bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comprehensive analysis of uterine artery flow velocity waveforms for the prediction of pre‐eclampsia
Authors: Aquilina J. , Barnett A. , Thompson O. , Harrington K. 
Published: March 2003

AbstractObjectivesTo evaluate the performance of velocimetric indices of uterine artery flow velocity waveforms (FVW's) at 20 weeks' gestation, alone or in combination with qualitative analysis, and establish the optimal screening method for the prediction of pre‐eclampsia.MethodsA total of 614 primiparous women had color flow/pulsed Doppler (CFPD) imaging of both uterine arteries at 20 weeks gestation. Receiver operator characteristic (ROC) curves were created for the systolic/end‐diastolic (A/B) ratio, resistance index (RI) and systolic/early diastolic (A/C) ratio for placental and non‐placental uterine arteries, individually or in combination with the presence of unilateral or bilateral notches. Based on data from ROC curves, the sensitivity of each method was compared with the false‐positive rate set at 17 and 11%.ResultsThe highest sensitivity (88%) and specificity of (83%) was obtained using bilateral notches/mean RI ≥ 0.55 (50th centile) and unilateral notches/mean RI ≥ 0.65 (80th centile). When the false‐positive rate was set at 17%, the inclusion of bilateral notches significantly improved the sensitivity of RI (P < 0.001), placental RI (P < 0.01), placental A/C ratio (P < 0.05), mean A/C ratio (P < 0.01) and mean A/B ratio (P < 0.05). Bilateral notches/mean RI or A/B cut‐offs were also superior to the persistence of a notch in either artery combined with RI (P < 0.01) or A/B ratio (P < 0.05). When the false‐positive rate was set at 11%, the inclusion of bilateral notches did not improve the sensitivity of the A/C (P = 1.00) or A/B ratio (P > 0.10). Placental velocimetric indices performed better than mean indices but the differences in sensitivity at the set false‐positive rates were not statistically significant.ConclusionAt 20 weeks' gestation, bilateral notches with mean RI cut‐offs is the best screening method if further screening later in pregnancy is proposed. The A/C ratio is complementary to bilateral notches when the false‐ positive rate is set at 17% and an effective quantitative substitute when the false‐positive rate is set at 11%. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasonographic evaluation of the postpartum uterus
Authors: Edwards A. , Ellwood D. A. 
Published: March 2003

AbstractObjectiveTo define the ultrasonographic appearance of the uterus and the uterine cavity, including its contents, in normal women making an uncomplicated postpartum recovery.MethodsForty women were scanned on days 7, 14, and 21 postpartum. At each scan the uterine and cavity volumes were estimated, and the appearance of the uterine cavity contents was documented. The amount and duration of postpartum vaginal bleeding, and method of infant feeding were also recorded.ResultsThe mean duration of postpartum bleeding was 24.5 (range 14–45) days. Fifty‐one percent (95% confidence interval 34–68) of the subjects scanned at 7 days postpartum, 21%(8–36) at 14 days, and 6%(0.8–20) at 21 days, had an echogenic mass within the uterine cavity. Statistical analysis revealed no difference, in terms of bleeding duration, between women with a uterine cavity echogenic mass noted at 7, 14, or 21 days postpartum, and those without (unpaired t‐test, P = 0.42, 0.39, and 0.06). The presence of an echogenic mass was not associated with heavier bleeding at the time of any of the scans (chi‐squared test, P = 0.58, 0.56, and 0.28). Statistical analysis revealed no correlation between the duration or amount of bleeding, and the uterine or cavity volume, at any of the three scans.ConclusionIn this study, ultrasound evaluation of the uterine cavity revealed an echogenic mass in 51% of women with normal postpartum bleeding at 7 days, 217% at 14 days, and 6% at 21 days postpartum. This questions the significance of echogenic material within the uterine cavity in the postpartum period. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Fetal ovarian cysts: a report of three cases managed by intrauterine aspiration
Authors: Perrotin F. , Potin J. , Haddad G. , Sembely‐Taveau C. , Lansac J. , Body G. 
Published: March 2003

AbstractSmall follicular or functional theca‐lutein cysts are a common finding in fetal and neonatal ovaries. After delivery, decrease of hormonal stimulation may lead to spontaneous resolution of the cyst. A high rate of complication has been underlined by recent studies, the most common being ovarian torsion with subsequent loss of the ovary. Because torsion may happen with any size of cyst, however large or small, we suggest in utero decompression even in small fetal ovarian cysts (< 5 cm). We report here three cases of such cysts managed by intrauterine aspiration with good outcome and no further need for neonatal surgery. In all cases cytology of the cyst aspirate demonstrated numbers of granulosa cells and fluid biochemistry showed a high amount of estradiol, progesterone, and testosterone that confirmed the etiology as ovarian. Despite the small size of the cysts, no technical difficulties were encountered and no maternal or fetal morbidity occured. Prenatal management of fetal ovarian cysts remains controversial, however, and our limited experience needs to be assessed on a larger number of cases. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Cervical assessment at the routine 23‐week scan: standardizing techniques
Authors: To M. S. , Skentou C. , Chan C. , Zagaliki A. , Nicolaides K. H. 
Published: March 2003

AbstractObjectiveTo examine the frequency of curvature of the cervix and to establish the degree of curvature with increasing cervical length. To assess the significance of this phenomenon in terms of the classification of patients as high risk for pre‐term delivery.MethodCervical length was measured prospectively by transvaginal sonography in 301 women at 23 weeks of gestation. The distance between the internal and external os was measured both as a straight line and also as a curved line along the endocervical canal. In addition, a search of our database was made to identify all women who had undergone cervical assessment as part of a policy of routine screening. In those with cervical length of less than 26 mm the thermal images of the cervix were used to obtain straight and curved measurements. The frequency of curved cervix was calculated and the relationship between the ratio of straight to curved measurement to the curved one was determined.ResultsIn the prospective study curvature of the cervix was observed in 143 (48%) of the 301 women. Curvature was observed in 51% (135 of 267) with cervical length of 26–55 mm, 25% (8 of 32) with length of 16–25 mm, and none of the two with length of 1–15 mm. The ratio of the straight to the curved measurement decreased with increasing cervical length (r = −0.27, P = 0.001). In the retrospective study curvature of the cervix was found in 72 (15%) of 471 with length of 16–25 mm and in none of the 76 with length of 1–15 mm.ConclusionCervical length is influenced by the degree of cervical curvature. The disparity of measurements between the internal and external os taken as a straight line or along the cervical canal increases with cervical length. However, this disparity may not have any clinical implications because at short cervical length (less than 16 mm) the cervix appears to be always straight. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis and outcome of a ruptured aneurysm arising from the left atrium
Authors: O'Brien J. M. , Barton J. R. , Spirek A. J. , Allen A. A. , McCaffrey F. M. 
Published: March 2003

AbstractPrenatal diagnosis of a fetal cardiac aneurysm or diverticula is rare. We report what we believe to be the first case of an atrial wall aneurysm diagnosed as ruptured or leaking by fetal pericardiocentesis. Spontaneous resolution of the anomaly was observed in the third trimester with delivery of a vigorous newborn at term. The infant did not require surgical intervention after birth and has done well at follow‐up examinations. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal sonography, saline contrast sonohysterography and hysteroscopy for the investigation of women with postmenopausal bleeding and endometrium > 5 mm
Authors: Epstein E. , Ramirez A. , Skoog L. , Valentin L. 
Published: March 2003

AbstractObjectivesTo determine the ability of transvaginal ultrasound, with or without saline infusion, to detect focally growing lesions in the uterine cavity in women with postmenopausal bleeding and endometrium > 5 mm, and to determine the accuracy of conventional ultrasound, saline contrast sonohysterography and diagnostic hysteroscopy under general anesthesia to diagnose endometrial polyps, submucous myomas and uterine malignancy.DesignIn a prospective study, 105 women with postmenopausal bleeding and endometrium > 5 mm underwent conventional ultrasound examination and saline contrast sonohysterography. Diagnostic and operative hysteroscopy under general anesthesia was then performed. The presence of focally growing lesions and the type of lesion (endometrial polyp, submucous myoma, malignancy or unclear focal lesion) were noted at ultrasound examination and at hysteroscopy.ResultsThere was almost perfect agreement (96%) between saline contrast sonohysterography and hysteroscopy in the diagnosis of focally growing lesions. Saline contrast sonohysterography and hysteroscopy both had a sensitivity of approximately 80% with regard to diagnosing endometrial polyps (false‐positive rates of 24% and 6%, respectively), whereas conventional ultrasound missed half of the polyps (sensitivity, 49%; false‐positive rate, 19%). Hysteroscopy was superior to both saline contrast sonohysterography and conventional ultrasound with regard to discriminating between benign and malignant lesions (sensitivity, 84%, 44%, and 60%; false‐positive rate, 15%, 6% and 10%, respectively). The risk of malignancy was increased seven‐fold (odds ratio, 7.3; 95% confidence interval, 1.9–27.8) in women with distension difficulties at saline contrast sonohysterography, and two thirds of the women with a poorly distensible uterine cavity had a malignant diagnosis.ConclusionSaline contrast sonohysterography is as good as hysteroscopy at detecting focally growing lesions in the uterine cavity in women with postmenopausal bleeding. However, neither hysteroscopy nor saline contrast sonohysterography can reliably discriminate between benign and malignant focal lesions. Distension difficulties at saline contrast sonohysterography should raise a suspicion of malignancy. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
The value of sonohysterograpy in the diagnosis of abnormal uterine bleeding
Authors: Kepkep K. , Koç A. , Gurpinar H. 
Published: March 2003

Purpose:  The aim of study was to evaluate the value of transvaginal sonohysterography in the diagnosis of endometrial, submucosal and intracavitary lesions in patients with abnormal uterine bleeding.Methods:  This was a prospective case controlled study. Sonohysterography was performed in 50 women (aged 33–64 years) with abnormal uterine bleeding in whom transvaginal sonography suggested an increased endometrial thickness or poorly defined endometrium. Sterile saline solution (10–30 mL) was injected into the endometrial cavity under direct ultrasonographic visualization. Once the endometrial cavity was expanded, the presence of polyps or submucous myomas and the anterior and posterior endometrial thickness was assessed. Following that the endometrial biopsy was performed. The 26 of 50 patients underwent hysterectomy.Results:  In sonohysterographic examination, 11 patients had submucous myomas, six patients had endometrial polyps and the others had diffuse or focal increased endometrial thickness. The results of sonohysterography and transvaginal ultrasonography differed significantly (x2 = 11, P < 0.05). The results of sonohysterography and endometrial biopsy differed significantly (x2 = 11, P < 0.05). There was no significant difference between sonohysterography and pathologic findings of hysterectomy materials (x2 = 2, P > 0.05). Sensitivity and specificity for sonohysterography were 85 and 100% and positive and negative predictive values were 100 and 85%, respectively.Conclusion:  Sonohysterography is highly accurate method which allows differentiation of intracavitary, endometrial and submucosal lesions in patients with abnormal uterine bleeding.
First trimester ductus venosus Doppler screening in pregnancies with increased nuchal translucency risk
Authors: Mavrides E. , Sairam S. , Hollis B. , Carvalho J. , Thilaganathan B. 
Published: March 2003

Objective:  To evaluate the role of ductus venosus (DV) Doppler in pregnancies with an increased nuchal translucency (NT) adjusted risk for the prediction of fetal outcome.Methods:  Doppler assessment of the DV was performed in 124 fetuses with a first trimester NT‐adjusted risk of >1:300 for Down syndrome. The pregnancy outcome, including karyo‐type and structural abnormalities, were ascertained for all pregnancies.Results:  The DV Doppler was abnormal in 27 (21.8%) pregnancies with an increased first trimester NT‐adjusted risk. The outcome was normal in 69 pregnancies (55.6%). Thirty‐nine pregnancies (39.5%) were aneuploid and further six pregnancies had adverse outcomes (three unexplained intrauterine deaths, two structural abnormalities and one major cardiac defect). The sensitivity of abnormal DV in this selected population was 51.3% for aneuploidy and 33.3% for adverse outcome. An abnormal DV Doppler increases the risk for aneuploidy by 11.8 (95% CI: 3.3–42.2).Conclusions:  The finding of an abnormal DV Doppler signal increases the risk for aneuploidy 12‐fold in a pregnancy with an increased NT‐adjusted risk. Although DV Doppler can be used in addition to NT screening for aneuploidy, the sensitivity of DV Doppler is less than previously reported.
Congenital heart disease and the spectrum of karyotypic abnormalities in a prenatal population
Authors: Quinton A. E. , Smoleniec J. S. , Clarke J. , Ogle R. F. 
Published: March 2003

Aim:  To evaluate the frequency and type of chromosome anomalies in fetuses diagnosed by ultrasound with congenital heart disease (CHD).Methods:  The study is a retrospective descriptive case series with the nonrandom sample taken from all the pregnant women who had an ultrasound at the Feto‐Maternal Unit. There were 69 cases of congenital heart defects (CHD) collected from a data base search.Results:  Abnormal chromosomes were present in 47% of cases. Fifteen percent had trisomy 18, 13% trisomy 21 and 5% trisomy 13. Triploidy, monosomy X and 22q11 deletion occurred with a frequency of 3% each. Unusual chromosome anomalies were trisomy 16 mosaic and trisomy 7p, unbalanced translocation 7 and 11. Chromosome analysis was unavailable in 9% of cases. Maternal age was significantly different for those with CHD and an abnormal karyotype (P = 0.019, t‐test). CHD and the presence of other fetal anomalies was significantly associated with an abnormal karyotype (Fisher's exact test, P = 0.029). Hypoplastic left heart syndrome was the most common heart defect found with 44% of fetuses having an abnormal karyotype. Fifty percent of fetuses with an atrioventricular septal defect had an abnormal karyotype. Hypoplastic left heart was found in 33% of trisomy 18 fetuses and an atrioventricular septal defect in 50% of trisomy 21 cases. These results show a poor outcome for fetuses diagnosed in utero with CHD, with an overall mortality rate of 72%.Conclusion:  The frequency and type of abnormal chromosomes found in fetuses diagnosed with CHD agrees with other reports in the literature. The risk of aneuploidy with CHD is influenced by maternal age. Detection of CHD is improved when other fetal anomalies are present.
Determination of fetal gender by first trimester ultrasonography
Authors: Cha Sang Choon , Yamasaki A. A. , Braia G. 
Published: March 2003

Objective:  To assess the accuracy of first trimester ultrasonography in determining fetal sex by orientation of genital tubercle in relation to spine in a midsagittal plane.Material and methods:  Between May 2000 and 2001, 110 patients were studied from 11 to 14 weeks of gestation (average 12.1 weeks) at first trimester ultrasonography. The genital region was examined in a midsagittal plane and the fetal gender was assigned as male if the angle of the genital tubercle to a horizontal line through the lumbosacral skin surface was greater than 30° and female when the genital tubercle was parallel or convergent (<30°). All final results were checked after birth.Results:  Among 148 patients, only in 16 (10.8%) fetal sex was not determined. In 132 patients (89.2%), genital tubercle was identified and sex was determined. There were 106 (80.3%) hits and 26 mistakes (19.7%).Conclusion:  The diagnosis of fetal sex at first trimester has an important role in case of X‐linked anomalies so invasive procedures can be avoided if fetuses are female. Our results are similar to others in literature. The accuracy of gender determination by ultrasonography was 80.3%. Most common mistake was to assign male fetuses as female. We believe that this error is due to the angle variation of the genital tubercle during the exam.
Correlation between ductus venosus, gestational age and nuchal translucency at 11–14 weeks scan: preliminary study
Authors: Munoz H. , Parra M. , Pedraza D. , Jimenez P. , Villa S. , Puga M. 
Published: March 2003

Background/objective:  Fetal ductus venosus assessment at 11–14 weeks' gestation is one of the best tests to identify fetuses with cardiac malformation. Negative blood flow during atrial contraction has been used as qualitative sign in this cases. The aim of this study is to describe normal ranges for Doppler velocimetry of ductus venosus at 11–14 weeks' gestation and correlate it with nuchal translucency thickness.Material and methods:  We performed a prospective study, 88 patients were examined at 11–14 weeks of pregnancy. Crown rump length, nuchal translucency, fetal anatomy and uterine artery Doppler velocimetry were evaluated transabdominally. Ductus venosus was identified using longitudinal plane and Doppler velocimetry index was measured using Doppler duplex ultrasound. An average of three waveforms were analyzed and pulsatility index venousus was measured. For statistical analysis mean values and 95% CI for pulsatility index of ductus venosus was established for each crown rump length, Spearman regression and normal centile distribution was performed.Results:  The 77 out of 88 patients with nuchal translucency below 95th centile were used for calculating normal ranges for each gestational age. Mean maternal age was 29 ± 6.5 years old (range = 15–42), and 20% was over 35 years old. Mean pulsatility index was 1.02, 0.99, 0.95 and 0.92 at 11, 12, 13 and 14 weeks, respectively. Although ductus venosus pulsatility index was not modified according to gestational age, there was a significant positive correlation with nuchal translucency thickness (r = 0.59, P ≤ 0.001).Conclusion:  Ductus venousus pulsatility index is correlated positively with nuchal translucency at 11–14 weeks' gestation.
Ultrasonographically measured umbilical cord cross‐sectional area – reproducibility of the method
Authors: Vasques F. A. P. , Moron A. F. , Murta C. G. V. , Carvalho F. H. C. , Cattini H. , Gonçalves T. R. , Barbosa M. M. , Hishaba W. J. 
Published: March 2003

A prospective cross‐sectional study was developed in order to determine the reproducibility of the measurement of the umbilical cord cross‐sectional area (UCCSA) during normal pregnancies (patients with known dates of LMP and an ultrasound examination before the 20th week, without any pathologic condition), measured by different and trained examiners. The measurements of the umbilical cord cross‐sectional area were obtained in a plane adjacent to the insertion of the cord abdomen, as proposed by Raio et al. 1999, after the different examiners were trained by the author. The inclusion criteria were: (1) singleton pregnancy; (2) gestation age >20 weeks; (3) intact membranes (4) normal umbilical Doppler flow velocimetry. The exclusion criteria, in the presence of any of those were: (1) congenital and/or chromosomal abnormalities; (2) pregnancy complications (any type); (3) inadequate size for gestational age with when the examination was performed, i.e. the weight below the 10th percentile or above the 90th; (4) abnormal AFI for the gestational age. The patients were examined and included only once. During the period of the study (February 2000–May 2001), 545 patients were examined, after meeting the inclusion criteria determined for the present study. The age of the patients ranged from 15 to 42 years (mean = 26.7 ± 4.8), 242 patients (44.4%) had two gestations, 135 patients (28.1%) were at their first gestation, 129 patients (23.7%) were at their third gestation and 39 patients had four or more gestations (3.8%). The ultrasound machine used was the Synergy Multi Sync M 500. The statistical program used was the statistical package for social sciences (SPSS). The first examiner collected 22% of the data, the second examiner collected 45% of the data, the third examiner collected 24% of the data and the fourth one collected 9% of the data. According to the analysis of variance (anova), we performed, comparing the data obtained by the different examiners, no significance was found and this fact was also showed by the comparison of the data among them and verifying that the data had a dispersion inside tolerable limits. The anova showed the following data (example for 3 weeks): At 25 weeks, the F‐test showed a value of 0.930 and a P‐value of 0.454; at 32 weeks the values were 0.106 for the F‐test and 0.956 for the P‐value and for week 38 the values were 0.102 (F‐test) and 0.904 (P‐value). We conclude that the measurement of the UCCSA as proposed by Raio et al. 1999 is reproductible and can be adopted as a new obstetric ultrasound parameter.