published: March 2003

AbstractObjectiveThe aim of this study was to evaluate the feasibility and reproducibility of a novel image‐scoring method of first‐trimester nuchal translucency measurement as an objective tool of ongoing audit and training.DesignThis was an independent evaluation of nuchal translucency images by three separate reviewers unaware of the examiner.SubjectsThere were 105 consecutive singleton pregnancies undergoing first‐trimester screening.MethodsEach image was scored according to the following criteria: section (oblique, 0; mid‐sagittal, 2), caliper placing (misplaced, 0; proper, 2), skin line (nuchal only, 0; nuchal and back, 2), image size (unsatisfactory, 0; satisfactory, 1), amnion (not visualized, 0; visualized, 1) and head position (flexion/hyperextension, 0; straight, 1). The final score was categorized into one of four quality groups: excellent (8–9), reasonable (4–7), intermediate (2–3), unacceptable (0–1).ResultsThe distributions of the four quality groups were similar between the three reviewers: 11.4% were classified as excellent, 57.1% as reasonable, 25.7% as intermediate and 5.7% as unacceptable. Inter‐reviewer agreement showed identical classification, by each pair of reviewers, from 65.7% to 74.3%, and partial agreement to neighboring quality groups from 25.7% to 34.3% of the cases. In none of the cases did the reviewers differ in categorizing cases to remarkably different quality groups. Application of the auditing method to the examiners showed similar distribution to the various quality groups and similar mean final score of 4.69 (0.39, SE), 4.54 (0.15, SE) and 4.65 (0.15, SE).ConclusionsThe described image‐scoring method represents a new approach towards the evaluation of ultrasound performance as a whole and nuchal translucency measurement in particular. It may be employed by every center in an independent manner with minimal resources and regardless of the method of risk assessment. More studies will be needed to determine the standards required from the examiners and to elucidate the contribution of the proposed auditing method to the examination's quality and the process of training. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Fetal yawning activity in normal and high‐risk fetuses: a preliminary observation
Authors: Petrikovsky B. , Kaplan G. , Holsten N. 
Published: March 2003

AbstractObjectiveTo study yawning activity in healthy fetuses and in fetuses at high risk.MethodsYawning activity was studied in 16 healthy and 22 high‐risk fetuses. Studies were performed in the postprandial state at 09.00 and 12.00 in a quiet room with the woman in the lateral recumbent position. All ultrasound examinations were performed using a 3.5‐MHz Acuson 128 PX curvilinear probe. Fetal lips, mouth, tongue, pharynx, larynx, trachea and esophagus were surveyed in serial coronal and sagittal planes. All fetal mouthing movements were analyzed by a review of the videotape in slow motion.ResultsIn both normal and high‐risk fetuses, yawning was represented by isolated mouthing movements and consisted of slow opening of the mouth with simultaneous downward movements of the tongue. This phase occupied 50–75% of the yawning cycle. After reaching its maximum opening, the mouth remained wide open for 2–8 s and returned to its resting position within seconds. Growth‐restricted fetuses demonstrated yawning patterns consisting of isolated yawns similar to those seen in healthy fetuses. Unusual bursts of fetal yawning activity were recorded in anemic fetuses.ConclusionYawning activity in anemic fetuses may represent a compensatory process to increase venous return to the heart. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Antenatal visualization of vascular anastomoses in monochorionic twins using color Doppler sonography: the protective function of these anastomoses and the phenomenon of interference beating
Authors: Joern H. , Klein B. , Schmid‐Schoenbein H. , Rath W. 
Published: March 2003

AbstractThis report concerns the antenatal visualization and velocimetry of an arterioarterial and a venovenous anastomosis in a monochorionic twin pregnancy using color Doppler sonography. The phenomenon of ‘interference beating’ occurs when two flow velocity waveforms are super‐imposed in one blood vessel. This characteristic image can be generated antenatally to confirm the existence of a vascular communication. We were able to reveal these anastomoses postnatally using the dye injection technique. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology