bluuebunny/crossref_metadata_2025_split huggingface dataset:
WS06‐07Examination of the fetal heart by five short‐axis views: The optimal screening method for fetal cardiac anomalies?
Authors: Yagel S. 
Published: March 2003

‘Classic’ fetal echocardiography is based on 7 transverse planes: the upper abdomen, the traditional four‐chamber view, the five‐chamber view in which the aortic root is visualized, and the fourth transverse view revealing the bifurcation of the pulmonary arteries, and long‐axis views of the outflow tracts and aortic arch. We recently proposed the three vessel and trachea (3VT) plane of insonation be added, to facilitate and expedite fetal heart evaluation.The (3VT) is the most cephalad transverse view, visualized on a plane crossing the fetal upper mediastinum. It is obtained easily by moving the transducer cephalad and slightly oblique from the FCV, and shows the main pulmonary trunk (MPA) in direct communication with the ductus arteriosus (DA). A transverse section of the aortic arch is seen to the right of the MPA and DA. Cross sections of the superior vena cava (SVC), and posterior to it the trachea, are visualized.The clinical applicability of the 3VT was demonstrated in a recent study encompassing 1263 low‐and high‐risk cases scanned between 14 and 24 weeks' gestation. We consider one of the greatest advantages of our novel approach the ease with which the examiner can scan the fetal heart, beginning with the caudal upper‐abdomen view. By sliding the transducer cephalad in one continuous motion, all the pertinent views are readily visualized. It was also shown to be effective in the diagnosis of such aortic arch anomalies as right and double aortic arch, among others.We showed that five short axis views including the 3VT simplified and streamlined fetal cardiac examination, without compromising diagnostic effectiveness.
WS08‐04Fetal brain: cerebral and cerebellar circulation in early fetal jeopardization
Authors: Arduini D. , Giannini F. , Exacoustòs C. , Romanini C. 
Published: March 2003

BackgroundThe aim of this study was to investigate with color‐power doppler sonography the arterial and venous circulation in fetal brain, in normal and pathologic circumstances.MethodWe studied 101 appropriate for gestational age (AGA) fetuses, 20 intrauterine growth‐retarded fetuses (IUGR), 10 fetuses with cmv infections and 10 fetuses with supraventricular tachycardia.In all fetuses we obtained reliable blood flow velocity waveforms of middle cerebral and superior cerebellar artery and trasverse sinus.The pulsatility index (PI) for arterial vessels and flow velocity for venous vessels were used. Doppler measurements of AGA fetuses were compared with other fetuses.ResultsAn increase in fetal middle cerebral PI and cerebral transverse sinus was observed in IUGR and a slightly decrease in case of fetal arrhytmia when compared with AGA fetuses. In 6 of 10 fetuses affected by cmv infection was observed a reduction in PI cerebral and cerebellar, while no difference was found for venous velocities.A longitudinal study was performed in 30 AGA and 8 IUGR fetuses. The IUGR fetuses showed a characteristic early reduction of cerebellar PI in respect to cerebral PI about 4–8 days prior the evidence of late heart rate (HR) decelerations; however, the two vessels did not differ significantly in the 4 days prior HR decelerations.ConclusionVenous and arterial cerebral circulation shown a response to pathological conditions that could affect fetal brain.
WS08‐05Ultrasound evaluation of fetal brain space occupying lesions
Authors: D'addario V. , Pinto V. , Naro E. D. I. , Anfossi A. 
Published: March 2003

ObjectiveTo evaluate the accuracy of ultrasound in identifying fetal brain space occupying lesions.Study designA retrospective evaluation of 14 cases of fetal brain space occupying lesions has been performed. All prenatal ultrasonographic diagnoses (5 teratomas, 1 choroid plexus papilloma and 8 arachnoid cysts) were compared with the postnatal findings on the aborted fetuses or on the newborns.ResultsIn 11 out of 14 cases the antenatal ultrasonographic diagnosis was confirmed postnatally; 1 case of supratentorial arachnoid cyst was mistaken for a teratoma and 2 cases of porencephalic cysts were wrongly diagnosed as arachnoid cysts (specificity = 78.5%). The specificity was better in the subgroup of solid or complex masses (5 out of 6 = 83.3%) than in the subgroup of cystic lesions (6 out of 8 = 75%).ConclusionsPrenatal ultrasonography is a useful tool to identify any intracranial space‐occupying lesion. In the present study it has shown a 78.5% specificity in the diagnosis of brain masses, with better results in the solid than in the cystic lesions. The distinction between the different causes of fetal brain space occupying lesions is clinically relevant, as each one carries different prognostic implications.
WS08‐07Brain plasticity after perinatal damage—prospective neurodevelopmental and ultrasonographic/magnetic resonance study
Authors: Mejaški‐Bošnjak V. 
Published: March 2003

ObjectiveTo assess long‐term neuodevelopmental outcome and structural reorganisation of children suffering hypoxic‐ischemic (H‐I) and/or haemorrhagic perinatal brain damage; To test the hypothesis of more successful recovery of prematures and/or unilateral lesions after perinatal brain damage; To estimate prenatal events, in particularly value of pathological findings of Color Doppler (CD) in the pathogenesis of perinatal brain damage;Study design68 children suffering perinatal brain H‐I (10) and/or haemorrhagic lesions (58) diagnosed by ultrasonography (US) underwent neurologic and psycho‐linguistic examinations by age 16. High resolution 2 T MRI was used to assess structural reorganisation; 20 children suffering unilateral perinatal brain damage (MCA infarct.) were followed up (neurodevelopmentally, transcranial CD and US/CT, MRI); 25 children with CD findings (C/U ratio < 1) during pregnancy underwent prospective follow‐up postnatally by age 2.ResultsAll children with H‐I lesions have still at age 16 one or more severe handicaps, while 39 children with mild grade of hemorrhage had minor neurological dysfunction, 15 were normal. MRI revealed destructive and/or atrophic lesions in all children with H‐I lesions and mild atrophy and/or signs of preiventricular haemorrhage in rest children. 20 children with unilateral perinatal brain damage have contralateral hemiparesis and various accompanying neurodevelopmental disorders. There were no strict correlation between size, site, hemispheral involvement gestational age and neurodevelopmental outcome of children examined. Out of the 25 children having pathological CD findings during pregnancy, 7 revealed mild grade (I–II) of peri‐intraventricular haemorrhage, 10 children isolated or combined H‐I and haemorrhagic lesion, 7 children have no apparent perinatal brain damage. Short‐term neuro‐developmental outcome revealed mild delay and/or disorders in 10 infants and in the rest normal status.
WS09: Adnexal masses WS09‐01Role of imaging modalities in pelvic tumor practice
Authors: Nakano H. , Satoh S. 
Published: March 2003

BackgroundTo clarify the diagnostic usefulness of imaging modalities in pelvic tumor practice, inpatients having pelvic neoplastic disorders in our Institute were reviewed.MethodsFor a total of 1506 cases undergoing ultrasonography (US) only, those receiving a combined usage of computed tomography (CT) and US, magnetic resonance imaging (MRI) and US, and all three modalities, we compared the indications and selected imaging modalities in relation to the stream of therapeutic procedure.Results324 cases (21.5%) judged to have no structural disease through imaging techniques at previous Hospitals underwent no further imaging examination. 420 cases (27.9%), most of which underwent surgery and/or radiation due to malignant lesions in the ovary and/or uterus, had US alone, and 564 cases (37.5%) had CT in addition to US. The main indications for ordering additional CT were suspected distant metastasis, including pelvic and paraaortic lymphnodes. 95 patients (6.3%) had US and MRI under indication of tissue characterization in tumors. 103 cases (6.8%) with difficulties in diagnosis had all modalities; US, CT and MRI. In 324 cases without imaging modalities, 60 cases (18.5%) undergoing operative procedure were those with cervical neoplasm, and 70.0% of the cases followed by chemotherapy were for ovarian cancer. Such will be further discussed in detail.
WS12‐02Systematic screening with a uterine Doppler in low‐risk pregnant women followed by low‐dose aspirin in cases with abnormal results: results of the two French multicenter randomised controlled trial
Authors: Goffinet F. , Aboulker D. , Subtil D. , Uzan  , Bréart G. , Uzan S. 
Published: March 2003

ObjectivesTwo large multicenter randomised trials were performed in France to assess whether systematic screening with an artery uteroplacental Doppler (AUD) in low‐risk pregnant women followed by the prescription of low‐dose aspirin in cases with abnormal results reduced the incidence of intrauterine growth restriction (IUGR) and of preeclampsia.Study design and populationThe first trial ‘Seine Saint‐Denis’ (SSD) trial included 3317 low‐risk pregnant women (multi and primigravidae) in 17 French maternity Hospitals and the second ‘Erasme’ trial included 1869 primigravidae in 12 centres. In the Doppler group, the AUD was performed between 20 and 24 weeks, and women with abnormal results received 100 mg of aspirin daily until the 35th week.ResultsIn the Doppler group, 232 patients (15.7%) had an abnormal result in the SSD trial and 20% in the ERASME trial. The predictive value of the AUD was comparable to that reported in the studies of low‐risk populations, but with a low sensitivity. Finally, IUGR, whether defined by the third or tenth percentile, and preeclampsia did not differ significantly between the treatment groups in both trials.ConclusionsThere is no proof justifying the recommendation of a systematic AUD in a low‐risk population, even if abnormal results are followed by aspirin treatment and increase in prenatal surveillance. Future studies must assess predictive tests that can be performed early in pregnancy and can identify populations at very high risk of preeclampsia and IUGR. Only when all of these conditions are fulfilled can aspirin prove its efficacy.
WS13: Multiple pregnancy WS13‐01The effect of treatment of twin‐to‐twin transfusion syndrome on the diagnosis to delivery interval
Authors: Skupski D. , Gurushanthaiah K. , Chasen S. 
Published: March 2003

PurposeNo randomized controlled trials of treatment of twin‐to‐twin transfusion syndrome (TTTS) exist. Since severely preterm neonatal survival has increased over time, survival as an outcome measure is confounded by calendar time. The diagnosis‐to‐delivery interval is a calendar year independent measure of success of treatment. We wished to evaluate whether treatment of TTTS is associated with a lengthening of the diagnosis‐to‐delivery interval.MethodsMEDLINE search supplemented by careful reference review. All TTTS series were included where the following information on each patient was available: survival, fetal demise, gestational age (GA) at diagnosis and diagnosis to delivery interval in days.Inclusion criteriaGA ≤ 29 weeks and diagnosis by ultrasound in the absence of maternal symptoms. Cases undergoing multiple types of treatment were excluded. Data were evaluated by Kruskal–Wallis anova, logistic regression & Wilcoxon rank sum testing.ResultsThe 8 publications used included the following cases: controls (n = 16), amnioreduction (n = 61), septostomy (n = 12), and fetoscopic laser occlusion of chorioangiopagus vessels (FLOC) (n = 51). FLOC therapy showed a significantly longer diagnosis‐to‐delivery interval compared to amnioreduction (median 75 vs. 56 days) (p = 0.01). There was no difference in overall survival, at least one survivor, or number of fetal deaths between the 4 groups. Logistic regression using at least one survivor as the dependent variable revealed a positive association with GA at diagnosis and with diagnosis to delivery interval, a negative correlation with fetal death, and no correlation with treatment group.ConclusionsFLOC therapy for TTTS is associated with a longer diagnosis‐to‐delivery interval compared to amnioreduction without a significant increase in survival. The lack of increase in survival appears to be due to a small sample size.
WS14‐04Improved fetal weight estimation by three‐dimensional ultrasound
Authors: Schild R. L. , Hansmann M. 
Published: March 2003

AimTo investigate the value of 3D‐ultrasound in predicting fetal weight at delivery.Patients and methodsThe study group consisted of 251 pregnant women (formula‐finding group: n = 125; evaluation group: n = 126) with a singleton pregnancy and an ultrasound examination within seven days of delivery. Pregnancies with major structural or chromosomal anomalies were excluded. Ultrasound examinations included standard biometry as well as three‐dimensional volumetry of the upper arm, the thigh and the abdomen of the fetus. All examinations were performed with a Voluson 530D MT system (Kretztechnik, Zipf, Austria). The results were compared with commonly used weight formulas.ResultsAll measurements were completed successfully. Polynomial regression analysis with standard biometric parameters and volumes of the upper arm, the thigh and the abdomen was employed to yield the best‐fit formula for prediction of fetal weight at birth. The new 3D formula (Estimated fetal weight (EFW) = – 1478.557 + 7.242 * thigh volume + 13.309 * upper arm volume + 852.998 * lg abdominal volume + 0.526 * BIP3) proved to be superior to established two‐dimensional equations with the lowest mean error (25.8 ± 194.4 g), the lowest mean absolute error (155.2 ± 118.2 g) and the lowest mean absolute percentage error (6.1 ± 5.0%) when studied prospectively in the evaluation group.ConclusionFetal weight estimation by 3D–ultrasound compares favourably with conventional 2D–formulas.
WS14‐06Implemented three‐dimensional power Doppler for evaluation of fetal and placental circulation: implications for clinical management
Authors: Shih Jin‐Chung , Chen Hsi‐Yao , Hsieh Fon‐Jou 
Published: March 2003

BackgroundThe study of fetal and placental circulation has focused on the interaction betweens fetal hypoxia and abnormal flow regulation. The assessed methods including spectral and color Doppler US. However, their uses in the depiction of angioarchitecture to make the specific diagnosis are limited.MethodsWe use three‐dimensional (3D) power Doppler sonography (Voluson 530D, Medison; and HDI 3000, ATL) a to detect and visualize the fetal vasculature since 8 weeks gestation. We also use the same method to render the angioarchitecture of placenta as early as 5 weeks gestation. The scanning methods were using either free‐handed or built‐in mechanical probe. We also assess its application in decision making for difficult cases.ResultsPower Doppler provides excellent visualization of fetal circulation (including umbilical vein, portal vein systems, ductus venosus, hepatic veins, etc.). Furthermore, these data can be rendered in 3D perspectives, which is more comprehensive for understanding the complicated vasculature of fetus. It can correlates the embryonic findings in vivo, therefore can confirm the normalcy and also contribute in the diagnosis of pathological state.ConclusionOur results indicate 3D power Doppler is a promising tool in evaluation of complicated fetal and placental anatomy, and might help to make decision in clinical dilemmas.
WS15‐05Fetal venous Doppler: is it helpful in timing of delivery of hypoxic fetus?
Authors: Latin V. , Hafner T. 
Published: March 2003

BackgroundThe aim of this study was to investigate the potential of fetal venous Doppler in detection of fetal hypoxia and timing of the delivery.MethodsThe study group consisted of patients with increased risk for developing fetal hypoxia. These were patients with diagnosed fetal intrauterine growth retardation (IUGR) and patients with pregnancy induced hypertension (PIH), or a combination of both problems. All patients had Doppler assessment of fetal arterial (umbilical artery, aorta, middle cerebral artery) and venous circulation (ductus venosus and umbilical vein), and cardiotocography 24 h before delivery. Collection of postnatal data included pH of umbilical chord blood, admission in neonatal intensive care unit, and perinatal death.ResultsA total of 360 patients were included in the study (IUGR 48%, PIH 20%, IUGR + PIH 32%). Deterioration in fetal venous return developed after fetal arterial circulation had been severely compromised. The decrease in end‐diastolic flow in ductus venosus anticipated development of umbilical vein pulsatile flow. Patients with pulsations in umbilical vein blood flow had high incidence of perinatal acidosis, morbidity, and mortality.ConclusionDelivery should be performed before umbilical vein pulsations develop. Careful monitoring of ductus venosus blood flow is helpful predictor of this event.
WS15‐07Assessment of a formula using Doppler velocimetry to calculate fetal hemoglobin (Hb)
Authors: Voto L. S. , Mulki O. B. , Zapaterio J. L. , Falco A. , Mathet E. R. , Lede R. L. , Margulies M. 
Published: March 2003

AimTo assess agreement between fetal cord blood Hb concentration by Doppler velocimetry and a formula (Oepkes et al, Br J Obstet Gynaecol 1994; 101:680–4), and the actual Hb concentration by cord blood sampling.Material and methodsA prospective cohort of 31 Rh isoimmunised fetuses undergoing Doppler cord blood velocity measurements within the 24 hs previous to cordocentesis or delivery was included. Mean aortic velocity at descent fetal aorta and maximum umbilical vein flow at intrahepatic portion were measured blindly by a single operator with pulsed Doppler and a 3.5 Mhz transducer. Cord Hb was the gold standard. Abnormality and normality were defined as a Hb level lower and higher, respectively, than the cut‐off point (<7, <8, <9, <10, <11 and <12 g/dL were tested). Likelihood ratio was also calculated.ResultsInterval between Doppler study and cordocentesis/delivery was 24–48 hs. Fetal blood sampling was performed by cordocentesis in 4 cases, following a C‐section in 24, and following vaginal delivery in 3.

Distribution of cases according to results obtained (n cases)

Cut‐off point
<7g
<8g
<9g
<10g
<11g
<12g

True+
1
5
7
14
23
26

False+
1
1
7
7
6
5

True–
29
25
15
7
2
0

False–
0
0
2
3
0
0

Agreement at different cut‐off points in the diagnosis of abnormality and normality [point estimate (CI)]

Cut‐off
<7
<8
<9
<10
<11
<12

Abn.
50(5–100)
83(36–99)
43(21–69)
58(37–77)
79(60–91)
84(66–94)

Norm.
97(81–100)
96(78–100)
62(41–80)
41(17–67)
25(4–64)
0(0–54)

LR
30(2.3–129.8)
26(4.2–132.4)
2.7(1.2–5.9)
1.6(1–3)
1.3(1–2.4)
1(0.9–2)

ConclusionAn acceptable agreement was found. Further population‐based studies are required to corroborate its clinical significance.
F102The prenatal ultrasonographic diagnosis of migrational disorders
Authors: Malinger G. , Lerman‐Sagie T. , Ben‐Sira L. , Glezerman M. 
Published: March 2003

BackgroundNeuronal migration occurs between the third to fifth month of pregnancy, during this time neurons migrate from the ventricular zone to the cortical mantle. The hallmark of the migrational disorders is an aberration of gyral and sulcal development. The aim of this study was to report on prenatal diagnosis, management and outcome of 6 cases with migrational disorders.MethodThe records of all the fetuses that were scanned for a possible migrational disorder during a 7‐year period ending in May 2000 were reviewed.ResultsSix fetuses with migrational disorders were identified at a gestational age ranging from 22 to 34 weeks (mean 27.5 weeks), one with lissencephaly, one with pachygyria, two with polymicrogyria and two with neuronal heterotopia. In 3 cases corpus callosum hypoplasia was also present. One of the fetuses had 2 magnetic resonance studies performed in utero and only the second one performed 4 weeks after the index US was diagnostic.ConclusionMigrational disorders, although uncommon may be diagnosed prenatally. The very bad prognosis in most cases justifies the effort of early detection.
F105Transvaginal sonographic appearance of the cerebellar vermis at 14–16 weeks' gestation
Authors: Perlitz Y. , Peleg D. , Ben‐Ami M. 
Published: March 2003

BackgroundThe aim of this study was to evaluate the normal development of the fetal cerebellum at 14–16 weeks' gestation using transvaginal sonography (TVS).Method195 low risk women who had structurally normal fetuses determined by a detailed anomaly scan, were included in the study. The sonographic image of the cerebellar hemispheres and the vermis was evaluated by the modified axial view of the fetal head. All women underwent a follow up scan at 20–24 weeks' gestation to determine the status of the cerebellar vermis.ResultsAll fetuses had an open vermis at 14–16 weeks' gestation. On the follow up scan at 20–24 weeks' gestation, closure of the vermis was demonstrated in all fetuses.ConclusionsAt 14–16 weeks' gestation the cerebellar vermis is demonstrated to be open by TVS. This is a normal finding, and therefore, the prenatal diagnosis of Dandy‐Walker variant should be made only later than 16 weeks' gestation.
F124Prenatal diagnosis of congenital heart disease and postnatal outcome in a tertiary care center
Authors: Toth B. , Römer U. , Schulze A. , Strauss A. 
Published: March 2003

BackgroundPrenatal sonographic diagnosis of congenital heart disease (CHD) is important for proper perinatal and neonatal management as CHD occurs in approximately eight of 1000 live birth.MethodAll fetal echocardiograms obtained in the department of obstetrics and gynecology between January 1994 and June 2000 and postnatal echocardiograms obtained in the department of pediatric cardiology were reviewed.ResultsA CHD was found in 63 fetuses prenatally and in 116 newborns postnatally. The prenatal diagnosis was confirmed in 82%. Most of the false‐negative diagnosis were septal defects.Thirty‐three of the 116 neonates with a CHD died in the first year of life (28.4%). Eight (7%) needed a surgical intervention. Regarding only the neonates with a septal defect 64 (92%) showed normal developing, without surgical or medical intervention.ConclusionEchocardiographic diagnosis of CHD can be achieved with accuracy in fetal life. Septal defects are the most unrecognized CHD prenatally but did not influence the postnatal hemodynamic circulation in most neonates. Nearly one third of the children with a CHD died and around 10% needed a surgical intervention in the first year of life. 59% were in good clinical condition and showed normal developing.
F130The importance of the fetal echocardiography in nonimmunological hydrops fetalis (analysis of the 156 cases)
Authors: Kaczmarek P. , Krasoń A. , Janiak K. , Respondek‐Liberska M. 
Published: March 2003

BackgroundThe aim of the research was to assess the usefulness of fetal echocardiography in nonimmunological hydrops (NIHF).Method156 fetuses with NIHF had echocardiography in 1994–99.ResultsThe most common cause of NIHF were structural abnormalities 99/156 (63%), especially congenital heart defects (CHD) 30/156 (19%). The fetal congestive heart failure was present in approx. 50% cases.ConclusionFetal echocardiography in NIHF allows not only the precise diagnose but also helps to establish a prognosis and qualification for ongoing procedures. Fetal echocardiography should become the recommended procedure in diagnostic/therapeutic algorithm in cases with NIHF.