bluuebunny/crossref_metadata_2025_split huggingface dataset:
F11Ultrasound evaluation of the uterus after pregnancy
Authors: Van Den Bosch T. , Van Schoubroeck D. , Timmerman D. , Hart A. Z. H. 
Published: March 2003

ObjectivesTo evaluate the sonographic appearance of the uterus after a recent pregnancy, with special attention to the occurrence of placental rests, hyperechogenic lesions, and areas of enhanced vascularity.Patients and methodsCross‐sectional observational study on 239 consecutive women presenting at follow‐up visit after pregnancy. The uterus was evaluated using ultrasound with color Doppler. In case of placental rests, blood was sampled. When indicated a D & C was performed.ResultsHyperechogenic areas were seen in 11.3%, mostly spots (85.2%) localized in the (sub)endometrial region. In 4.6% placental rests were evidenced. In these cases blood sampling revealed βHCG levels below 30 mIU/ml in 64%; serological infection parameters and hemoglobin concentration were within normal range. In 5% of women areas of enhanced vascularity were detected on color Doppler. Most cases were focal areas of one or more vessels perfusing retained placental tissue. There were 2 cases of placenta accreta. In 3 patients abnormal vascularity extended over the whole of the myometrium.Conclusions(1) (Sub)endometrial echogenic spots are common in primigravidas without a history of curettage. (2) Serology proved to be of little help in the diagnosis of retained gestational products. (3) Areas of enhanced vascularity of the uterus can be devised in 3 groups: focal vascular pedicle of a placental rest, placenta accreta, and areas of abnormal enhanced vascularity over the whole thickness of the myometrium.
F123Intracardiac echogenic focus: no apparent association with structural cardiac abnormality
Authors: Wolman I. , Diamant S. , Gull I. , Hartoov J. , Fait G. , Amster R. , Lessing J.B. , Jaffa A.J. 
Published: March 2003

ObjectiveThe purpose of this prospective study was to evaluate whether intracardiac echogenic foci (ICEF) are related to impairment of ventricular performance.Study methods3744 low risk patients were prospectively evaluated by the same ultrasonographer. ICEFs were defined as an hyperechogenicity located on the chordae tendinae. Fetuses with ICEFs underwent further echocardiographic evaluation. After birth, the neonates were referred for an additional echocardiographic evaluation only if a clinical suspicion of cardiac impairment arose. Fetuses with ICEFs were compared to a control group consisting of low‐risk fetuses, with no detectable ICEF, who underwent a similar echocardiographic evaluation.ResultsOf the 3744 patients in the study group, 138 fetuses (3.7%) presented with icefs. The majority of the ICEFs (78%) were located in the left ventricle. Eighteen percent were located in the right ventricle and 4% were bilateral. Of the 138 fetuses in this group, there was one case (0.7%) of pulmonic stenosis in a twin gestation. There was no other cardiac malformation or dysfunction in the other fetuses. Of the 167 fetuses in the control group, there was one case of fetal bicuspid aortic valve there was no statistical significance between the 2 groups.ConclusionsWe conclude that the finding of icefs is not correlated with cardiac dysfunction. However, these lesions should be carefully differentiated from rhabdomyoma or teratoma.
F125Fetal pulmonary venous Doppler flow velocity waveforms in congenital heart defects
Authors: Chaoui R. , Lenz F. 
Published: March 2003

Aim of the studyis to analyze blood flow velocity waveforms (FVW) in the pulmonary veins using pulsed Doppler ultrasound in fetuses with a prenatally detected congenital heart defect (CHD).MethodsIn 96 fetuses with various CHD Doppler FVW from the pulmonary veins were assessed. Gestational age varied between 18 and 38 weeks. Following Doppler parameters were analyzed and compared to reference ranges: systolic (S), diastolic (D) peak velocity, end‐diastolic velocity during atrial contraction (A), peak velocity index for veins (PVIV) and Pulsatility Index for veins (PIV).ResultsWe could distinguish 5 different patterns of FVW reflecting different stages of pulsatility and preload within the left atrium. Abnormal patterns were mainly observed in fetuses with left atrial obstruction and a restrictive foramen ovale having a reversed A‐wave as well as in mitral regurgitation.ConclusionsAbnormal FVW in fetal cardiac defects depend from the left atrial pressure rather than on the cardiac defect itself. Patterns of FVW can help in quick differentiation of increased interatrial pressure, which can impair early neonatal outcome.
F131The role of fetal echocardiography during maternal pharmacological treatment
Authors: Krasoń A. , Kaczmarek P. , Janiak K. , Respondek‐Liberska M. 
Published: March 2003

BackgroundThe aim of this study was retrospective analysis of fetal tricuspid valve regurgitation (TR) during echo in the second half of pregnancy in 100/5079 (1.98%) fetuses with normal heart anatomy (NHA) and without extracardiac malformations (ECM), beetwen 01.01.1994–31.12.1999.MethodIn this group, 43 (53.75%) cases with TR had treatment: 36 fetuses betamimetics, 4 fetuses indomethacin and 3 fetuses aspirin. In 34 (79.06%) cases trivial TR and in 9 (20.94%) cases holosystolic TR were diagnosed. The mean fetal gestational age was 30.9 ± 4.1 hbd. Twenty neonates (80%) were delivered vaginally and 5 by cesarean section, at mean gestational age of delivery was 37 ± 3.7 hbd. The mean Apgar score was 9 pts.Conclusions1. Fetal TR with NHA was diagnosed in 53.7% fetuses with maternal treatment. 2. The most common finding of TR with NHA was exposure on betamimetic. 3. Fetal echocardiography was helpful to confirm the safety and fetal well‐being during maternal pharmacological treatment due to premature labour.
F14Functional ovarian cysts during the use of levonorgestrel releasing intrauterine system
Authors: Ekholm E. , Inki P. , Hurskainen R. , Palo P. 
Published: March 2003

BackgroundWe wanted to study the effect of a levonorgestrel‐releasing intrauterine system (Mirena) on ovarian morphology in hypermenorrheic women.Methods236 women suffering from menorrhagia participated in this study. The patients were randomized to two groups: 118 women received mirena and 106 went through hysterectomy. All the subjects were 35–49‐year‐old. Transvaginal ultrasound was performed at baseline, and both six months and one year after mirena insertion/hysterectomy.ResultsAn ovarian cyst of more than 30 mm in diameter was detected in 13 patients at baseline. The mean diameter of the cyst was 34 mm (SD 8, range 32 × 19 to 62 × 28 mm). At six month control 19 patients had an ovarian cyst of a diameter more than 30 mm and at one year follow‐up an ovarian cyst was detected in 23 and two cysts in two patients using Mirena. In the hysterectomized group the number of ovarian cysts were 3 and 8, respectively. The mean size of the ovarian cysts was similar in both groups. None of the ovarian cysts required surgical intervention during the follow‐up period. At baseline 110 patients (46.6%) were diagnosed as having uterine fibroids with a mean diameter of 22 mm. The size of uterine fibroids did not increase during the study period.ConclusionFunctional ovarian cysts are more frequent in women using mirena compared to hysterectomized women of similar age. However, the ovarian cysts observed during the study did not lead to surgical intervention.
F15Tubal sterilization by laparoscopic electrocoagulation is not associated with disturbances in pelvic blood flow velocimetry
Authors: Hershkovitz R. , Goldstein D. , Mazor M. 
Published: March 2003

BackgroundSterilization by laparoscopic tubal electrocoagulation is a well‐known technique. The purpose of the present study was to evaluate pelvic blood flow velocimetry before and after laparoscopic tubal ligation and to determine hormonal profile.MethodsSixteen women underwent laparoscopic tubal electrocoagulation. Doppler studies of uterine, arcuate and ovarian arteries was performed at early follicular and midluteal phases at the cycles before and after the laparoscopic procedure. Serum blood samples were obtained concordantly.ResultsMean maternal age at the time of procedure was 38 ± 8 years. No significant differences were noted between all the following parameters:

Early Follicular Phase
Midluteal Phase

Pre  Ligation
Post  Ligation
Pre  Ligation
Post  Ligation

Rt. Uterine  artery
2.5
2.3
1.9
2.2

PI‐median   (range)
(1.2–3.5)
(1.4–3.7)
(1.05–3.2)
(1.1–3.5)

Lt. Uterine   artery
2.9
2.7
2.5
2.6

PI‐median   (range)
(1.5–3.9)
(1.6–3.4)
(1.3–2.9)
(1.4–3.3)

Arcuate artery
2.4
2.6
2.1
2.3

PI‐median   (range)
(2.0–2.9)
(1.8–3.4)
(1.7–2.7)
(1.8–2.9)

Rt. Ovarian
3.4
3.5
3.2
3.1

PI‐median   (range)
(2.4–4.1)
(2.5–4.2)
(2.0–3.9)
(2.1–3.8)

Lt. Ovarian
3.7
3.5
3.2
3.1

PI‐median   (range)
(2.7–4.5)
(2.6–4.4)
(2.3–4.1)
(2.4–3.9)

Estrogen   (pg/ml)   mean ± SD
32.0 ± 15.2
29.0 ± 5.7
209.5 ± 95.2
187 ± 72.0

DHEAS   (µg/dl)   mean ± SD
190.5 ± 90
215.4 ± 105
201.2 ± 48.5
251.1 ± 120

Progesterone   (ng/ml)   mean ± SD
0.5 ± 0.4
0.6 ± 0.5
15 ± 5.4
19 ± 3.9

ConclusionLaparoscopic tubal electrocoagulation is not associated with changes in the pelvic blood flow velocimetry and the hormonal profile.
F23Reproducibility of transvaginal three‐dimensional endometrial volume measurements during ovarian stimulation using virtual organ computer aided analysis (VOCALTM)
Authors: Salle B. , Affif A. , Bory A. M. , Rudigoz R. C. 
Published: March 2003

BackgroundThe aim of this study was to document the reproducibility of endometrial volume measurements by 3D‐ultrasound and VOCALTM.Materials and methodsOne three‐dimensional endometrial measurement was performed on each 79 consecutive infertile patients undergoing IVF. All scans were obtained using the Voluson 530 D (Kretztechnik AG, Zipf, Austria) the day of the oocytes retrieval and stored on a 540 Mbyte with an integrated magneto optical drive. After B mode analysis of the endometrium the system was switched into volume mode. Endometrial volume was calculated with the VOCALTMsoftware. Volume was calculated by two different observers (O1 and O2) and every 15° and 30° in order to appreciate inter and intra observer reliability.ResultsMean endometrial volume was 4.00 cm3for each observer. Intra observer reproducibility was better for volume calculated at 15° (0.9754 for O1 and 0.9683 for O2) than volume calculated at 30° (0.9303 for O1 and 0.9602 for O2). A paired t‐test showed that there was no statistical difference between the two observers for volume calculated each 15° and significant difference for volume calculated each 30°.ConclusionVOCAL permitted an easy and reproducible inter and intra observer calculation of endometrial volume during controlled ovarian stimulation for IVF.
F03Transvaginal sonographic detection of endometrial pathology in postmenopausal women on HRT
Authors: Exacoustòs C. , Carusotti C. , Angelozzi D. , Rinaldo D. , Arduini D. , Romanini C. 
Published: March 2003

BackgroundThe aim of this study was to assess the sonographic aspect of the endometrium in postmenopausal patients receiving hormone replacement therapy (HRT) at different phases of the treatment and to identify endometrial pathologies on the basis of abnormal sonographic findings.MethodThe study group was composed of 103 women treated with sequential (82) or combined (21) HRT for at least 6 months. All patients underwent transvaginal sonography (TVS) with evaluation of endometrial thickness and echopattern. Patients on seqential regimes underwent TVS subsequently in the estrogen (phase E) and progestogen phases (phase P) and after withdrawal bleeding or immediately 5 days after the last progestogen administration (phase 0). Patients with an endometrial thickness > 5 mm (in phase 0 for patients on sequential HRT) or with TVS anomalies of the endometrial pattern underwent sonohysterography and/or hysteroscopy.ResultsIn the 82 women on sequential HRT regimes mean endometrial thickness was significantly lower in phase 0 (3.8 ± 1.2 mm) compared to phase E (5.8 ± 1.7 mm) and phase P (6.2 ± 2.1 mm). On 20 patients with TVS abnormal endometrial findings sonohysterography identified 8 benign endometrial polyps which were removed by hysteroscopy and 2 simple hyperplasia were diagnosed by histeroscopically guided biopsy.ConclusionsSonohysterography is useful in HRT patients to detect endometrial polyps. In case of diffuse or focal endometrial thickness on sonohysterography an office hysteroscopy with guided biopsy could be useful.
F35Trade‐off of different combining methods of ultrasound and biochemical screening tests for Down syndrome
Authors: Herman A. , Dreazen E. , Bukovsky I. , Weinraub Z. , Maymon R. 
Published: March 2003

AimTo assess the efficacy of different combining methods of 1st trimester nuchal translucency and 2nd trimester triple test.MethodsResults of both NT and TT were obtained in 706 euploid fetuses and in 16 DS cases. The net effect of each test was evaluated by using its likelihood ratio (LR). A combined risk for DS live birth > 1:400 was used to assess false‐positive rate (FPR) and detection rate (DR), adjusted to different age groups.The tests were combined using the following methods:a. Summation – all cases with a risk > 1:400 by either NT or TT;b. Calculated risk – derived from combined LR (LRNTx LRTT).ResultsIn normal pregnancies the overlap of cases with a LR > 1.5 – by both tests – was negligible (P < 0.001), whereas in DS cases the overlap was 33%. The table at the foot of the page shows better efficacy of the calculated risk vs. the summation method (e.g. for 30‐year‐old group yield of 1:26 and 1:78, respectively).ConclusionsThe FPRs derived from the summation method seems to be a reasonable trade‐off for the high DR obtained by this method. Also, the yield of the summation combining method is much more efficacious than that obtained by the worldwide policy of karyotyping patients at 35, 37 or even 40 y.

Summation (NT or TT risk > 1:400)
Calculated risk  (Combined risk > 1:400)

Age Years
Yield* by age only
Yield*
FPR
DR
Yield*
FPR
DR

20
1:1529
4.5%
81%
1:85
1.0%
56%
1:27

25
1:1351
4.5%
81%
1:75
1.0%
56%
1:24

30
1:910
6.9%
81%
1:78
2.0%
69%
1:26

35
1:384
15.7%
94%
1:65
4.3%
81%
1:20

40
1:112
44.7%
100%
1:50
10.6%
94%
1:13

Number of invasive procedures required to detect 1 case of DS.
F52Evidence of unidirectional pulsatile flow in the umbilical interarterial anastomosis
Authors: Raio L. , Ghezzi F. , Di Naro E. , Franchi M. , Bolla D. , Lischetti B. , Balestreri D. , Dürig P. , Schneider H. 
Published: March 2003

BackgroundAn anastomosis between umbilical arteries (UAS), located within 1–3 cm from the placental insertion, has been previously described at delivery and in utero. However, the prenatal investigation of this vessels is limited to case reports. We report a series of antenatal functional evaluation of this vessel.Method41 women underwent a target ultrasonography to evaluate the blood flow characteristics of UAS and UAS anastomosis. The resistance index (RI) of the anastomosis and the UAS RI before and after the anastomosis was obtained. The direction of the blood flow in the anastomosis was determined by color Doppler evaluation.ResultsAn anastomosis between the two stems of the UAS was present in 36 cases while a fusion of the two UAS was found in the remaining 5 cases. The median (range) gestational age at diagnosis was 33.1 weeks (25.5–40.1). The median (range) diameter of the anastomosis was 2.3 mm (1.3–7.1). The blood flow in the anastomosis was pulsatile with a median (range) RI of 0.62 (0.45–0.85). The difference between UAS RI was higher after than before the anastomosis [0.07 (0–0.3) vs. 0.04 (0–0.17), P = 0.051]. The anastomosis blood flow was always unidirectional.ConclusionDuring fetal life, the UAS anastomosis acts as a pressure‐equalizing system between UAS and the placental lobes.
F53Umbilical venous volume flow: reproducibility and developmental data
Authors: Boito S. , Struijk P. C. , Stijnen H. R. , Wladimiroff J. W. 
Published: March 2003

BackgroundTo determine reproducibility of volume flow components; to calculate volume flow in normal and growth restricted fetuses in a cross‐sectional study design.MethodUsing Labview and Imaq‐vision software, the cross‐sectional inner vessel area was traced. Vessel area (mm2) and mean flow velocity (cm/s; Doppler) were multiplied to calculate volume flow (ml/min) including flow/kg fetus. The coefficient of variation (CV) for vessel area and flow velocity scans and tracings was determined (n:13; 26–35 weeks). Normal charts for components and volume flow were constructed (n:72; 20–36 weeks) and related to data from growth restricted fetuses (birthweight < P5) (n:20; 23–36 weeks).Results reproducibilityCV was 5.4% (vessel area) and 7.3% (mean velocity) for scans and 6.6% and 10.5% for tracings resulting in a CV of 8.1% (scans) and 11.9% (tracings) for volume flow. Gestational age related increase exists for vessel area, mean flow velocity, and volume flow: 47.5 ± 19.3(SD) ml/min at 20 week and 229.6 ml/min ±29.6(SD) ml/min at 36 week, but not per kg/fetus. In fetal growth restriction, volume flow was reduced (P < 5) in 18/20 cases, but for volume flow/kg fetus only in 11/20 cases.ConclusionMeasurements of vessel area results in acceptable reproducibility of volume flow calculations, which show a 5‐fold increase at 20–36 week. In fetal growth restriction, volume flow is significantly reduced but equally distributed between normal and reduced values when calculated per kg/fetus.
F57Intra‐observer and inter‐observer variability of Ductus Venosus blood flow indices in fetuses between 10 and 14 weeks of gestation
Authors: Mavrides E. , Holden D. , Hollis B. , Tekay A. , Thilaganathan B. 
Published: March 2003

BackgroundThe aim of this study is to assess the intra‐observer and inter‐observer variability of transabdominal Doppler velocity measurements of ductus venosus (DV) blood flow in fetuses at 10–14 weeks.MethodDoppler indices in the DV of first trimester fetuses were repeated three times by the same trained observer in 67 pregnancies and by a second trained observer in 24 pregnancies. In addition, both observers documented the presence of normal/abnormal blood flow during atrial contraction.FindingsIntra‐observer reproducibility of measurements of peak systolic velocity, end‐diastolic velocity and systolic to diastolic ratio were poor. Intra‐observer pulsatility index (PI) repeatability was adequate (CC 0.60, CV 8.9%). Inter‐observer agreement for all the Doppler measurements was unsatisfactory (CC 0.18–0.44; CV 11.5% to 47.2%).ConclusionThere is significant variability in all Doppler indices, except for the intra‐observer repeatability of PI. Determination of normal/abnormal atrial flow is a repeatable measurement.
F59Fetal venous Doppler in the normal first and second stage of labor
Authors: Krapp M. , Denzel S. , Germer U. , Gembruch U. 
Published: March 2003

BackgroundThe aim of the study was to evaluate, whether differences in fetal venous flow velocity waveforms can be seen in fetuses during labor compared to fetuses before labor.MethodThe Pulsatility index for veins (PIV) of the ductus venosus was analysed in 127 fetuses (37th to 41th weeks) before labor by color Doppler sonography (control group). Identically 42 fetuses with normal cardiotocogram were analysed during and between contractions consecutively in the early first stage of labor, at 2–4 cm and 6–8 cm and at full dilatation of the cervix (study group).ResultsThe control group showed a normal PIV of 0.59 (SD 0.24). In the study group between contractions the PIV was normal during all stages of labor with average values of 0.55 − 0.68 (SD 0.26 − 0.42). During contraction the average values of the PIV were 1.64 – 2.48 (SD 0.76 – 1.16). These values were significant elevated (P < 0.001) during contraction compared to the values of contraction free episodes as well as to the control group. The increase of the PIV during contractions was not related to any fetal heart rate deceleration.ConclusionDuring contractions the fetal venous pressure is significantly elevated in normal labor. Reference ranges for the ductus venosus should be established and compared to values in compromised fetuses.
F61The ductus venosus blood flow velocity waveforms during labour in 42 singleton fetuses at term
Authors: Denzel S. A. , Krapp M. , Germer U. , Gembruch U. 
Published: March 2003

BackgroundThe aim of this study was to learn about the physiological changes in the ductus venosus blood flow velocity waveforms during labour.MethodDuctus venosus flow curves were obtained by Doppler ultrasonography during and in‐between uterine contraction during the first and second stage of labour in 42 singleton fetuses at term. In every patient we tried to measure at four different times of dilatation of the cervix (0–2 cm, 2–4 cm, 6–8 cm, fully dilated). In average we obtained 3.76 measurement periods. At every period the ductus was continuously recorded on video tape throughout 5–10 min.ResultsChanges in the ductus venosus blood flow were observed during labour. The flow profiles did not change with increasing cervix dilatation, but they changed during contraction compared to in absence of contractions. The peak velocity index (PVIV) and the pulsatility index for veins (PIV) within uterine contraction differed significantly (P < 0.001) compared to pviv and piv in absence of contractions in all four stages of cervix dilatation.ConclusionsThe ductus venosus blood flow velocity waveforms undergo great changes intrapartum in cases of uneventful pregnancy and delivery. It has to be further evaluated which subgroup of pregnancies will benefit from Doppler velocimetry of the ductus venosus for intrapartum surveillance.
F68Changes in ovarian vascularization during the menstrual cycle as assessed by three‐dimensional Power Doppler imaging (3D‐PDI)
Authors: Sladkevicius P. , Ojha K. , Campbell S. , Nargund G. 
Published: March 2003

BackgroundThe study was conducted to determine the pattern of the vascular changes during the normal menstrual cycle in the ovaries using the 3D Power Doppler imaging technique.MethodsObservations were made during 19 normal menstrual cycles. Women were scanned transvaginally using VOLUSON 530D ultrasound machine during midfollicular, perifollicular and midluteal phases. The presence of a dominant follicle was recorded and ovaries were classified as dominant or nondominant based on these findings. The volume of the ovaries was acquired using 3D‐PDI. The vascularization index (VI), flow index (FI) and vascular flow index (VFI) were calculated using VOCAL software.ResultsThe dominant ovary VI 4.6 ± 2.5, FI 51.6 ± 4.8, VFI 2.5 ± 1.5 in the midfollicular phase were significantly lower than those in the midluteal phase (VI 19.8 + 10.5; FI 61.1 + 1 + 3.8; VFI 12.2 + 6.3). These parameters in the perifollicular phase had intermediate values, although being significantly higher than in midfollicular phase and significantly lower than in the luteal phase. In the contralateral nondominant ovary, no cyclical changes were seen in the values of VI, FI, VFI. There were significant differences between dominant and nondominant ovaries in all phases investigated. The most prominent midluteal increase of VI, FI and VFI in the dominant ovary were 6.6, 1.3 and 9.2 folds, respectively.ConclusionThese data indicates that there are significant vascularization and blood flow changes in the dominant ovary.There were no changes observed on the nondominant ovary.