bluuebunny/crossref_metadata_2025_split huggingface dataset:
P18Fetal cerebral ventriculomegaly. An observational study
Authors: Pinzano R. , Meir J. , Natale R. , Conoscenti G. C. , Fischer‐Tamaro L. , Maso G. P. , Bogatti P. , Rustico M. A. , D'ottavio G. 
Published: March 2003

BackgroundThe aim of this study is to review all the cases of FCV diagnosed in the Obstetric and Gynecology Unit of our Institution from 1990 to 1999 and to evaluate the neonatal outcome.MethodThis is a retrospective study. The diagnosis of ventriculomegaly is according to Cardoza criteria and to atrial width ≥ 10 mm between 15 and 40 weeks gestational. For all cases we consider: progression and/or resolution; association with other fetal ultrasound signs of malformations and with chromosomal abnormalities; fetal infections (TORCH); pregnancy termination and follow‐up by pediatric report. In cases of interruption of pregnancy we evaluate postmortem examination.ResultsAmong 165 cases of FCV, n 84 (50.9%) are associated with malformation of SNC, n 59 (35.76%) are isolated, n 22 (13.33%) are associated with other fetal malformations. In the group of isolated: 32 case are borderline (≤ 15 mm), chromosomal abnormalities are 4 among 40 evaluated (10%), favourable neonatal outcome is present in 22 cases of 29 born (75.86%).ConclusionsIn this study the percentage of chromosomal abnormalities in the FCV isolated is higher than other series in the literature. The reproducibility of measurement of atria rather permits comparisons than other qualitative and quantitative signs.
P20Early membrane funnelling may occur from 16 weeks onwards and carries a worse prognosis
Authors: Bellver J. , Lberico G. , Lara C. , Ferro J. , Remohí J. , Pellicer A. , Serra‐Serra V. 
Published: March 2003

BackgroundSonographic screening for cervical incompetence during pregnancy is currently a routine procedure. However, no consensus exists on the optimal gestational age to perform such screening.MethodSerial transvaginal ultrasound examinations of the uterine cervix were routinely performed from 12 weeks onwards. The screening was considered positive when membrane funnelling was present or the cervical length was < 2 cm. Therapeutic measures included bed rest, antibiotics, tocolytic treatment and a modified McDonald's cervical suture (up to 25 weeks).ResultsMembrane funnelling was detected between 16 and 22 weeks (group A) in 9 women (31%); between 23 and 28 weeks (group B) in 11 women (38%) and between 29 and 36 weeks (group C) in 9 women (31%). Two women presented with hourglass membranes at 20 and 23 weeks, respectively. Comparison between groups A and B showed similar women characteristics and risk factors (P = NS). Delivery rate at ≤ 28 weeks was higher in group A (62.5%) than in group B (9.1%) (P < 0.03). Only one woman in group A and three in group B delivered at term.ConclusionThis small series provides evidence to recommend serial monographic examinations of the uterine cervix, starting at 16 weeks. A greater risk of very premature delivery was evident when membrane funnelling was diagnosed before 23 weeks.
P21Fetal liver volume in normal and reduced fetal growth
Authors: Boito S. , Struijk P. C. , Laudy J. , Stijnen H. R. , Wladimiroff J. W. 
Published: March 2003

BackgroundTo establish reproducibility and normal values for fetal liver volume and its significance in identifying fetal growth restriction relative to head (HC) and abdominal circumference (AC) according to a cross‐sectional study design.MethodThe measurements were obtained using a Voluson 530‐D for volume scanning. The coefficient of variation (CV) for liver volume scans (t0, t20 min) and liver area tracings (t0: 2x; t20: 2x) was determined (n: 20; 23–36 weeks). Normal charts for liver volume, HC, AC were constructed (n: 60; 22–37 weeks) and related to data from growth‐restricted fetuses (birthweight < P5) (n: 13; 23–36 weeks).ResultsCV is 2.9% for volume scans and 1.6% for area tracings. Mean liver volume (P50) ranges between 16.5 mL (± 5.9 (SD)) at 22 weeks and 101.8 mL (± 8.2 (SD)) at 37 weeks. In fetal growth restriction, liver volume, HC and AC expressed as percentage of the normal P50 is 45%, 91% and 83%, respectively. Mean difference in liver size between fetal growth restriction (FGR) and normal fetal development (Z score = Liver volumeFGR– P50normal/SDnormal) is −4.5 ± 1.6 (SD), which is significantly different (P < 0.05) from HC: − 3.2 ± 1.5 (SD), but not from AC: − 4.3 ± 1.3 (SD).ConclusionAcceptable reproducibility exists for liver volume determinations. Normal liver volume increases 6‐fold at 22–37 weeks. Fetal growth restriction: reduction is more pronounced for liver volume than HC and AC; liver volume is a better discriminator than HC, but not AC.
P24Fetal porencephaly as a rare complication of epignathus occluding blood flow in the internal carotid artery
Authors: Lex B. , Berg C. , Reusche E. , Masson D. , Gembruch U. 
Published: March 2003

BackgroundEpignathus is a rare benign congenital teratoma of the hard palate. Some of these tumors protrude bidirectionally involving pharyngeal as well as intracranial structures. The poor prognosis of the affected fetuses is due to consecutive airway obstruction and destruction of brain tissue. We report an unusual case of epignathus leading to compression of the internal carotid artery with subsequent porencephaly.In a 27‐year‐old gravida 1 at 25 weeks gestational age with polyhydramnios, ultrasound examination demonstrated extensive epignathus with displacement of adjacent structures, hydrocephaly and porencephaly. Neither brainstem nor cerebellum could be clearly identified. A steal effect was excluded as low tumor vascularisation and high resistance indices of the supplying vessels was demonstrated, therefore porencephaly was suspected to be caused by vascular compromise. Amniocentesis revealed a normal karyotype. The parents elected to terminate the pregnancy. Autopsy results were confirmatory. An immature teratoma of the hard palate measuring 95 × 42 × 32 mm compressing the left internal carotid artery was demonstrated, leading to colliquation necrosis of the left hemisphere. Additionally displacement of brainstem and infiltration of cerebellum led to cerebrospinal fluid block and consecutive hydrocephalus.ConclusionOnly few reports exist on the prenatal diagnosis of epignathus. We report the first case of epignathus causing extensive brain damage by vascular compromise.
P28Prenatal diagnosis of schizencephaly: case report
Authors: Lagos N. , García C. , Walton R. , Hoffmann I. , Muñoz H. 
Published: March 2003

BackgroundSchizencephaly is a rare congenital malformation of the central nervous system. It consists in the finding of unilateral or bilateral clefts in the cerebral hemispheres.Case report36‐year‐old patient, at week 22, an ultrasound showed hydrocephaly with a 19‐mm atrium. At week 27, a 6‐mm diameter defect was shown in the cerebral parenchyma of the right hemisphere, that was comunicated with the lateral ventricle, with normal atrium. The conclusion was Schizencephaly. Magnetic resonance imaging (MRI) also showed the parenchymal defect, with comunication to the lateral ventricle, and no hydrocephalus. Cesarian section was performed at week 38, with a 2780 g.NewbornPostnatal echography and computed tomography showed no changes.DiscussionTwo types of schizencephaly have been described: Type I, in which the defect is closed‐lip, because the lips of the clefts are fused within a pia‐ependymal seam that is continous with the ependyma of the lateral ventricle, and type II, in which the lips remain open, and the clefts are more extensive. Pathogenesis is unclear but anomalies of neuronal migration during the third to fifth gestational months are invoked. Clinically, patients have seizures, developmental delay and hemiparesias. In this case, diagnosis was suspected by ultrasound and confirmed by MRI, which is the best method. Ultrasound permited us to follow the defect and best decide when to interrupt pregnancy.
P03The value of ultrasound screening for fetal abnormalities in the first trimester
Authors: Tankó A. , Steinmetz G. Y. , Varga Á. , Kovács A. G. , Godó G. Y. , Marton T. , Papp Z. Z. 
Published: March 2003

ObjectiveEvaluation of routine screening in the early pregnancy by transvaginal sonography (TVS) in an unselected population. Design and methods: A routine ultrasound examination was offered to every woman in the 12th week of her pregnancy. Besides a detailed survey of fetal anatomy, a measurement of nuchal translucency and karyotyping was performed as appropriate.ResultsIn a five‐year period (from 1. Jan. 1995 – to 31. Dec. 1999) 9556 women were examined. Fetal anomalies were diagnosed in 54 cases at the 12th week of pregnancy: 63 morphological abnormalities and 16 chromosomal aberrations. The detection rate for structural and chromosomal abnormalities in early pregnancy was 50.5% (54/107) of all anomalies, which were diagnosed antenatally.ConclusionsIt is possible to detect fetal abnormalities very early in pregnancy. The ultrasound screening may increase the detection rate of chromosomal disorders. The interpretation of fetal anatomy in the first trimester requires comprehensive understanding of embryological development. The detection rate of fetal malformations is increased significantly by introducing an early pregnancy scan in addition to the mid‐trimester scan. The fetopathological examination can add more information to the clinicians and to genetic counselling.
P30Early prenatal diagnosis of fetal seizures
Authors: Haddad S. , Younis J. , Peleg D. , Ben‐Ami  
Published: March 2003

BackgroundPrenatal diagnosis of fetal seizures is rarely reported. We present the earliest prenatal case of fetal seizures diagnosed by ultrasound during the 15th week of gestation.MethodA 34‐year‐old woman gravida 10, para 3, with 6 miscarriages and 2 healthy living children, was referred for targeted sonographic examination at 15 weeks' gestation because of her bad obstetric history. Normal fetal structures and biometry were revealed. Repetitive episodes of jerking movements of fetal body and limbs were detected. Limited flexion of the limbs was also observed.ResultsTriple marker screening performed at 17 weeks' gestation was abnormal with a 1:13 risk for Trisomy 21, but the woman refused amniocentesis. The couple received extensive counselling, but refused further investigation and were lost to follow‐up until delivery. At 36 weeks' gestation, the woman was admitted with prom and breech presentation. A female newborn weighing 2000 g with apgars of 8 and 9 and cord ph 7.32 was delivered by cesarean section. Several hours after delivery, the newborn developed apnea and seizures requiring anticonvulsive treatment. The neonatal investigation revealed mitochondrial disease.ConclusionFetal seizures can be diagnosed in early gestation. In this presentation, we will present the case and review the literature and differential diagnosis of fetal and neonatal seizures.
P38Prenatal diagnosis of severe hypotonia and polihydramnius in a fetus with mitochondrial disorder
Authors: De León J. A. , Pérez Fernández R. , Granados M. , González M. , López J. , Clavero J. 
Published: March 2003

IntroductionThe diagnosis of polihydramnius is ultrasound and can be measure with a various test but finally the result is the increment of the amnioticus liquid. It is secundary from a differents pathological situations but severe hypotonia is a rare cause. The hypotonia is the result of a heterogeneous group of conditions including severe hypoxia, neuromuscular disorder, deposit disease, chromosomal, and mitochondrial pathology.Case reportA 30‐year‐old woman in the 40th week of gestation came to us referring a decrease in foetal movements during the last 24 h. The pregnancy curse had been normal. The foetal heart rate variability was pathological and the ultrasound study showed a decrease in respiratory movements, foetal movements and foetal tone with a abnormal amniotic liquid volume. The foetus was delivered by urgency caesarean section. A 3160‐g male was born, Apgar 6/8, pH 7.32. The newborn was taken to nciu and the neonatal outcome was unfavourable. The newborn had a severe hypotonia, hyporeflexia, the eec was pathological. Finally the newborn died.
P44Fetal kidney biometry from 10 to 14 weeks of gestation
Authors: Spathopoulos Y. , Chatzipapas I. , Whitlow B. , Economides D. 
Published: March 2003

BackgroundTo determine fetal biometrical reference ranges for the fetal kidney from 10+° to 14+6 weeks' gestation.MethodsA prospective cross‐sectional study in a University Department of Obstetrics and Gynaecology, London. Four hundred and thirty‐eight women from an unselected population underwent a detailed assessment of fetal anatomy at 10–14 weeks' of gestation (confirmed by crown‐rump length) using transabdominal sonography, and transvaginal sonography (37.4%: 164/438) when necessary. Anterior‐posterior (AP), transverse (T) and longitudinal (L) parameters for the kidney and renal pelvis were measured and charts for centiles derived using regression analysis and a model of best fit constructed.ResultsCentiles were derived for each biometrical parameter. New charts for each biometrical parameter are presented and compared with previously published data. The 95th centile for the renal pelvis anterior‐posterior diameter varied from 1.4 to 3.1 mm from 10+° to 14+6 weeks, respectively.ConclusionWe have constructed new reference ranges for kidney dimensions including new data on the renal pelvis dimensions.
P63The effect of fetal neck position on nuchal translucency measurement
Authors: Chatzipapas I. , Spathopoulos Y. , Whitlow B. , Economides D. 
Published: March 2003

BackgroundThe aim of this study was to determine whether the position of the fetal neck has a significant effect on nuchal translucency measurement (NT).MethodA prospective cross‐sectional study was carried out. One hundred and ninety‐six women from an unselected population underwent transabdominal sonography. The nuchal translucency was measured in the mid‐sagittal plane, with the fetal neck in the flexed, neutral and extended positions. Measurement was taken to the nearest 0.1 mm. Statistical analysis using a paired t‐test for the differences in the extended and neutral position nuchal translucency [delta extended NT] and in the flexed and neutral position nuchal translucency [delta flexed NT] was performed.ResultsOn average the extended NT was 0.62 mm greater than the neutral NT value [95% confidence interval 0.53–0.70, T = 14.33, P = < 0.00001]. The flexed NT was on average 0.40 mm less than the neutral NT value [95% confidence interval 0.34–0.47, T = 11.99, P = < 0.00001]. The repeatability coefficient was lower in the case of neutral NT measurement [0.48] and was higher in the other groups [extended = 1.04, flexed = 0.70].ConclusionThe effect of fetal neck position can make a significant difference on nuchal translucency measurement. Repeatability of measurements are more accurate with the fetal neck in the neutral position. These findings have important implications for clinicians using nuchal translucency to screen the general obstetric population.
P65Feasibility and accuracy of NT measurement in twin pregnancies
Authors: Dreazen E. , Maymon R. , Weinraub Z. , Herman A. 
Published: March 2003

BackgroundThe aim of our study was to evaluate the feasibility and accuracy of nuchal translucency measurement (NT) in twin pregnancies.MethodWe reviewed nt images of 66 pairs of twins (10.3–14 weeks gestation), matched with nt images of 66 pairs of consequent singleton pregnancies with similar gestational ages. Each of the inspected images was assigned a score, which classified it into one of four quality zones.ResultsIn the twins, as well as in the singleton control group, the vast majority of the nt images were in the excellent‐reasonable zones (−88%), and 10% in each of the groups had their nt images in the intermediate zone (11% vs. 12%). Less than 1.5% of the images were of unsatisfactory quality (1.5% vs. 0.8%), according to the strict criteria, required for reliable, comparable and reproducible results. (Hennan et al. Ultrasound Obstet Gynecol 1998; 12: 398–403).ConclusionNT measurement in twin pregnancies is as feasible, accurate and reproducible as in singleton pregnancies. However, it provides a better DS risk assessment when compared with the second trimester triple test in twin pregnancies, as it evaluates DS risk individually for each of the fetuses.
P67Analysis of fetal karyotypes after abnormal ultrasound findings
Authors: Auren J. , Ekholm E. , Palo P. 
Published: March 2003

BackgroundThe aim of this study was to evaluate fetal karyotypes in pregnancies with abnormal ultrasound findings. The cases were obtained from the catchment area of the Turku University central Hospital between March 1993 and September 1999. In 48% of cases maternal age was below 30 years.Methods287 pregnancies with abnormal ultrasound findings were evaluated. Ultrasound examination was performed on average at 21 weeks of gestation (range 10–40 weeks). In 247 cases fetal structural abnormality was detected. In the remaining 40 cases ultrasound abnormality was fetal intrauterine death, small fetal size, and or oligohydramnion or polyhydramnion and partial hydatiform mola (two cases). Amniocentesis was done in 90% and villus biopsy in 10% of cases.ResultsFetal karyotype was found abnormal in 15% of pregnancies. Trisomy 21 was found in 10 cases. Six of these pregnancies were sent for evaluation because of increased nuchal translucency, the remaining because of fetal hydrops, ascites or pleural effusion. Nine fetuses had monosomy XO and ultrasonography revealed a cystic hygroma. Four fetuses with trisomy 18 and four with trisomy 13 were found due to structural abnormalities. Fifty pregnancies were terminated, 19 of these because of fetal chromosomal abnormality. Six pregnancies ended in spontaneus abortion. Three of these carried a chromosomally abnormal fetus. Moreover, eight fetuses died in utero later in pregnancy. Karyotyping was not possible in one case.ConclusionFetal karyotyping should be done also in young mothers in the first and second trimester when fetal ultrasound examination is abnormal.
P76Early diastolic notch of uterine artery Doppler velocimetry in relation to placental location
Authors: Lee C. H. , Park Y. W. , Cho J. S. , Han S. S. 
Published: March 2003

BackgroundThe aim of this study was to investigate the relation between types of early diastolic notch and placental location and to evaluate the difference in perinatal outcome.MethodWe evaluated the Doppler waveform of the uterine artery in 149 pregnant women having an early diastolic notch after 26 weeks gestation, however, we were unable to follow the obstetric outcomes in 20 women. Placental location was determined by transverse view of ultrasonography and classified as central and lateral placenta. The unilateral diastolic notches were divided into 3 groups depending on the placental location (ipsilateral: same side of the placenta, contralateral: opposite side of the placenta, and median: central placenta).ResultsIn the bilateral notch group, the S/D ratio of the contralateral uterine artery was higher than the ipsilateral one (n = 60, mean = 3.22 VS 2.80, P = 0.0067). Of the 89 unilateral notches observed, the S/D ratio of the uterine artery in patients having early diastolic notch was higher compared to those without early diastolic notch. (t‐test, mean = 2.74, 1.92, P = 0.0001) Patients with bilateral notches were associated with poor perinatal outcomes significantly more than the patients with unilateral notches (P = 0.003). Among the unilateral groups (ipsilateral: n = 10, median: n = 21, contralateral: n = 58), there was no significant difference in perinatal outcomes.ConclusionThe early diastolic notch can be observed on both or either sides of the uterine artery independent on placental location. More bilateral notches were associated with poor pregnancy outcomes than unilateral notches. The pregnancy outcomes tended to be similar in unilateral notch irrespective of placental side is necessary because of the frequent appearance of early diastolic notch and higher vascular resistance.
P08Case report: transvaginal ultrasonographic aspiration in the management of an ovarian cyst detected at the seventh gestational week
Authors: Tekin B. , Hassa H. , Şener T. , Saraç I. 
Published: March 2003

ObjectiveTo discuss a different approach, other than cystectomy, to an ovarian cyst detected at early gestation due to the risk of torsion.Case reportDuring ultrasonographic control of a pregnant at seven weeks of gestation, 30‐year‐old with two gravidity, one parity and one living child, a cyst with regular contour, measuring 150 × 130 mm with a wall thickness smaller than two mm was detected. By Doppler evaluation, vascular pattern could not be detected on the cyst wall. Ca 125, AFP, CEA levels were measured as 41.4 U/ml, 2.4 IU/ml, 1.2 ng/ml, respectively. The cyst was aspirated by a 17 g needle through posterior fornix with the assistance of tranvaginal ultrasonography. In cytological evaluation of the cyst fluid, no malignant cells were found. The case was called for control at 12th week of gestation which was known as the week of the completion of luteoplacental shift.ConclusionSince ca125 levels could be increased by pregnancy and there was no malignant feature except the dimensions of the cyst, the cyst was supposed to be benign and a conservative approach was planned. Corpus luteum is necessary for the continuation of pregnancy at these weeks of gestation so the anxiety about cystectomy was the termination of pregnancy due to corpus luteum deficiency. On the other hand, however, expectant management could not also be chosen, because the risk of torsion was high due to the texture, dimensions and mobile characteristic of the cyst. For this case who was at a younger age for ovarian malignancy the shrinkage of the cyst by aspirating it with the assistance of transvaginal ultrasonography without dysfunctioning corpus luteum, was decided. The management could be changed according to the cytological evaluation.In conclusion, at the early weeks of gestation, transvaginal cyst aspiration could be a way of management by decreasing the torsion risk without being a handicap for the continuation of pregnancy.
P83Fetal hemodynamic profile in pregnancies with absent or reversed end‐diastolic velocity waveforms in the umbilical artery that presented fetal death
Authors: Yamamoto R. M. , Francisco R. P. V. , Steinman D. S. , Miyadahira S. , Zugaib M. 
Published: March 2003

BackgroundA description of the fetal hemodynamic profile in pregnancies with absent or reversed end‐diastolic velocity (AREDV) that presented fetal death.Material and methodsBetween 1997 and 2000, 107 high risk pregnant women with AREDV were followed by the Fetal Surveillance Unit. Seventeen cases that presented fetal death (FD) were submitted to Dopplervelocimetry of the umbilical artery (UA), descending thoracic aorta (DTA), middle cerebral artery (MCA) and ductus venosus (DV).ResultsThe results are shown in the table:

AREDV diagnosis
19–24 week  (n = 10)
25–28 week  (n = 7)
Total  (n = 17)

GA at fetal death
24.7 + 1.6
26.3 + 1.0
25.4 + 1.6

Reversed flow
6 (60%)
7 (100%)
13 (76%)

UA Doppler PI
5.0 ± 3.1
6.3 ± 1.8
5.5 ± 2.7

Abnormal DV
10 (100%)
6 (86%)
16/17 (94%)

DV Doppler – PIV
2.3 ± 1.5
2.3 ± 1.3
2.3 ± 1.4

Abnormal DTA
9/10 (90%)
3/6 (50%)
12/16 (75%)

MCA PI < 5th p
6 (60%)
6 (86%)
12 (71%)

loss of redistribution
4 (40%)
1 (14%)
5 (29%)

ConclusionsThe results show severe fetal hemodynamic profile abnormalities, revealed by Doppler studies conducted in AREDV cases that presented fetal death.