bluuebunny/crossref_metadata_2025_split huggingface dataset:
WS15‐06Doppler ultrasonography of the human fetal pulmonary circulation and its role in the prediction of pulmonary hypoplasia
Authors: Laudy J. A. M. , Tibboel D. , Robben S. G. F. , De Krijger R. R. , De Ridder M. A. J. , Wladimiroff J. W. 
Published: March 2003

ObjectivesTo determine the value of Doppler flow velocity waveforms from the fetal arterial pulmonary branches relative to fetal biometric indices and clinical correlates in the prenatal prediction of lethal lung hypoplasia (LH) in prolonged oligohydramnios.Study design42 singleton pregnancies with oligohydramnios associated with premature rupture of membranes (PROM, n = 31) or bilateral renal pathology (n = 11) were examined using a combined color coded Doppler and 2d real‐time ultrasound system. Thoracic (TC), cardiac (CC) and abdominal circumference (AC) and the largest vertical amniotic fluid pocket were measured. Pulsed Doppler measurements of the arterial pulmonary branches were made at the level of the cardiac four‐chamber view after visualization with color Doppler. Diagnosis of LH was based on pathological, clinical and radiological criteria.ResultsThe prevalence of lethal LH was 43%. In the PROM‐subset, combination of onset of PROM = 20 weeks; duration of oligohydramnios = 8 weeks and degree of oligohydramnios = 1 cm, presented the highest clinical prediction rate for lethal LH. For both the total group and the PROM‐subset, the highest prediction rate for lethal LH from biometric and Doppler parameters was presented by TC/AC ratio, peak systolic velocity in the proximal branch and time‐averaged and end‐diastolic velocity in the middle branch of the pulmonary artery. In the prom subset, combination of all three clinical, biometric and Doppler parameters revealed the most favorable combination to predict lethal LH (PPV 100%, accuracy 93%, and sensitivity 71%).ConclusionDoppler velocimetry may detect changes in blood velocity waveforms from the arterial branches of the fetal pulmonary circulation in the presence of LH, but fails to be the ultimate test for the prenatal prediction of lethal LH. The best prediction can be achieved by combining clinical, biometric and Doppler parameters.
Workshops
Authors: Cafici D. 
Published: March 2003

The prenatal diagnosis of fetal malformations seems to be a very difficult challenge, mainly for those who are beginning with the practice of ultrasound.As it would be impossible to refer to so many fetal malformations the presentation will cover a few interesting issues.These cases are not frequently diagnosed and in many cases present controversial aspects referred to their prognosis and management.Those topics are:Unilateral ventricular dilatationFetal hyperechogenic lung lesionsUmbilical vein varixFacial cleftsUnilateral ventricular dilatation may be a difficult diagnosis and its prognosis is variableFetal hyperechogenic lesions include a broad range of anomalies with a variable behaviour. Even large lesions can disappear in utero but often the lesion can persist with severe prognosis for the fetus. Varix of the umbilical vein is a relatively uncommon abnormality that carries an increased risk for fetal demise, chromosomal abnormality and hydrops.Facial clefts are a relatively common malformation and the fetal face must be properly scanned in every fetal study.3D ultrasound helps a lot in the diagnosis of these and other malformations and we'll discuss some examples concerning this new technology.
F103Response of the fetal pupil in the chromosomal anomalies
Authors: López Ramón y Cajal C. 
Published: March 2003

BackgroundWe studied sonographically the response of the fetal pupil to the stimulus of color Doppler (CD) in fetuses with chromosomal anomalies below 22nd weeks.MethodThe pupils of 28 fetuses were studied sonographically between 15 h‐21 weeks' gestation, diagnosed of a chromosomal alteration through of genetic amniocentesis. The areas of the pupil and iris were compared before and after CD imaging.ResultsThe great majority of the fetuses have some data out of range in the relationship pupil/iris in basal conditions or after CD. Usually, we observed an atypical response (mydriasis before the 19 weeks or miosis after this) and/or an exaggerated response (hyperreflexia).ConclusionThese results affirm that this type of test increases the possibilities in a fetal study of high resolution performed before the 22nd weeks of gestation and it can be a useful indicator like an aneuploidy marker.
F120Effectiveness of screening for major cardiac defects in a routine obstetric population
Authors: Mavrides E. , Cobian F. , Moscoso G. , Campbell S. , Thilaganathan B. , Carvalho J.S. 
Published: March 2003

BackgroundThe aim of this study is to evaluate the effectiveness of routine antenatal screening for CHD in a routine obstetric population.MethodA three‐year prospective, observational study. All women were routinely offered first trimester nuchal translucency screening and an 18–23 week anomaly scan, where the four chamber view and outflow tracts were visualised. The main outcome measure was identification of major CHD in all pregnancies, either in the antenatal or postnatal period.ResultsMajor defects of the heart and the great arteries were identified in 51 out of 9277 pregnancies. Major CHD were diagnosed antenatally in 42 fetuses and postnatally in nine (including 15 aneuploidies). The overall antenatal detection rate was 82.4% in all pregnancies and 80.6% in chromosomally normal pregnancies. In 10 cases, the first trimester NT measurement was increased.ConclusionThe overall prevalence of major CHD (5.4/1000) suggests that ascertainment in the study population was thorough. The combination of first trimester NT screening and visualisation of the four‐chamber/outflow tracts is effective in the detection of the majority of major CHD.
F127Prenatal diagnosis of fetal cardiac tumors: 18 cases reported
Authors: Galindo A. , Gutiérrez‐Larraya F. , Grañeras A. , Alvarez C. , De La Fuente P. 
Published: March 2003

AimTo evaluate our experience with fetal cardiac tumors.MethodsRetrospective study of 18 cases from Jan.1991–Apr.2000, analyzing US features, histology and perinatal outcome.ResultsThe incidence was one in 3224 deliveries (18/58037). Mean gestational age at diagnosis was 32 weeks (22–38). In 17 cases (94%) were isolated while in one the fetus had another defects. In 7 cases (39%) there was one tumor, in 6 two (33%) and in 5 three or more (28%); total number of masses was 42. Size ranged from 2 to 46 mm. In 3 cases (17%) a significant growth of the mass was observed prenatally. Most masses (26) were sited at ventricles (18 left and 8 right). Pericardial effusion was observed in 8 cases (44.4%). In 4 cases there were a significant arrythmia. Histology was available in 7; 5 rhabdomyomas, one cavernous hemangioma and one pericardial teratoma. In the other cases the sonographic appearance was compatible with rhabdomyoma. A postnatal conservative management has been performed in most cases. Overall survival rate was 67% and if top are excluded (2 cases) survival rate rose to 75%. At one year follow‐up, extracardiac manifestations of tuberous sclerosis were diagnosed in 5 cases (28%). In all the 5 cases, there were 2 or more cardiac masses. In 5 of the 11 cases (45%) with more than one tumor, extracardiac manifestations of tuberous sclerosis were observed.ConclusionsFetal cardiac tumors are unfrequent and the diagnosis is usually made in the III trimester. They appear commonly isolated and its size is widely variable; in up to 61% of the cases more than one tumor is observed. Main localization is ventricular and the most common type is rhabdomyoma. A conservative approach is recommended as can behave in a benign fashion. Caution is advocated when counselling families about tuberous sclerosis, mainly if several cardiac masses are detected.
Infertility F22Computerized analysis of uterine peristalsis from transvaginal ultrasound images after ovulation induction by clomiphen citrate
Authors: Eytan O. , Halevi I. , Har‐Toov J. , Gull I. , Wolman I. , Lessing J. B. , Elad D. , Jaffa A. J. 
Published: March 2003

BackgroundUterine peristalsis plays a central role in assisting the transport of an embryo to a fundal implantation site.ObjectiveComputerized characterization of the dynamics of intrauterine fluid–wall interface (IUFWI) from in vivo images of the sagittal cross‐sections of the uterus of patients treated with Clomiphen Citrate (CC) and healthy women with normal cycle.MethodTransvaginal ultrasound (TVUS) images of sagittal cross‐sections of nonpregnant uterus were scanned. Images at consecutive times (1 second apart) were digitized and processed by techniques of image processing. The images were compared to evaluate time variation of the IUFWI with respect to amplitude, frequency and symmetry.ResultsTVUS images from 6 women treated by CC (Group A) and 25 healthy volunteers (Group B) during the proliferative phase were analyzed. The amplitudes of the IUFWI of Groups A and B yielded 0.106 ± 0.041 mm and 0.082 ± 0.045 mm, respectively. The frequency of Group A, 0.036 ± 0.017 Hz, was higher than the frequency of Group B, 0.029 ± 0.017 Hz, in contrast to reported observations. The motility of IUFWI among Group B revealed higher symmetry, −0.712 (−1 yields full symmetry), than the symmetry of −0.660 of Group A.ConclusionsIt may well be that the differences in the amplitude, frequency and symmetry change the pregnancy rate of women undergoing ovulation induction by CC.
F25Changes in the endometrium between the day of oocyte retrieval and embryo transfer. Does it matter?
Authors: Sladkevicius P. , Ojha K. , Campbell S. , Nargund G. 
Published: March 2003

BackgroundMultiple studies have confirmed a lower implantation and pregnancy rates in women who exhibit a homogenous pattern of the endometrium compared to a triple‐line pattern on the day of hCG administration. However, there are no studies comparing the pattern of endometrium and its vascularization on the days of oocyte retrieval and embryo transfer.MethodsWe prospectively evaluated the endometrium in 97 women undergoing 116 IVF‐ET cycles. Endometrial thickness and pattern, endometrial vascularization and blood flow waveforms in subendometrial vessels and uterine arteries were registered on the days of oocyte retrieval and embryo transfer.ResultsThere was no difference in age, basal FSH, number of oocytes, number of embryos transferred and endometrial thickness between pregnant and nonpregnant patients, or between patients with homogenous endometrium and those with triple‐line pattern of the endometrium. The ongoing implantation rate was 11% having homogenous endometrium and 23% having triple‐line pattern of the endometrium on the day of oocyte retrieval. By the day of embryo transfer 89% of endometrium seemed to be homogeneously echogenic. All pregnancies occurred in the patients who had a homogenous endometrium on the day of embryo transfer.ConclusionEndometrial pattern, rather than endometrial thickness on the day of oocyte retrieval and its changes towards the day of embryo transfer appear to be important prognostic factors of endometrial receptivity.
Chromosomopathies F30The clinical impact of increased nuchal translucency
Authors: Pajkrt E. , Muller M. A. , Bleker O. P. , Bilardo C. M. 
Published: March 2003

BackgroundThe aim of this study was to examine the relationship between nuchal translucency measurements and outcome of pregnancy.MethodFetal nuchal translucency measurements were performed on 6300 consecutive women attending the prenatal diagnosis centre of our Hospital.ResultsOf the 384 fetuses (6.1%) with an enlarged (≥ p95) nuchal translucency 104 (27%) had an abnormal karyotype. Ten (2.6%) pregnancies ended in a spontaneous abortion before karyotyping was performed. In the remaining 270 eukaryotic fetuses with enlarged nuchal translucency 22 (8.2%) had a structural anomaly or genetic syndrome detected by ultrasound later in pregnancy and 3 (1.3%) after birth. The total incidence of an unfavourable outcome in the group of fetuses with enlarged nuchal translucency was 40%. In contrast, in the group with a normal nuchal translucency (< p95), the incidence of an unfavourable outcome was 4.0%.ConclusionWhen counselling parents in case of an increased nuchal translucency fetal karyotyping is the first step. If the karyotype is normal detailed ultrasound examination around 20 weeks' gestation is the second step. When both the fetal karyotype and the anomaly scan are normal there is still a 1.3% risk that the fetus will be affected by a congenital abnormality or genetic syndrome.
F34Early prenatal diagnosis of chromosomal defects: value of sonographic markers
Authors: Galindo A. , Puente J. M. , Gómez M. J. , Moreno A. , Fernández J. , Alvarez C. , Grañeras A. , Barreiro E. 
Published: March 2003

AimTo evaluate the role of early sonographic markers (SM) of chromosomal defects combined with maternal age (MA).MethodsRetrospective study of 1470 amniocentesis performed in high‐risk patients mainly because of advanced MA from Jan.97‐Dec.99. SM of chromosomal defects are routinely searched for at first scan at 11–14 weeks. We analyze the association between chromosomal defects and MA regarding the existence of SM.ResultsOverall chromosomal defects rate was 4.6% (66/1470). SM were detected in 147 cases (10%) and, regardless of MA, a chromosomal defect was diagnosed in 44 of these cases (30%). Of the 1323 cases without SM the rate of chromosomal abnormalities was 1.5% (20 cases) (P < 0001). When MA was = 35 years, the rate of chromosomal defects in cases with SM was 35.2% (19/54) and in those without SM 1.8% (20/1125) (P < 0001). No significant differences were found in cases with SM as a function of MA neither in cases without SM. The number and percentage of chromosomal defects according to MA and SM are expressed in the Table.

Age
< 35
35
36
37
38
39
= 40

SM+
25/91
1/7
2/13
1/5
–
5/6
10/23

27%
14%
15%
20%

83%
43%

SM–
2/198
3/102
5/207
1/262
6/204
2/158
3/192

1%
3%
2%
0,4%
3%
1%
2%

14 out of the 20 cases of chromosomal defects (70%) diagnosed in fetuses without SM were sexual aneuploidies or structural defects while the remaining 6 were trisomies 21 (30%). By contrast, in cases with SM were mainly trisomies 21, 18, 13 and 45X0.ConclusionsSM are best correlated with chromosomal defects than other risk factors (RR = 15). However, when risk factors other than SM are present, fetal karyotype analysis is still also indicated.
F38Normogram of nuchal fold thickness during 14–16 weeks' gestation of 195 normal fetuses by transvaginal ultrasound
Authors: Perlitz Y. , Mukary M. , Ben‐Ami M. 
Published: March 2003

BackgroundThe aim of this study was to establish normal values of nuchal fold thickness during 14–16 weeks' gestation by transvaginal sonography (TVS).MethodSingleton fetuses of 195 women with normal pregnancies were studied by TVS at 14–16 weeks' gestation. Gestational age was determined by last menstural period and confirmed by biometry. Nuchal fold thickness was measured by the modified axial view of the head, cerebellum and the nuchal fold. All women delivered normal infants with no evidence of anomalies. t‐testing was performed to determine any correlation between nuchal fold thickness and gestational age.ResultsMean value of nuchal fold thickness during 14–16 weeks' gestation was 2.2 ± 0.5 mm (mean ± SD). The mean values for 14, 15 and 16 weeks' gestation were 2.1 ± 0.5 mm, 2.2 ± 0.4 mm and 2.4 ± 0.9 mm, respectively. There was only a marginally significant increase of the nuchal fold thickness between 15 and 16 weeks' gestation (P = 0.054, t‐test).ConclusionsNormal values of nuchal fold thickness at 14–16 weeks' gestation for normal fetuses were constructed by TVS. The mean value of nuchal fold thickness only slightly increased during 14–16 weeks' gestation. Therefore, the same mean value (2.2 ± 0.5 mm) may be used throughout this period.
F39Chorionic villus sampling after the first trimester
Authors: Podobnik M. , Duić Ž. , Skalak D. , Podgajski M. , Ciglar S. , Gebauer B. 
Published: March 2003

ObjectivesThe purpose of this article was to evaluate the association between late CVS (placental biopsy) and complications between sampling and delivery.MethodLate chorionic villus sampling under ultrasound guidance was carried out in 2600 (86.7%) cases in the second trimester and 400 (13.3%) cases in the third trimester of pregnancy. Out of 3000 late CVS, 684 (22.8%) were performed because of suspicious ultrasonographic findings. In the 500 patients between 13 and 16 weeks of gestation color Doppler was used to investigate the uteroplacental and fetal vessels before and after late chorionic villus sampling.ResultsIn 24 patients (0.8%), complications between sampling and delivery were found. There were only nine (0.35%) spontaneous abortions four to six weeks after late chorionic villus sampling. We found 156 (5.2%) chromosomal abnormalities. In the group with suspicious ultrasonic findings (684 cases) we found significant oligohydramnios in 300 (43.8%) and significant polyhydramnios in 150 (21.9%), and 105 (15.4%) had chromosomal abnormalities. Among the 156 patients with chromosomal abnormalities, ultrasonographic findings in 85 (54.4%) were detected after 20th week of pregnancy. There were no significant differences in mean pulsatility indices between uteroplacental and fetal vessels before and after late chorionic villus sampling. Preliminary data for 20 trisomic fetuses indicate an abnormally increased umbilical PI and abnormally decreased middle cerebral artery PI.ConclusionsLate CVS is a safe method of prenatal diagnosis for high‐risk couples and does not significantly affect the outcome of pregnancy.
F45Acquired right heart outflow tract anomaly in twin–twin transfusion syndrome: not such a bad prognosis
Authors: Nizard J. , Vaillant M. C. , Grangé G. , Bonnet D. , Audibert F. , Fermont L. , Ville Y. 
Published: March 2003

BackgroundSignificant hemodynamic changes are commonly observed in both fetuses in twin–twin transfusion syndrome. Cardiac dysfunction is common and well known in the donor twin with hypertrophy of the left ventricle and overall enlargement of the heart, whereas there is dilatation of the right ventricle with tricuspid regurgitation in the recipient twin.CasesWe report 3 cases of twin–twin transfusion syndrome with right ventricle outflow tract obstruction acquired in utero in the recipient twin which are likely to have developed as a cardiac dysfunction. Two of the tree recipient twins survived and are well being with more than one year of follow‐up due to correct surgical treatment.AnalysisThese acquired anomalies of the right heart are probably related to the very particular hemodynamic conditions and the volume shifted between the twins.ConclusionRight heart anomaly in the recipient twin should be known of all ultrasonographers since it calls a particular neonatal treatment.
F50Short‐term variation (STV) in centralized fetuses
Authors: Cha S.C. , Toma O.T. , Braia G.O. , Lopes M.A. , Carvalho M.B. 
Published: March 2003

AimTo evaluate the importance of STV in centralized fetuses.Material and method43 centralized fetuses were evaluated by computorized cardiotocography (CCT) (System 8002 – Oxford). As group control, 1235 computorized cardiotocography trace from fetuses with normal Doppler were analysed.ResultAt 10 min of CCT, 15/43 (35%) of centralized fetuses showed STV < 4 msec. At the end of CCT 4 (9.4%) centralizad fetuses maintainned STV < 4 msec against only 12 (1%) fetuses in the normal group. The duration of CCT in centralized fetuses was 30 ± 10 min and 20 ± 9 min in the normal group. The mean STV of centralized fetuses was significantly lower than normal fetuses at any time of the trace. At the end of the trace, STV in centralized fetuses was 5.5 ± 1.5 msec and in normal fetuses was 8.7 ± 2.5 msec (P < 0.05). However, 90% of centralized fetuses showed normal CCT (STV > 4 msec. or presence of two or more transitory acceleration).ConclusionThis preliminary study shows that short‐term variation seems to be earliest abnormal finding at CTC in centralized fetuses. Since 90% of centralized fetuses had normal CCT (STV > 4 msec.), this parameter can be used to avoid premature interruption of the pregnancy due to abnormal Doppler.
Interventional procedures F62Interventional ultrasound based on national registrations of fetal interventions in Japan
Authors: Chiba Y. , Nakano H. 
Published: March 2003

MethodsJapanese Society of Obstetrics and Gynecology conducted the Registration of Fetal Therapy. One hundred 62 Institutes in Japan join the registration. From 1966 to 1999, totally 584 fetuses treated inutero including interventional procedures were registered from 86 Institutes. Effects of fetal therapies were determined by self‐judgements of reporters.ResultsOne hundred 81 cases of hydrops aspirated their pleural effusion or ascites. The mortality of this group was 38.7%. Totally 47 cases of hydrops were medicated through maternal vein or directly. Thirty‐four (72.3%) cases in 47 of this group judged ineffective or unknown effect. The mortality of the group was 68.1%. Sixteen fetal transfusions were reported, effectiveness of that was 62.5% and the mortality was 31.2%. Shunting operations for hydrothorax or ascites were performed on 28 fetuses. The effectiveness of feto‐amnio shunting for hydropic fetuses was high as 82.1% and the mortality was 46.4%. Medical therapies for tachycardia were performed for 31 fetuses. The effectiveness was 67.7% and the mortality was 12.9%. There were 21 cases of shunting operation for obstuctive uropathies. The effectiveness of urinary shunting operation was 71.4% and the mortality was 47.6%. One hundred 60 fetuses of the amnio‐aspiration for TTTS, 16 fetuses of the rupture of septal membrane, 2 fetuses of closure blood flow and 2 fetuses of selective delivery were reported. After the period of the registration, we performed successfully endoscopic closure of umbilical cord for acardiac twin by the good guidance of ultrasound.ConclusionsThere are some fetal interventions which we can accept as the general therapy for fetus. They are shunting operation for obstructive uropathy, medication for tachy‐arrythmia, and fetal transfusion. Shunting operation for hydrothorax will be accepted.
F07Hysterosonosalpingography – a new concept of diagnostic procedures in gynaecology
Authors: Bernardo M. J. , Leitão C. , Dias I. , Bugalho J. , Neto I. 
Published: March 2003

BackgroundThe aim of this study is to find the effectiveness of hysterosonosalpingography in the diagnosis of the endometrial pathology and in the study of tubal patency.MethodWe have studied 550 cases backwards. The women enrolled came from four departments of our Hospital: Menopause (n = 206), Reproductive Medicine (n = 195), General Gynaecology (n = 125) and Senology − Women on Tamoxifen (n = 24). We have analysed epidemiological data, Transvaginal Sonography and hysterosonosalpingography findings, as well as the conventional Hysterosalpingography, Laparoscopic, Hysteroscopic and histological data. We have looked for the concordance rate between the hysterosonosalpingography and the other diagnostic procedures.Results Main findings: Round hyporeflective broad‐based structures representing polyps or submucosal myomas, thin endometrium, floating thin or rigid strips, subseptate uterus, unobstructed tubes, uni or bilateral tubal occlusions. High concordance rate (from 85% to 95%) was verified between the hysterosonosalpingography and the classic diagnostic proceedings.ConclusionHysterosonosalpingography is a good and valuable complement of Transvaginal Sonography in the endometrial study. It makes possible appropriate preoperative triage to hysteroscopy. It may be also a first class exam of screening infertility. The success of this technique led us to include it at the diagnostic protocols in our Hospital.