bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal coronary and cerebral blood flow in acute fetomaternal hemorrhage
Authors: Baschat A. A. , Harman C. R. , Alger L. S. , Weiner C. P. 
Published: March 2003

AbstractA fetal heart rate tracing with absent variation and a sinusoidal pattern led to the diagnosis of acute fetomaternal hemorrhage at 29 + 2 weeks' gestation. The middle cerebral artery had increased peak blood flow velocity with reversed end‐diastolic flow. Fetal coronary arteries visualized by color‐coded and pulsed wave Doppler sonography showed slight decrease of time‐averaged maximum velocities after oxygen administration, while cerebral flows remained unchanged. After administration of 50 ml blood (pre‐transfusion hematocrit < 11%) the middle cerebral artery flow normalized and coronary artery velocities decreased further until coronary blood flow could no longer be visualized within 30 min of the transfusion (post‐transfusion hematocrit 27%). Evidence of successful fetal resuscitation also included normalization of the fetal heart rate tracing and resumption of fetal activity (biophysical profile score 8/10). This was also observed after a second transfusion of 38 ml blood. Deterioration from repeated fetomaternal hemorrhage led to delivery of a severely anemic neonate (cord hematocrit 7%) by Cesarean section. Postnatally, a single seizure, moderate severity respiratory distress syndrome and grade III intraventricular hemorrhage were noted.Increased peak blood flow velocity with reversed end‐diastolic flow may be observed in the middle cerebral artery of fetuses with acute anemia. Correction of this phenomenon with transfusion suggests that hypovolemia and low blood viscosity are major contributing factors. Furthermore, decreasing coronary artery blood flow velocities with supplemental oxygen and blood replacement confirm functional autoregulation of the fetal coronary circulation. Observation of these acute flow changes during fetal surveillance warrants investigation for a potentially serious underlying condition. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
The significance of choroid plexus cysts in an unselected population: results of a multicenter study
Authors: Chitty L. S. , Chudleigh P. , Wright E. , Campbell S. , Pembrey M. 
Published: March 2003

AbstractObjectivesChoroid plexus cysts are commonly found at the time of a routine second‐trimester scan, but there is much debate as to their clinical significance. The aims of this study were to define the incidence of choroid plexus cysts in an unselected population and describe their association with aneuploidy.DesignThis was a prospective, observational multicenter study.SubjectsSubjects were all fetuses found to have choroid plexus cysts with a maximum diameter of 3 mm or greater and who were between 14 and 24 weeks' gestation when scanned in the routine ultrasound department at any of the 13 participating hospitals.ResultsThere were 658 fetuses with choroid plexus cysts in a total of 101 600 births. The overall incidence of aneuploidy was 2.1%, but in fetuses with isolated choroid plexus cysts the incidence of proven aneuploidy was 0.5% (95% confidence interval (CI), 0.1–1.4%). If age is taken into consideration, then the incidence of aneuploidy in fetuses with isolated choroid plexus cysts where the mother is under the age of 36 years was 0.36% (95% CI, 0.04–1.3%), and 2.4% (95% CI, 0.06–12.6%) in older women.ConclusionsWe conclude that the presence of choroid plexus cysts increases the risk for aneuploidy, mainly trisomy 18. In the majority of cases, the final risk will remain small, but will increase as maternal age increases. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
A strategy for reducing the mortality rate from vasa previa using transvaginal sonography with color Doppler
Authors: Oyelese K. O. , Schwärzler P. , Coates S. , Sanusi F. A. , Hamid R. , Campbell S. 
Published: March 2003

AbstractVasa previa is a cause of sudden unanticipated fetal death, with a fetal mortality of 33–100%. Transvaginal sonography (TVS) and color Doppler may aid in making the diagnosis antenatally, allowing elective Cesarean delivery, thereby avoiding fetal death from exsanguination which would occur if the membranes were allowed to rupture in labor. Whilst it is not feasible to screen all pregnant women for vasa previa, antenatal examination with TVS and color Doppler of women at risk, specifically those with low‐lying placentas, bi‐lobed, multi‐lobed and succenturiate‐lobed placentas, multiple pregnancies and pregnancies resulting from in vitro fertilization may lead to antenatal diagnosis of the condition. We present the last three cases of vasa previa to have occurred in our institution, two of which were diagnosed antenatally using TVS and color Doppler. In all three cases, routine 20‐week obstetric sonography revealed low‐lying placentas; in only one of these did the placenta remain low at term. A low‐lying placenta at 20 weeks may be a risk factor for vasa previa; we suggest that further studies be carried out to ascertain this. Judicious use of TVS and color Doppler in women considered at risk of vasa previa may help to reduce the mortality from this condition. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Cardiac blood flow studies in fetuses with homozygous α‐thalassemia‐1 at 12–13 weeks of gestation
Authors: Lam Y. H. , Tang M. H. Y. , Lee C. P. , Tse H. Y. 
Published: March 2003

AbstractObjectiveFetuses affected by homozygous α‐thalassemia‐1 develop anemia as early as the first trimester. Our objective was to study hemodynamic indices in affected fetuses at 12–13 weeks of gestation to determine whether these would be useful in the prediction of anemia.DesignProspective observational study.SubjectsWomen referred before 14 weeks of gestation for the prenatal diagnosis of homozygous α‐thalassemia‐1.MethodsTransabdominal and/or transvaginal Doppler sonography was performed to measure the flow velocities in the fetal ascending aorta and pulmonary artery at 12–13 weeks. The Doppler indices were compared between those that were subsequently confirmed to be affected by homozygous α‐thalassemia‐1 and those that were unaffected.ResultsBetween June 1997 and April 1998, 60 eligible women were recruited. Doppler examination was successful in 58 fetuses. Of these, 22 were subsequently confirmed to be affected by homozygous α‐thalassemia‐1. The diagnosis was made by chorionic villus sampling and DNA analysis in two affected fetuses and by cordocentesis and hemoglobin evaluation in 20 affected fetuses. Hemoglobin concentrations could be measured in ten fetuses and these ranged from 4 to 8 g/dl. The affected fetuses had significantly higher peak velocities at the pulmonary valve and ascending aorta and a larger inner diameter of the pulmonary valve than that in unaffected fetuses. The total cardiac output was increased by one‐third in affected fetuses and was mainly due to an increase of the right‐side cardiac output.ConclusionIn the early stage of anemia, the fetus responds mainly by increasing its right‐side cardiac output. However, there is extensive overlap of the values of cardiac output between the affected and the unaffected fetuses, precluding its use in the prediction of anemia. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Individual growth patterns in the first trimester: evidence for difference in embryonic and fetal growth rates
Authors: Deter R. L. , Buster J. E. , Casson P. R. , Carson S. A. 
Published: March 2003

AbstractObjectiveTo evaluate individual fetal growth during the first trimester in pregnancies resulting from spontaneous and fertilization (IVF).MethodsThe growth of 11 fetuses conceived by spontaneous fertilization (known dates of ovulation) in nine patients and 15 fetuses conceived by IVF in 12 patients were evaluated at weekly intervals from 6 weeks, menstrual age, to 14 weeks. Fetal length was determined at each examination. Measures of fetal length included the crown‐rump length (CRL), maximum straight line length (MSLL) and maximum axial length (MAL). Comparisons of CRL and MSLL to MAL were carried out. The MSLL was used as the measure of length except when the MAL was available. Linear and quadratic functions were fitted to the complete data sets of individual fetuses in the two groups. Individual data sets from ten fetuses in each group were then divided into early and late growth phases, and linear functions were fitted to each data subset. Start points and pivotal points for each fetus were estimated from the coefficents of these two functions. Growth in these two groups of fetuses was compared, on the basis of slope values.ResultsEvaluation of length measures indicated that, before 8 weeks, only MSLL could be measured. After 8 weeks, all three measures could be obtained, with the MAL being the largest. Both the linear and quadratic models performed well with individual data sets (mean R
2(± SD): linear 98.1 (1.0)%; quadratic 99.4 (0.4)%), with no differences found between spontaneous and IVF groups (maximum possible differences in mean slopes (95% probability): 5–8%). Similar findings were obtained for the early and late growth phase data subsets. Slope values in the early and late growth phases showed low variability (CV: early 13.5%; late 11.6%), but were significantly different (early 0.72 (± 0.10 SD) cm/week; late 1.21 (± 0.14 SD) cm/week). The mean start point was 5.9 (± 0.3 SD) weeks' menstrual age, while the mean pivotal point was 9.2 (± 0.7 SD) weeks, menstrual age.ConclusionsFirst‐trimester growth studies in individual fetuses indicate that there is a change in length growth rate between 9 and 10 weeks, menstrual age. This is consistent with a shift in development from organogenesis to growth. These results can be used for more accurate assessment of first‐trimester growth and may aid in the detection of fetal problems that manifest themselves as growth abnormalities. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasound during pregnancy and subsequent childhood non‐right handedness: a meta‐analysis
Authors: Salvesen K. Å. , Eik‐Nes S. H. 
Published: March 2003

AbstractObjectiveA possible association between ultrasound during pregnancy and subsequent non‐right handedness among children has been suggested. The association has been reported to be stronger among boys. The aim of the present study was to explore this further through a meta‐analysis of two follow‐up studies of three randomized controlled trials of routine ultrasonography during pregnancy.DesignHandedness was assessed through a questionnaire to the parents, and 4715 children at the age of 8–9 years were included in the meta‐analysis.ResultsThere was no statistically significant difference in the prevalence of non‐right handedness between the ultra‐sound‐screened children and the controls, but there was a statistically significant difference in a subgroup analysis among the boys. Exploratory analyses according to exposure or non‐exposure indicated an even stronger association between ultrasound and non‐right handedness.ConclusionsA conservative analytical approach indicates no association between ultrasound and subsequent non‐right handedness. The results from the exploratory analyses must be interpreted with caution. There is still a need for further research. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Direct intrauterine fetal therapy in a case of bronchopulmonary sequestration associated with non‐immune hydrops fetalis
Authors: Anandakumar C. , Biswas A. , Chua T. M. , Choolani M. , Chia D. , Wong Y. C. , Gole L. 
Published: March 2003

AbstractBronchopulmonary sequestration associated with non‐immune hydrops fetalis is generally recognized as a uniformly fatal fetal condition without fetal surgical intervention. We describe here the first case of such a condition treated successfully with direct intrauterine fetal therapy using digoxin and frusemide. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
The value of echogenic foci (‘golfballs’) in the fetal heart as a marker of chromosomal abnormalities
Authors: Bettelheim D. , Deutinger J. , Bernaschek G. 
Published: March 2003

AbstractObjectiveThe aim of our study was to determine the significance of antenatally detected hyperechogenic foci in the fetal heart.DesignProspective study.Subjects and methodsDuring a 21‐month period, 6995 women underwent a sonographic screening investigation. A detailed structural survey was performed on each fetus according to our sonography protocol, including a four‐chamber view and an evaluation of the great vessels, as permitted by gestational age. We prospectively identified each fetus with an echogenic intracardiac focus.ResultsA total of 150 fetuses with this sonographic finding were identified. The incidence rate was 2.15%. In 114 patients (76%), prenatal karyotyping was performed. The aneuploidy rate was 4.4%ConclusionsThe echogenic intracardiac focus can be easily diagnosed in most cases. This should prompt an extensive search for other ‘soft’ markers. The presence of an echogenic intracardiac focus as a single soft marker should raise the question of prenatal karyotyping. It might help in the decision‐making regarding invasive prenatal testing in cases with an otherwise low risk for chromosomal abnormality. In cases with other markers for chromosomal abnormality (advanced maternal age, sonographic signs, positive serum marker screening), the presence of an echogenic intracardiac focus should be an additional incentive for a chromosomal examination. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Women's knowledge, concerns and psychological reactions before undergoing an invasive procedure for prenatal karyotyping
Authors: Cederholm M. , Axelsson O. , Sjödén P.‐O. 
Published: March 2003

AbstractObjectivesTo evaluate women's reasons for having an invasive procedure, their knowledge, how information was obtained, their satisfaction with this information, their concerns about complications and psychological reactions and distress evoked by the procedure.MethodsNinety‐four pregnant women undergoing early amniocentesis or chorionic villus sampling (CVS) at 10–13 weeks' gestation participated in a questionnaire study. The women could choose between early amniocentesis (n = 38) and CVS (n = 31), or to be randomized to either of them (n = 25).ResultsApart from two items, no differences were found between the groups. Age was the main reason for testing, and anxiety was stated as a reason by 38.3%. The women knew more about methods for fetal karyotyping, what the tests can reveal and how they are performed, than about the risks and reliability of the tests. The main source of information had been doctors and midwives at the antenatal care center. For a majority of women (64.9%) the decision to have the test was made together with their partner. The women's concerns were focused on worry about fetal injury, miscarriage and waiting for the result. The test did not have a major psychological impact on the women in general, but a substantial minority reacted with anxiety and distress.ConclusionsKnowledge of factors important to women and their concerns is essential for professionals working with genetic counselling and performance of invasive procedures. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Fetal intracranial tumors detected by ultrasound: a report of two cases and review of the literature
Authors: Schlembach D. , Bornemann A. , Rupprecht T. , Beinder E. 
Published: March 2003

AbstractTwo cases of fetal intracranial tumors detected prenatally by ultrasound, together with a review of the literature on this rare disease, are presented. Sonographic features, histopathological type and location of the tumors, sex distribution, associated anomalies and overall prognosis are described as well as obstetric and postnatal therapeutic management. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Comparison of transvaginal ultrasonography and saline infusion sonography for the detection of intracavitary abnormalities in premenopausal women
Authors: Dijkhuizen F. P. H. L. J. , de Vries Laila D. , Mol B. W. J. , Brölmann H. A. M. , Peters H. M. , Moret Eveline , Heintz A. P. M. 
Published: March 2003

AbstractObjectiveTo compare the diagnostic accuracy of transvaginal sonography (TVS) and saline infusion sonography (SIS) for detecting intracavitary abnormalities in premenopausal women with abnormal uterine bleeding.MethodConsecutive premenopausal women who underwent hysterectomy for abnormal uterine bleeding were included. All women underwent TVS and SIS before their hysterectomy. The findings at TVS and SIS were compared with the findings of the hysterectomy specimen. Sensitivity, specificity, and likelihood ratios were calculated.ResultsThe results of 50 patients with abnormal uterine bleeding were evaluated. Histological examination revealed normal endometrial histology in 27 patients, submucus myomas in 13 patients and intracavitary polyps in 10 patients. The sensitivity of TVS in directly visualizing intracavitary abnormalities was 61% for a specificity of 96%. The likelihood ratio of presence of an intracavitary abnormality was 16 and the likelihood ratio of absence of such a finding was 0.41. When defining abnormality at TVS as direct visualization of an intracavitary abnormality or an increased endometrial thickness (cut‐off level 5 mm), the sensitivity of TVS was 87% for a specificity of 56%, with corresponding likelihood ratios of 2 and 0.23, respectively. The sensitivity and specificity of SIS was 100% and 85% with likelihood ratios of 6 and 0.0, respectively. No intracavitary abnormality was missed by SIS.ConclusionThe diagnostic accuracy of SIS is higher than the accuracy of TVS. A combined approach using endometrial thickness measurement by TVS and, reserving SIS for patients with increased (> 5 mm) endometrial thickness, or endometrium inadequately visualized on TVS, is the optimal method of reducing the hysteroscopy rate. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Serial sonographic features of a fetus with hydranencephaly from 11 weeks to term
Authors: Lam Y. H. , Tang M. H. Y. 
Published: March 2003

AbstractFetal hydranencephaly is a rare congenital cerebral abnormality characterized by complete or near complete absence of the cerebral cortex. We present the sonographic evolution of a case of fetal hydranencephaly from 11 weeks of gestation to term. At 11 weeks, the fetal head appeared small and the forehead was sloping. The normal cerebral hemispheres could not be identified. Follow‐up sonography showed that the cerebral hemispheres were almost entirely replaced by fluid, except in the occipital region. The baby died 2 weeks after birth. Post‐mortem examination confirmed the diagnosis of hydranencephaly. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal ultrasound diagnosis of infantile myofibromatosis – a case report
Authors: Meizner I. , Shalev J. , Mashiach R. , Vardimon D. , Ben‐Raphael Z. 
Published: March 2003

AbstractInfantile myofibromatosis, the most common soft tissue tumor of infancy, was diagnosed at 30 weeks of gestation. The tumor presented on ultrasound as a large mass measuring 42 mm × 75 mm × 35 mm located on the fetal back. The ultrasound diagnosis was further validated by MRI. Termination of pregnancy was carried out, and a multicentric visceral type of the tumor was diagnosed at autopsy.
The prenatal diagnosis of Binder syndrome before 24 weeks of gestation: case report
Authors: Cook K. , Prefumo F. , Presti F. , Homfray T. , Campbell S. 
Published: March 2003

AbstractA case of Binder syndrome was diagnosed at 21 weeks of gestation using two‐dimensional and three‐dimensional ultrasound. The first indication of any abnormality was a flattened fetal nose demonstrated in the mid‐sagittal plane. Further ultrasound imaging showed the virtual absence of the naso‐frontal angle, giving the impression of a flat forehead and small fetal nose. Suspected mild hypertelorism was also seen using transverse and coronal planes. Differential diagnosis of this condition is discussed. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Three‐dimensional transvaginal neurosonography of the fetal brain: ‘navigating’ in the volume scan
Authors: Monteagudo A. , Timor‐Tritsch I. E. , Mayberry P. 
Published: March 2003

AbstractObjectivesFetal neuroscan by ultrasound has gained in importance over recent years. Two‐dimensional (2D) transvaginal sonography was an important step in understanding the constantly changing and developing fetal brain. The objective of this article is to describe the use of three‐dimensional ultrasound of the fetal brain enhanced by the transvaginal transfontanelle scanning technique.MethodsThirty‐four pregnant patients were referred to us because of a history of brain anomaly or suspected brain pathology. The fetuses were scanned transvaginally. Two‐dimensional as well as three‐dimensional (3D) images were generated. The volumes obtained by the 3D‐ultrasound machine were displayed in the three conventional orthogonal planes (coronal, sagittal and axial).ResultsOf the 34 fetuses 10 had normal brain anatomy and 24 had brain pathology. In all 34 cases the 2D images as well as the 3D volumes were of diagnostic quality and all three planes could be obtained. The axial sections could only be obtained by the 3D re‐construction of the volume scans. The 2D images produced were acquired from a common point originating from the foot print of the transvaginal probe at the fetal anterior fontanelle or the sagittal suture, the sections ‘radiate’ from this point. Therefore, these sections are not parallel sections, but are oblique to each other. In contrast, the 3D volume could be examined using the classical parallel sections in all three orthogonal planes. The posterior fossa could be seen better if the footprint of the probe was placed over the posterior fontanelle or on the sagittal suture. The marker dot enabled a precise creation of anatomy and pathology. In the ‘angio mode’ it was possible to follow the anterior cerebral and pericallosal artery.ConclusionsThe 3D‐ultrasound technology using the transvaginal approach is effective and practical to perform during fetal neuroscan. The ability to ‘navigate’ in the volume and the ‘marker dot’ enables exact location of normal structures and evaluation fetal brain pathology. The volume can be reviewed over and over again, can be mailed to an expert, could be shown to consultants (pediatric neurology and neurosurgeons) and used for teaching. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
The association of aneuploidy and mild fetal pyelectasis in an unselected population: the results of a multicenter study
Authors: Chudleigh P. M. , Chitty L. S. , Pembrey M. , Campbell S. 
Published: March 2003

AbstractIntroductionMild pyelectasis is a common finding and there is some debate as to its association with aneuploidy. The results of a large, prospective, multicenter study of mild pyelectasis designed to determine the incidence and association with aneuploidy in an unselected population are reported.MethodsA large multicenter, prospective observational study of unselected fetuses with mild pyelectasis identified between 16 and 26 weeks' gestation in routine ultrasound departments.ResultsThere were 737 fetuses with mild pyelectasis of which 12 had an abnormal karyotype. Pyelectasis was isolated in three fetuses with Down syndrome, but in one the mother was older (36 years).ConclusionThese data confirm the fact that the presence of mild fetal pyelectasis increases the risk for aneuploidy, in particular trisomy 21. However, other risk factors should be considered before embarking on fetal karyotyping, as for most pregnancies complicated by isolated mild pyelectasis, risks of aneuploidy will remain small. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology