bluuebunny/crossref_metadata_2025_split huggingface dataset:
Precocious signs of polycystic ovaries in obese girls
Authors: Sampaolo P. , Livieri C. , Montanari L. , Paganelli A. , Salesi A. , Lorini R. 
Published: March 2003

As several studies have reported that 35% of patients with polycystic ovary syndrome are obese and that this syndrome seems to originate during the early phase of sexual maturation, we undertook a study of such subjects. We studied ultrasound and hormonal findings in 49 obese girls aged from 7.9 to 19.10 years, with a mean excess weight of 44%; 23 premenarcheal girls and 26 postmenarcheal girls with mean gynecological age of 2.5 years. As controls, we studied 18 girls in the pubertal phase and 17 healthy girls with regular menses, matched for age and gynecological age.Pelvic ultrasonography was carried out in all girls and estrone, estradiol, progesterone, prolactin, follicle stimulating hormone, luteinizing hormone, sex hormone binding globulin (SHBG), testosterone, free testosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA‐S), androstenedione and 17‐hydroxyprogesterone (17‐OHP) were measured by radioimmunoassay in 11 of the 18 postmenarcheal girls. Five girls (10.2%) with excess weight of > 40% presented with mild or severe hirsutism based on Ferriman and Gallway scores; six (12.2%) presented with acne and 14 (28.5%) presented with acanthosis nigricans.Hormonal evaluation showed elevated levels of estrone (p < 0.005) and testosterone (p < 0.01) but lower than normal levels of SHBG (p < 0.05) and estradiol (p <0.05). On the basis of our results, 23%) of the postmenarcheal obese subjects showed clinical, hormonal and ultrasonographic signs of polycystic ovaries, and 23% of postmenarcheal obese girls showed multifollicular ovaries. Six of these, at 1 year after menarche, showed a uterine cross‐sectional area larger than normal jar gynecological age (21.92 ± 5.64 cm2 vs. 16.36 ± 2.34 cm2). Further serial echographic studies and a careful follow‐up will demonstrate if both multifollicular ovaries and increased uterine cross‐sectional area in obese girls are precocious signs of polycystic ovaries.
The biophysical profile as a tool for prediction of preterm delivery
Authors: McFarlin B. L. , Baumann P. , Sampson M. B. , Kruger M. , Cotton D. B. 
Published: March 2003

AbstractOur objective was to determine if any of the following parameters is a predictor of preterm delivery: gestational age, cervical dilatation, or biophysical profile score.Sixty‐two women with certain dates, intact membranes, and preterm contractions more frequent than 300 min underwent a 30‐min ultrasonographic assessment of fetal breathing movements, fetal tone, fetal movement and amniotic fluid volume, each of which was scored as 0, 1, or 2 before any tocolytics were given. The total score (0–8) was calculated and cervical dilatation was recorded. All women were subsequently placed on tocolytics. Data were analyzed using survival analysis with stepwise regression of the covariates to determine the predictive values of the total score, its individual parameters, gestational age, and cervical dilatation to the outcome variable of hours to delivery. Gestational age, cervical dilatation and time interval to delivery were categorized and entered into a logistic regression model with the total score and its components to determine predictive odds.Total score (p < 0.0001) and cervical dilatation (p < 0.0001) were the most significant variables associated with time interval to delivery, followed by gestational age (p = 0.035). When the individual biophysical parameters were entered into the model, fetal tone (p < 0.0001), cervical dilatation (p < 0.0001) and gestational age (p < 0.014) were the only variables related to time interval to delivery. Predictive odds of delivery in less than 48 h in relation to fetal tone and cervical dilatation were calculated.Total score, fetal tone, and cervical dilatation were strongly associated with time interval to delivery. Our study did not support fetal breathing movements as a predictor of preterm delivery. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
The implementation of first‐trimester scanning at 10–13 weeks' gestation and the measurement of fetal nuchal translucency thickness in two maternity units
Authors: Pandya P. P. , Goldberg H. , Walton B. , Riddle A. , Shelley S. , Snijders R. J. M. , Nicolaides K. H. 
Published: March 2003

AbstractThe aim of this prospective screening study was to evaluate the implementation of an additional ultrasound examination, incorporating the measurement of fetal nuchal translucency thickness, at 10–13 weeks' gestation in two maternity units providing routine antenatal care. During the 1 year prior to the introduction of the first‐trimester scan, the major indication for fetal karyotyping was maternal age ≥ 35 years and only two out of the total of 11 cases of trisomy 21 were identified. In the first 5 months of the study, 70% of the women delivering in these hospitals attended for measurement of fetal nuchal translucency thickness and the measurement was obtained in all cases. This was achieved without an increase in the number of sonographers or ultrasound machines. The incidence of fetal nuchal translucency thickness ≥ 2.5 mm was 3.6% (63 of 1763), and this group included three of the four fetuses with trisomy 21. The findings of this study demonstrate the feasibility of introducing scanning at 10–13 weeks' gestation and the measurement of fetal nuchal translucency thickness in routine maternity units. The sensitivity and specificity of this method of screening are at present being evaluated in a large multicenter study. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Cerebellar hypoplasia in the second trimester associated with microcephaly at birth
Authors: Rees A. E. J. , Bates A. , Clarke H. 
Published: March 2003

AbstractThe antenatal diagnosis of microcephaly is most commonly made in the third trimester. Biometric measurements of the head of three or four standard deviations below the mean are suggestive of microcephaly. We report a case of microcephaly where abnormalities in intracerebral architecture, i.e. cerebellar hypoplasia, were noted early in the second trimester. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal gray‐scale and Doppler ultrasound examinations of the uterus and ovaries in healthy postmenopausal women
Authors: Sladkevicius P. , Valentin L. , Maršál K. 
Published: March 2003

AbstractThe aim of this study was to elicit reference data representative of normal findings at transvaginal gray‐scale and Doppler ultrasound examination of the uterus and ovaries in postmenopausal women. A total of 144 asymptomatic postmenopausal women with normal findings at clinical gynecological examination were included in the study. They underwent transvaginal sonography including Doppler measurements of blood flow velocity in the uterine and ovarian arteries. Ninety‐eight (68%) women had a normal uterus and normal or non‐visible ovaries at ultrasound examination, 23 (16%) had small uterine myomas but normal or non‐visible adnexa, 19 (13%) had small adnexal cysts but a normal uterus, and four (3%) had both small myomas and small adnexal cysts. The median time‐averaged maximum velocity (TAMXV) and pulsatility index (PI) values for the right and left uterine artery of normal uteri (n = 117) were 10.4 cm/s (range 2.2–43.0) and 10.6 cm/s (2.9–30.8), and 2.33 (0.97–5.13) and 2.35 (0.98–4.58) respectively. Median volumes of the normal right (n = 93) and left ovaries (n = 90) were 1.3 cm3 (0.4–3.7) and 1.2 cm3 (0.4–3.0)) respectively, and median TAMXV and PI values for the stromal arteries in the normal right (n = 53) and left ovaries (n = 54) were 2.1 cm/s (1.3–4.6) and2.3 cm/s (l.l–7.3), and 1.31 (0.65–2.61) and 1.26 (0.63–1.85), respectively.Our results provide a basis for gray‐scale and Doppler ultrasound studies of pathological conditions in the female pelvis after the menopause. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
The reliability of transvaginal ultrasonography to detect retained tissue after spontaneous first‐trimester abortion, clinically thought to be complete
Authors: Alcázar J. L. , Baldonado C. , Laparte C. 
Published: March 2003

AbstractIn order to assess the reliability of transvaginal ultrasonography for the detection of trophoblastic tissue retained after spontaneous first‐trimester abortion and clinically thought to be complete, the clinical, sonographic and pathological data of 33 women were retrospectively analyzed. The patients' mean age was 34 years (range 24–48). The mean gestational age at presentation of symptoms was 8 weeks (range 5.1–11.1). Transvaginal sonography showed that in 18 cases retained tissue was absent, and that in 15 patients, retained trophoblastic tissue was suspected. Pathological reports (following dilatation and curettage) confirmed the absence of retained tissue in 17 cases and demonstrated its presence in 16 patients (13 in whom retained tissue was suspected by sonography and three in whom retained tissue was not suspected). Sensitivity, specificity, positive predictive value and negative predictive value in our series were 81%, 94%, 93% and 83%, respectively for the detection of retained trophoblastic tissue. We conclude that transvaginal ultrasonography is a reliable method to detect the presence of retained trophoblastic tissue following spontaneous first‐trimester abortion, clinically thought to be complete. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Prospective study on fetal weight estimation using limb circumferences obtained by three‐dimensional ultrasound
Authors: Favre R. , Bader A.‐M , Nisand G. 
Published: March 2003

AbstractThe aim of this prospective study was to evaluate the usefulness of fetal weight estimation in a prospective study, based on formulae derived from a previous retrospective study, using forward stepwise multiple regression analysis. Three‐dimensional ultrasound was used to make reproducible measurement of limb circumferences, which formed the basis of our models.A total of 213 women with singleton pregnancies were scanned in the week prior to delivery and the following variables were measured: biparietal diameter, head circumference, transverse abdominal diameter, abdominal circumference, femur length, thigh circumference and arm circumference. The whole population was divided in to three subgroups according to the abdominal circumference (< 10th centile, 10–90th centile, and > 90th centile).We demonstrated the need for only two models for accurate fetal weight estimation, one for the small‐for‐dates fetuses and a second for the others. The most accurate results were obtained for the macrosomic fetuses with a standard deviation of 8.8%. Our data confirm the usefulness of measurement of fetal thigh circumference for the small‐for‐dates‐fetuses and arm circumference for the other groups.We concluded that the use of three‐dimensional ultrasound could facilitate the accurate prediction of fetal weight. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Fetal midgut herniation into the umbilical cord: improved definition of ventral abdominal anomaly with the use of transvaginal sonography
Authors: Achiron R. , Soriano D. , Lipitz S. , Mashiach S. , Goldman B. , Seidman D. S. 
Published: March 2003

AbstractThe most common anomalies of the fetal ventral abdominal wall include omphalocele and gastroschisis. Umbilical cord hernia is another abdominal wall defect that is poorly defined and usually mistakenly considered as a small omphalocele. The present report describes the sonographic features and clinical significance off our cases of umbilical cord hernia identified transvaginally in the early second trimester of pregnancy. These cases seemed to present a different entity from that of simple omphalocele. The transvaginal sonographic approach provided a clear image of the midgut protruding into the umbilical cord, precise localization of cord insertion in the region of the umbilical ring, Doppler flow evaluation of the umbilical vessels and their relation to the protruding mass. Serial sonographic observations revealed a stable umbilical cord mass in three fetuses, and an enlarging mass in one. Normal karyotype was determined and no associated malformations were detected prenatally. However, in one case that underwent immediate correction of the hernia after delivery at term, the neonate was subsequently found to have pulmonic stenosis and severe neonatal seizures developed at 4 months of age. In two cases, pregnancy was terminated due to parental request. The fourth fetus was delivered vaginally at term and catastrophic division of the umbilical cord containing a loop of small intestine was avoided only by the diligent observation of the midwife. We suggest that umbilical cord hernia is a distinct anomaly originating at a different stage of embryogenesis, thereby having a unique clinical significance, unlike simple omphalocele. Umbilical cord hernia should therefore be defined and as separate entity. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Micro‐bead embolization of uterine spiral arteries and changes in uterine arterial flow velocity waveforms in the pregnant ewe
Authors: Ochi H. , Suginami H. , Matsubara K. , Taniguchi H. , Yano J. , Matsuura S. 
Published: March 2003

AbstractThe aim of the present study was to simulate the pathological uteroplacental circulation observed in complicated human pregnancies in the pregnant ewe and to analyze its velocimetric changes. Four pregnant ewes at 16–17 weeks of pregnancy were used in the study. Micro‐beads (Gelfoam) were administered stepwise into the uterine artery and changes in the uterine circulation were assessed by Doppler velocimetry. Gelfoam administration successfully embolized the uterine spiral arteries located in the decidual segment. The Gelfoam embolization decreased the uterine bloodflow dose‐dependently from 550 ± 48 ml/min (mean ± SD) to 142 ± 12 ml/min and reciprocally increased the uterine vascular resistance from 139 ± 12 mmHg min l−1 to 540 ± 46 mmHg min l−1 at 0 mg and 30 mg Gelfoam, respectively. It dose‐dependently attenuated the pregnancy‐related physiological elevation in diastolic flow velocity, while the systolic flow velocity was unaffected, resulting in a dose‐dependent increase in the pulsatility index from 0.5 ± 0.2 to 3.2 ± 0.7 at 0 mg and 30 mg Gelfoam, respectively. The pulsatility index linearly correlated with the uterine vascular resistance, giving a high correlation coefficient of r = 0.947. It could be concluded that the uterine arterial pulsatility index is an indicator of uterine vascular resistance. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of gastroesophageal reflux by color and pulsed Doppler ultrasonography in a case of congenital pyloric atresia
Authors: Rizzo G. , Capponi A. , Arduini D. , Romanini C. 
Published: March 2003

AbstractA case of pyloric atresia diagnosed in the third trimester is described. Real‐time ultrasonographic examination revealed polyhydramnios, enlarged stomach, evident gastric peristalsis and esophageal dilatation. Color and pulsed Doppler studies of the gastroesophageal junction revealed the presence of a biphasic flow pattern that was consistent with gastroesophageal reflux. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology
Sonographic diagnosis of a non‐previa placenta accreta
Authors: Jauniaux E. , Toplis P. J. , Nicolaides K. H. 
Published: March 2003

AbstractAn unusual case of placenta accreta diagnosed before delivery and managed conservatively is reported in a third‐trimester pregnant woman with 120 past obstetric history. Ultrasound revealed a large echo‐poor area where the decidual interface was absent. Uterine vessels immediately under and around the placental abnormal insertion site appeared dilated. In one area, where the myometrium could not be identified at all, the basal plate of the placenta appeared to float inside uterine vessels. A Cesarean section was performed at term and after partial delivery of the placenta a wedge resection of the accreta area was made. Brisk bleeding was controlled by rapid reconstitution of the myometrium. It is suggested that non‐previa placenta accreta can be diagnosed antenatally in a low‐risk population using gray‐scale ultrasound imaging and enabling, in most cases, conservative management. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Blood flow velocity waveforms from peripheral pulmonary arteries in normally grown and growth‐retarded fetuses
Authors: Rizzo G. , Capponi A. , Chaoui R. , Taddei F. , Arduini D. , Romanini C. 
Published: March 2003

AbstractThe objective of this study was to describe blood flow velocity waveforms of fetal peripheral pulmonary arteries in normally grown and growth‐retarded fetuses. Doppler studies were performed in 182 normally grown fetuses (gestational age 18–40 weeks) and in 61 growth‐retarded fetuses (gestational Loge 24–36 weeks) that were free from structural and chromosomal abnormalities and whose umbilical and middle cerebral artery Doppler findings suggested uteroplacental insufficiency as the most likely etiology of the growth defect. The pulsatility index was used to quantify the velocity waveforms. Successful recordings were obtained in 90.1% of the normally grown and 93.4% of the growth‐retarded fetuses. In normally grown fetuses the pulsatility index values significantly decreased with advancing gestation. In growth‐retarded fetuses the pulsatility index values were significantly elevated compared to those of normal fetuses. A significant relationship was observed between the severity of hypoxia and pulsatility index values from the peripheral pulmonary arteries in 29 fetuses in which Doppler recordings were obtained immediately before cordocentesis. In conclusion, these data show that in normal fetuses the Doppler‐measured impedance to flow in the peripheral pulmonary circulation decreases with advancing gestation. Impedance to flow in the lungs is elevated in the presence of growth retardation and this increase is related to the severity of fetal hypoxia. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Doppler echocardiographic assessment of fetal blood flow redistribution during maternal hyperoxygenation
Authors: Almström H. , Sonesson S.‐E. 
Published: March 2003

AbstractSixteen normal human fetuses were studied at both 20–23 and 30–33 weeks of gestation to investigate whether hemodynamic changes in the heart and major fetal arteries occurred in response to maternal hyperoxygenation in normal pregnancy. Velocity waveforms from the mitral valve, aortic valve, middle cerebral artery, aortic isthmus and umbilical artery were recorded before and during maternal breathing of 100% oxygen. The cerebral artery pulsatility index (PI) increased with oxygen administration at the first examination (1.56 ± 0.25, mean ± 1 SD, to 1.72 ± 0.28, p < 0.05). At the second examination this increase in cerebral artery PI was more consistent (1.89 ± 0.43 to 2.22 ± 0.43, p <: 0.001) and there was also a decrease in the aortic isthmus PI (2.64 ± 0.43 to 2.40 ± 0.33, p < 0.01) during oxygen administration. The variables determined from the velocity waveforms of the umbilical artery, aortic and mitral value did not show any changes with maternal hyperoxygenation.Maternal hyperoxygenation resulted in velocity wave form changes suggesting an increase of cerebral vascular resistance and a redistribution of blood flow from the brain to the vascular beds supplied by the descending aorta in the normal human fetus in the third trimester, but this response was less obvious at mid‐gestation. The middle cerebral artery and the aortic isthmus seem to be suitable sites for verification of this response. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
The diagnostic value of endometrial thickness and volume measurements by three‐dimensional ultrasound in patients with postmenopausal bleeding
Authors: Gruboeck K. , Jurkovic D. , Lawton F. , Savvas M. , Tailor A. , Campbell S. 
Published: March 2003

AbstractWe compared endometrial thickness and volume in patients with postmenopausal bleeding, and examined the value of each parameter in differentiating between benign and malignant endometrial pathology. A total of 103 patients with a history of postmenopausal bleeding were recruited into the study. Patients who were taking hormone replacement therapy or other hormonal preparations with a known effect on the endometrium were excluded. Each patient underwent three‐dimensional ultrasonography for the measurement of endometrial thickness and volume. In 97 cases both of these measurements were obtained and the results were compared to the histological diagnosis after endometrial biopsy or dilatation and curettage. Endometrial cancer was diagnosed in 11 patients. The mean endometrial thickness was 29.5 mm (SD 12.59) and the mean volume was 39.0 ml (SD 34.16). In the remaining 86 patients there were eight cases with endometrial hyperplasia and seven with endometrial polyps The endometrial thickness and volume in patients with benign pathology was 15.64 mm (SD 5.26) and 5.47 ml (SD 6.32), respectively. In 71 patients with atrophic or normal endometrium the mean thickness and volume was 5.29 mm (SD 3.97) and 0.91 ml (SD 1.71), respectively. Receiver operating characteristic curves showed endometrial volume to be superior to endometrial thickness for the diagnosis of endometrial cancer. The optimal cut‐off value of endometrial thickness for the diagnosis of cancer was 15 mm, with the test sensitivity of 83.3 % and positive predictive value of 54.5%. With the cut‐off level of 13 ml for endometrial volume measurement the sensitivity was 100% and the positive predictive value 91.7%. Both the thickness and volume were higher in patients with advanced and less differentiated cancers. The measurement of endometrial volume was superior to that of endometrial thickness as a diagnostic test for the detection of endometrial cancer in symptomatic postmenopausal women. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Diagnosis and treatment of early cervical pregnancy: a review and a report of two cases treated conservatively
Authors: Jurkovic D. , Hacket E. , Campbell S. 
Published: March 2003

AbstractWe report two cases of cervical pregnancy which were diagnosed by ultrasound at 5 and 8 weeks' gestation. In both cases a gestational sac was visualized below the internal OS and color Doppler examination demonstrated peritrophoblastic blood flow characteristic of early implantation. Both patients were successfully treated with systemic methotrexate. Including these two cases, a total of 83 early cervical pregnancies have been reported in the literature over the last 10 years. Of these, 40 patients were primarily treated by conservative surgery, 40 by non‐surgical methods using methotrexate or potassium chloride, and the remaining three by other chemotherapeutic agents. The likelihood of being cured was similar in the surgical and non‐surgical groups (odds ratio 1.1; 9.5% confidence interval 0.4–3.2). However, patients who were primarily treated by surgery were more likely to sustain major hemorrhage (odds ratio 8.0; 95% confidence interval 2.4'26.5) and to require hysterectomy (odds ratio 7.4; 9.5% confidence interval 0.9'63.8) than those treated medically. This indicates that non‐surgical methods should be used for primary treatment of cervical pregnancy, while surgery should be reserved for those patients in whom medical therapy is not successful. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology