bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal echocardiography guidelines to predict survival of fetuses with ascites
Authors: Respondek M. , Kaczmarek P. , Pertyński T. 
Published: March 2003

AbstractIn a retrospective analysis of the standard protocols for fetal echocardiographic examination, 27 fetuses (mean gestational age 29 ± 5.4 weeks) with ascites were evaluated. Fetal cardiomegaly (increased heart area/chest area ratio), the presence or absence of atrioventricular valve regurgitation, inferior vena cava and ductus venosus Doppler flow velocity and umbilical vein pulsation were evaluated quantitatively in a group of survivors and non‐survivors. A statistically significant difference between the two groups was found for the presence of atrioventricular valve regurgitation (p = 0.003), and for cardiomegaly (p = 0.009). There was no statistical difference for the presence of abnormal venous flow and umbilical pulsation (p > 0.05). Abnormal venous Doppler flow velocities in the inferior vena cava and ductus venosus were observed more frequently than umbilical vein pulsation. The mean heart area/chest area ratios in the group of survivors and in the group of non‐survivors were 0.34 ± 0.09 and 0.48 ± 0.08, respectively (p < 0.001).The mean gestational ages at the time of diagnosis of ascites in the groups of survivors and non‐survivors were 33 ± 3.3 weeks and 28 ± 5.1 weeks, respectively (p < 0.05); the mean gestational ages at the time of delivery were 35.6 ± 2.3 weeks and 33.3 ± 4.9 weeks, respectively (p = 0.33).In terms of different echocardiographic features as well as the gestational age of the unborn patient with ascites, there is apparently no single indicator of a poor prognosis. Our results suggest that the prognosis is usually poor in a fetus with ascites, when cardiomegaly is detected, as well as the presence of tricuspid and mitral valve regurgitation. This is regardless of the type of venous flow and regardless of the etiology of the ascites. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Venous Doppler in the fetus with absent end‐diastolic flow in the umbilical artery
Authors: Gudmundsson S. , Tulzer G. , Huhta J. C. , Marsal K. 
Published: March 2003

AbstractHigh perinatal mortality has been reported in association with the finding of absent end‐diastolic flow velocities in the umbilical artery. The fetus is known to centralize its circulation during hypoxemia and abnormal venous blood flow velocities have been reported in cases of heart failure and imminent asphyxia. The aim of this study was to evaluate blood flow velocities recorded with Doppler ultrasound in the umbilical vein, inferior vena cava and middle cerebral artery as predictors of survival in 17 fetuses with absent or reversed end‐diastolic flow in the umbilical artery.There were five perinatal deaths, all having abnormal umbilical cord venous pulsations. An increased proportion of diastolic blood flow velocity in the middle cerebral artery as a sign of hypoxia was found in 12 fetuses without a relationship to perinatal mortality. An increased proportion of retrograde blood flow in the inferior vena cava was recorded in only one fetus, which died on the same day of congestive heart failure, suggesting fetal heart sparing in the remaining complicated pregnancies. The results suggest that abnormal end‐diastolic umbilical venous pulsation in the cord is a late and ominous sign of a severely compromised fetus, while abnormal blood flow velocimetry in the middle cerebral artery might be an earlier sign of fetal hypoxia, with a better prognosis. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Ovarian morphology as a predictor of hormonal values in polycystic ovary syndrome
Authors: van der Westhuizen S. , van der Spuy Z. M. 
Published: March 2003

AbstractThe objective of this investigation was to correlate the severity of ultrasound abnormality in the ovaries of women suspected of having the polycystic ovary syndrome (PCOS) with their endocrinopathy in an attempt to establish which anatomical abnormalities best predict endocrine dysfunction.There were 90 patients in the study group – all suspected clinically of having PCOS – and 12 control subjects. Of the study patients, 74 were classified ultrasonically as having polycystic ovaries, whereas 16 demonstrated no ovarian abnormality.On ultrasound examination of the ovaries, the follicular size, the number and type of distribution of follicles, ovarian volume and echogenicity of the stroma were assessed. Levels of the following serum hormones were measured: luteinizing hormone (LH), follicle stimulating hormone (FSH), estrone, estradiol, 17α‐OH‐progesterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin and testosterone. Calculations were made using these results to obtain the LH : FSH ratio and the free androgen index.Endocrine assessment of these 90 patients demonstrated significantly lower LH levels, lower LH : FSH ratio and lower testosterone levels in the women without ovarian abnormality, compared to those with polycystic ovaries. The women with ultrasound evidence of polycystic ovaries had high LH levels, a raised LH : FSH ratio and higher testosterone, DHEAS and androstenedione levels than the control subjects.Although a number of multivariate regressions of biochemistry on ovarian morphology were statistically significant, ovarian morphology predicted only a small proportion of the variability in the hormone levels. Multivariate regression models predicting androstenedione and the LH : FSH ratio had the best overall fit with ovarian volume and a rosary follicular pattern as factors, but even for these variables the adjusted R2 value was very low (0.23 for androstenedione and 0.20 for the LH : FSH ratio).It is therefore concluded that, although ovarian morphology may accurately diagnose polycystic ovaries, it does not predict the severity or presence of endocrine dysfunction. Management and prognosis must be determined on an individual basis against the background of a combination of the clinical, biochemical and ultrasound findings. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal color Doppler sonography in adnexal masses: which parameter performs best?
Authors: Alcázar J. L. , Ruiz‐Perez M. L. , Errasti T. 
Published: March 2003

AbstractThe aim of this study was to establish which of several commonly used parameters performs best in the evaluation of adnexal masses by transvaginal color Doppler sonography. A total of 79 adnexal masses in 73 consecutive patients were included in the study. There were 43 (58.9%) premenopausal and 30 (41.1%) postmenopausal patients. The median age was 45 years (range 20–78 years). The parameters compared were: number of vessels detected in each tumor, tumor vessel location (central vs. peripheral), peak systolic velocity (PSV), lowest resistance index (RIlowest), mean resistance index (RImean), lowest pulsatility index (PI lowest) and mean pulsatility index (PImean). Receiver operating characteristic (ROC) curves were plotted to analyze the test performance of the parameters, except for tumor vessel location, and to estimate the best cut‐off value of the parameters studied to differentiate between malignant and benign tumors. Definitive histopathological diagnosis was obtained in every case and used as the ‘gold standard’. There were 20 (25.3%) malignant and 59 (74.7%) benign masses. Color Doppler signals were detected in 100% of the malignant masses (20 out of 20) and 74.6% (44 out of 59) of the benign masses, and the difference was found to be statistically significant (p < 0.001). Tumor vessel location was central in 18 out of 20 (90%) malignant masses, whereas it was peripheral in 39 out of 44 (88.6%) benign masses. ROC analysis showed that the best cut‐off values for number of vessels, PSV, RIlowest, RImean, PIlowest and PImean were three vessels, 2.5 cm/s, 0.45, 0.55, 0.90 and 1.50, respectively. However, for all these parameters except RIlowest, there was a considerable overlap between benign, and malignant tumors, with a high false‐positive rate. In conclusion, in our experience, the parameters that performed best were the RIlowest with a cut‐off value of 0.45 (sensitivity 100%; false‐positive rate 11.4%) and central tumor vessel location (sensitivity 90%; false‐positive rate 11.4%). Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Antenatal sonographic findings associated with scimitar syndrome
Authors: Grisaru D. , Achiron R. , Lipitz S. , Yahav J. , Hegesh J. , Rotstein Z. 
Published: March 2003

AbstractScimitar syndrome is a rare congenital anomaly that consists of secondary dextroposition in situs solitus, due to right pulmonary hypoplasia. The prenatal sonographic findings of this abnormality have not been previously described. We describe early sonographic findings in a fetus that included isolated cardiac dextroposition with normal abdominal situs, hydramnios and mild narrowing of the right pulmonary artery. Postnatally, the infant developed heart failure, and a right hypoplastic lung was found. Catheterization revealed collateral supply to the right lung arising from the descending aorta and anomalous drainage of right pulmonary veins to the inferior vena cava. The diagnosis of scimitar syndrome was therefore established. A coil embolization of arterial collaterals to the right lung was performed. Scimitar syndrome should be considered in a fetus with the sonographic findings of a right shift of the mediastinal structures, an intact diaphragm and narrow right pulmonary artery. This may allow early neonatal stabilization and treatment. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
The significance of echogenic foci in the fetal heart: a prospective study of 228 cases
Authors: Simpson J. M. , Cook A. , Sharland G. 
Published: March 2003

AbstractThe purpose of this study was to determine the pathological significance of echogenic foci in the heart of fetuses with no other sonographic abnormalities and in the absence of other risk factors for chromosomal abnormality. A total of 228 fetuses were identified with single or multiple echogenic foci. This represents 6.9% of the total number of fetuses scanned. The most frequent finding was a single echogenic focus in the left ventricle (n = 136; 60%) but multiple foci were observed in 33%. An echogenic focus in the right ventricle occurred in 16 cases (7%). Karyotypic abnormalities were diagnosed postnatally in two fetuses. One of these fetuses, with an echogenic focus in each ventricle, had trisomy 21, and the other, with two echogenic foci in the left ventricle, had an unbalanced translocation. The vast majority of fetuses which had echogenic foci were normal, but there was a risk of karyotypic abnormality of 1%. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal detection of congenital inherited cataracts
Authors: Drysdale K. , Kyle P. M. , Sepulveda W. 
Published: March 2003

AbstractIn a high‐risk pregnancy for ocular defects, routine second‐trimester ultrasonography revealed a highly echogenic area within the fetal left eye with no other associated abnormalities. The diagnosis of congenital cataracts was confirmed after birth. Examination of the fetal face is an important part of prenatal ultrasonography., and visualization of the fetal eyes and lenses should be included in the routine assessment of facial anatomy. This is especially important in pregnancies at risk for congenital cataracts or for other anomalies affecting the fetal eye. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Late prenatal ultrasound features of hydrometrocolpos secondary to cloacal anomaly: case reports and review of the literature
Authors: Odibo A. O. , Turner G. W. , Borgida A. F. , Rodis J. F. , Campbell W. A. 
Published: March 2003

AbstractCloacal anomalies are extremely rare and have variable presentations. Prenatal diagnosis can be difficult especially if they present in late gestation. Here we present two cases diagnosed in the late third trimester and review the literature regarding prenatal diagnosis of cloacal anomalies. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Increased nuchal translucency thickness at l0–14 weeks of gestation as a predictor of severe twin‐to‐twin transfusion syndrome
Authors: Sebire N. J. , D'Ercole C. , Hughes K. , Carvalho M. , Nicolaides K. H. 
Published: March 2003

AbstractThis study examines a possible association between increased nuchal translucency thickness at 10–14 weeks of gestation in monochorionic twin pregnancies and the subsequent development of severe twin‐to‐twin transfusion syndrome (TTS). In 132 monochorionic twin pregnancies, including 16 that developed severe TTS at 15–22 weeks of gestation and 116 that did not develop TTS, crown‐rump length, nuchal translucency thickness and fetal heart rate were measured at 10–14 weeks. In those that developed severe TTS, the prevalence of nuchal translucency thickness above the 95th centile of the normal range and the inter‐twin difference in nuchal translucency thickness and fetal heart rate were significantly higher than in the non‐TTS group; there were no significant differences between the groups in the inter‐twin difference in crown‐rump length. For fetal nuchal translucency above the 95th Gentile, the positive and negative predictive values for the development of TTS were 38% and 91%, respectively; the likelihood ratios of nuchal translucency above or below the 95th centile for the development of severe TTS were 4.4 (1.8–9.7) and 0.7 (0.4–0.9), respectively. These findings demonstrate that the underlying hemodynamic changes associated with TTS may manifest as increased fetal nuchal translucency thickness at 10–l4 weeks of gestation. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Increased nuchal translucency at 10—14 weeks of gestation as a marker for major cardiac defects
Authors: Hyett J. A. , Perdu M. , Sharland G. K. , Snijders R. S. M. , Nicolaides K. H. 
Published: March 2003

AbstractScreening for fetal cardiac defects is traditionally based on the ultrasonographic examination of the four‐chamber view of the fetal heart at mid‐gestation, which has been shown to identify 26% of major cardiac defects. Pathological studies in fetuses with increased nuchal translucency at 10–l4 weeks of gestation, a sonographic marker for chromosomal abnormalities, have shown an association between increased nuchal translucency and congenital abnormalities of the heart. This study reports the prevalence of cardiac defects in 1427 chromosomally normal fetuses with increased nuchal translucency thickness, and examines the potential value of this sonographic marker in screening for major cardiac defects. The diagnosis of cardiac defects was made either by postmortem examination in terminations of pregnancy and intrauterine or neonatal deaths or by clinical examination and appropriate investigations in live births. The prevalence of major cardiac defects was 17 per 1000 (24 of 1427 fetuses) and increased with translucency thickness from 5.4 per 1000 for translucency of 2.5–3.4 mm to 233 per 1000 for translucency of ≥ 5.5 mm. These findings suggest that measurement of nuchal translucency thickness at 10–l4 weeks may prove to be a useful method of screening for abnormalities of the heart and great arteries in addition to its role in screening for chromosomal defects. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
A cross‐sectional study of platelet volume in healthy normotensive women with bilateral uterine artery notches
Authors: Lees C. C. , Brown A. S. , Harrington K. F. , Beacon H. J. , Martin J. F. , Campbell S. 
Published: March 2003

AbstractHigh uterine artery resistance characterized by bilateral notches seen on Doppler ultrasound in the second half of pregnancy is associated with an increased risk of adverse outcome related to pre‐eclampsia and intrauterine growth retardation. We sought to establish whether there was a difference in platelet volume in healthy, normotensive women with high‐resistance uterine artery Doppler findings compared to those with normal uterine artery Doppler findings.Forty‐seven women were allocated prospectively into ‘bilateral notch’ and ‘no notch’ groups at color Doppler imaging of the uterine arteries carried out at a mean of 26 weeks' gestation. The difference in platelet volume between the two groups and the relationship of adverse outcome with raised platelet volume and high‐resistance uterine artery Doppler findings was investigated. Twenty‐three women had no evidence of uterine artery notches and 24 had bilateral uterine artery notches. Platelet volume in the women with bilateral notches was greater than in those with no notches (8.28 fl vs. 7.46 fl; p = 0.01). However, unlike high‐resistance uterine artery Doppler findings, increased platelet volume was not associated with adverse outcome.Uterine artery Doppler flow abnormalities have not previously been studied in combination with hematological or biochemical markers. Our findings show, for the first time, that women with bilateral uterine artery notches have an increased platelet volume compared to those with normal uterine artery Doppler findings many weeks before clinical signs of pre‐eclampsia or fetal growth retardation are evident. Women with abnormal uterine artery flow at this gestation may have other cardiovasctilar and hematological differences compared to those with normal flow. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Neural tube defects in chromosomally normal and abnormal human embryos
Authors: Coerdt W. , Miller K. , Holzgreve W. , Rauskolb R. , Schwinger E. , Rehder H. 
Published: March 2003

AbstractNeural tube defects (NTDs) were recognized in eight out of 91 intact embryos from spontaneous abortions and in one case of an induced abortion following prenatal diagnosis of a chromosomal disorder. Five of the nine cases showed chromosomal abnormalities. Trisomy 18 and triploidy were associated with spina bifida in three cases, trisomy 7 with parieto‐occipital encephalocele and monosomy X with spina bifida and iniencephaly in one case. A sixth anencephalic embryo in which chromosomal analysis was not performed showed a malformation pattern highly suggestive for trisomy 18. Discussion focuses on the high rate and the type of chromosomal abnormalities among spontaneously aborted NTD embryos, on the contrasting phenotype of 45,X conceptions and on the morphogenesis of the different neural tube defects in early development. In view of future early endovaginal ultrasound diagnosis, the changing morphological pattern is exemplified, and ranges from apparently hyperplastic to degenerative alterations of the exposed neural tissue. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Fetal lung volumetry by three‐dimensional ultrasound
Authors: Pöhls U.G. , Rempen A. 
Published: March 2003

AbstractThe aim of this study was to establish a method for determination of fetal lung volume by three‐dimensional ultrasound. The thoraces of a total of 113 fetuses (singleton pregnancies, 11–41 weeks of gestation without any signs of malformation or oligohydramnios) were examined by three‐dimensional ultrasound. Volumetric evaluation of each lung was performed in each of three perpendicular planes (six measurements in total). There were significant differences in all three measurements between the left and right lungs. Especially in the second and third trimesters, measurement of the frontal and the sagittal planes was sometimes prevented by poor imaging conditions. The scan volume was always too small for fetuses above 34 weeks. With these problems considered, nomograms of fetal lung volume for the left and the right lung were calculated. Lung volumes in the present study showed good correlation with published autopsy findings. Three‐dimensional ultrasonographic volumetry is a useful method for determining fetal lung volume and may have a role to play in the detection of pulmonary hypoplasia. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Pregnancy outcome among non‐participants in a trial on ultrasound screening
Authors: Kieler H. , Hellberg D. , Nilsson S. , Waldenström U. , Axelsson O. 
Published: March 2003

AbstractOur objective was to characterize and evaluate pregnancy outcome in women who declined participation in a trial on ultrasound screening in the second trimester. Between 1985 and 1987, 8768 women were recruited for a trial on ultrasound screening. By randomization, 4997 women were assigned to either a screening or a non‐screening group. Of the 1414 excluded women, data were retrieved from 1211 (86%). Participation was declined by 526 of these 1211 women, either because of anxiety regarding harmful effects of ultrasound or because they could see no benefits of ultrasound scanning. Non‐participants and participants were compared.The non‐participants were older, had a higher birth/pregnancy ratio, were less often smokers, and had fewer ultrasound examinations than the participants. There was a longer mean pregnancy length, an increased number of post‐term deliveries, more suspicions of small‐for‐gestational‐age fetuses and later detections of multiple pregnancies among non‐participants as compared with the screening group. No differences in neonatal morbidity were found except for a greater number of mild respiratory disorders in the non‐participant group.The non‐participant women were more obstetrically experienced and showed indications of a healthier lifestyle in comparison with participants. The differences found in pregnancy outcome could be explained by the ultrasound screening procedure. There were no major differences in neonatal morbidity between the groups. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
3D Color Power Angio™ imaging: a new method to assess intracervical vascularization in benign and pathological conditions
Authors: Suren A. , Osmers R. , Kuhn W. 
Published: March 2003

AbstractIt is well known that angiogenesis is a fundamental event in the growth of tumors as well as in physiological conditions. In an ongoing prospective study involving eight women, we investigated the microvasculature within the cervix by the use of 3D Color Power Angio™ imaging. The ultrasound equipment was used in conjunction with specialized software providing high‐resolution ‘3D‐Angiomode’. The system provides the ability to visualize blood flow in small vessels that are undetectable by conventional color Doppler techniques and also to study the architecture and determine the number of blood vessels. Comparison of the vessels in the normal cervix with those in the cervix affected by carcinoma or bacterial or viral infection demonstrated that, in malignant tissue, there is a chaotic network of tortuous vessels traversing the tumor mass, whereas, in benign tissue or tissue that is inflamed as a result of infection, the course of the vessels has a regular structure. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal ultrasound observations in subsequent pregnancies with Perlman syndrome
Authors: van der Stege J. G. , van Eyck J. , Arabin B. 
Published: March 2003

AbstractPerlman syndrome is a rare disease with a poor prognosis. Until now, the specific antenatal diagnostic criteria of this syndrome have not been documented.We report on two pregnancies with Perlman syndrome, in the same woman, in which karyotyping and ultrasound examination were performed. In the first pregnancy, the final diagnosis was made only postnatally, whereas, in the second affected pregnancy, nuchal translucency was seen at 11 weeks. From 23 weeks onwards the classical signs of renal and abdominal enlargement were observed.The impact of non‐specific early ultrasound markers on decision‐making in pregnancies with family risks, where specific tests are not yet available, must be evaluated. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology