bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal transverse cerebellar diameter measurements in normal and reduced fetal growth
Authors: Vinkesteijn A.S.M. , Mulder P.G.H. , Wladimiroff J.W. 
Published: March 2003

Objectives
To establish the increase in fetal transverse cerebellar diameter (TCD) relative to gestational age during normal and restricted fetal growth; to determine the significance of TCD and TCD/AC relationship in predicting fetal outcome as expressed by perinatal mortality.
Design
A retrospective cross‐sectional study.
Subjects
Three hundred and sixty normally developing fetuses between 17 and 34 weeks of gestation and 73 growth‐restricted fetuses between 24 and 34 weeks of gestation.
Methods
Ultrasonographic measurements included head circumference (mm), abdominal circumference (mm) and transverse cerebellar diameter (mm). A gestational age‐related normal reference chart was produced for TCD.
Results
Statistically significant relationships between transverse cerebellar diameter and gestational age, abdominal circumference and head circumference were found. The normal fetal TCD exhibited a more than twofold increase in size during the second half of pregnancy. Twenty‐six per cent of the small‐for‐gestational age (SGA) fetuses displayed a reduced TCD and 82% of the SGA fetuses demonstrated raised TCD/AC values. No statistically significant difference in perinatal mortality or birth weight was found between the subsets of growth‐restricted fetuses with reduced or normal TCD; or between the subsets with normal or raised TCD/AC values.
Conclusions
In the normally developing fetus the TCD increases with advancing gestational age. Increased TCD/AC values are suspicious of fetal growth restriction. The perinatal mortality in growth‐restricted fetuses with a small cerebellum is increased twofold over that of other fetuses.
Striking findings concerning the variability in the measurement of the fetal renal collecting system
Authors: Persutte W.H. , Hussey M. , Chyu J. , Hobbins J.C. 
Published: March 2003

Objective Using strict thresholds of normality, investigators have reported associations between fetal pyelectasis and aneuploidy, obstructive uropathy, postnatal pyeloplasty and vesicoureteral reflux. Although evidence continues to mount regarding the importance of fetal pyelectasis, little is known of the variability of collecting system measurements. To investigate the short‐term variability and its relationship to bladder dilatation, the following study was conducted.Design During May and June 1996, 20 mid‐ and late‐trimester patients with varying degrees of fetal pyelectasis were recruited into this study. Each consented to undergo periodic (every 15 min for 2 h) ultrasound measurements of the fetal renal collecting systems and bladder. To account for anatomic and technical variability in measurement, we used both the sum of the transverse and anterior–posterior (AP) measurements of the collecting systems, and AP measurement alone for comparison. The variability of the collecting system measurements was assessed based upon gestational age, magnitude of pyelectasis and fetal bladder size.Results We investigated 38 renal units in 20 patients (eight in the second trimester and 12 in the third). The mean(SE) AP diameter of all kidneys was 5.89(2.49) mm (range 15 (2–17) mm), and the sum of transverse and AP renal collecting system diameters was 13.91(5.73) mm (range 26 (4–31) mm). These data were normally distributed. When assessing the variability in individual kidneys over time, we found the mean variation (minimum to maximum) for the sum of the AP and transverse measurement to be 7.61(4.26) mm and for the AP measurement alone to be 3.80(2.49) mm. No relationship was found between variability of dilatation, magnitude of dilatation or fetal bladder size. Cyclic dilatation of the fetal bladder was observed in all cases. The mean time from maximal to minimal dilatation was 20 min (1.34 observations; range 12–30 min).Conclusions We found the size of the fetal renal collecting system to be highly variable over the course of a 2‐h period. Seventy per cent of cases (14 of 20) had both normal (< 4 mm) and abnormal values (≥ 4 mm) during the 2‐h study period. Significant caution should be used when considering the implications of renal collecting system dilatation based upon a single AP measurement.
Gray scale and color Doppler sonography in the third stage of labor for early detection of failed placental separation
Authors: Krapp M. , Baschat A.A. , Hankeln M. , Gembruch U. 
Published: March 2003

Objective The purpose of this study was the characterization of normal and abnormal third stage placental separation using gray scale and color Doppler sonography.
Methods The third stage of labor was examined in 62 patients using gray scale and color Doppler sonography. After identification of placental basal plate vessels by color Doppler sonography, the placentation site was examined throughout the third stage with combined gray scale and color Doppler mode. Placental separation from the myometrium was defined clinically and correlated to cessation of color Doppler detected blood flow in basal plate vessels.
Results Three sonographic phases of placental separation were: (1) latent = interval between delivery of the fetus and beginning placental separation; (2) detachment = mono‐ or multiphasic shearing off of the placenta and (3) expulsion = interval between completed separation and vaginal delivery of the placenta. In 57 cases with clinically normal placental separation blood flow between placenta and myometrium ceased immediately after delivery of the fetus during the latent period. In five cases manual or instrumental removal was necessary because of placenta adhaerens in one case and placenta accreta in four cases. The latter showed maternal blood flow from the myometrium deep into the placenta beyond the latent phase.
Conclusion Cessation of blood flow between the basal placenta and myometrium following delivery of the baby is the sonographic hallmark of normal placental separation. Persistent blood flow demonstrated by color Doppler sonography is suggestive of placenta accreta.
Maternal cardiac systolic and diastolic function: relationship with uteroplacental resistances. A Doppler and echocardiographic longitudinal study
Authors: Valensise H. , Novelli G. P. , Vasapollo B. , Borzi M. , Arduini D. , Galante A. , Romanini C. 
Published: March 2003

AbstractObjectiveTo test the hypothesis of the existence of a relationship between central and peripheral hemodynamic parameters by the longitudinal evaluation of maternal echocardiographic and uteroplacental resistance modifications during normal pregnancy.MethodsForty‐three healthy normotensive primigravidae were evaluated at 12 ± 1, 21 ± 1, and 33 ± 1 weeks of gestation with uterine artery color Doppler and maternal echocardiographic examinations to identify morphologic, systolic, and diastolic variables.ResultsCardiac output and stroke volume significantly increased during pregnancy. Uterine resistance index (RI) decreased from the first to the second trimesters (0.72 ± 0.10 versus 0.54 ± 0.09, P < 0.001). Left atrial dimensions increased during pregnancy (33.8 ± 1.9 cm, 38.1 ± 1.8 cm, 39.3 ± 2.1 cm, P < 0.001). Left atrial function also increased. Left ventricular mass increased (132 ± 18 g, 162 ± 16 g, 174 ± 27 g, P < 0.001). Diastolic function parameters showed significant modifications: E wave velocity and E/A ratio decreased; A wave velocity and deceleration time of the E wave (DtE) increased; the left ventricular isovolumetric relaxation time (IVRT) decreased significantly (88.7 ± 6.7 ms, 75.6 ± 7.7 ms, 71.1 ± 5.0 ms, P < 0.001) showing a correlation with left atrial dimensions and RI (r = −0.38, r = 0.47, respectively; P < 0.001).ConclusionsDiastolic cardiac function varies during pregnancy. A relationship between preload (left atrial enlargement), afterload (RI reduction), morphologic, and diastolic function modifications (IVRT reduction, DtE prolongation) appears to exist as a consequence of the hemodynamic modifications which occur during physiologic pregnancy. Diastolic function analysis maybe useful to identify women who fully adapt to pregnancy, and to understand the mechanisms that might be involved in women who show abnormal uterine artery Doppler waveforms. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
The frequency of the detection of fetal echogenic intracardiac foci with respect to maternal race
Authors: Shipp T. D. , Bromley B. , Lieberman E. , Benacerraf B. R. 
Published: March 2003

AbstractObjectiveTo determine if there is a racial difference in the frequency of identification of echogenic intracardiac foci (EIF) seen sonographically in the hearts of second‐trimester fetuses.MethodsOver a 2‐month period (June 1998–August 1998), all fetuses scanned between 15 and 20 completed weeks' gestation were evaluated prospectively for the presence or absence of EIF. Pregnancies specifically referred for the presence of EIF were excluded. The sonographer performing the scan indicated maternal race as Asian, black, white, or (if maternal race was not clear) unknown. Maternal race, gestational age, and the presence or absence of EIF were prospectively documented. Follow‐up of those fetuses with EIF was obtained from the referring physicians' offices. The groups were compared with respect to maternal race and presence or absence of EIF.ResultsThere were 46, 34, 400, and nine fetuses of the Asian, black, white, and unknown mothers, respectively. The mean gestational age ± 1 SD at examination was 18.2 ± 1.6, 17.5 ± 1.4, 17.7 ± 1.5, and 17.8 ± 1.1 weeks, for the Asian, black, white, and unknown mothers, respectively. The incidence of sonographically detected EIF was 30.4, 5.9, 10.5 and 11.1% for the Asian, black, white, and unknown mothers, respectively, P = 0.001. In a multivariate logistic regression model, Asian mothers had an odds ratio of 3.8 (95% CI, 1.8, 7.6) for having a fetus identified as having EIF, as compared with white mothers.ConclusionsThe Asian patient is more likely than patients of other races to have a fetus with identified EIF. The counseling implications for Asian mothers undergoing midtrimester sonography when EIF is identified should be tempered, due to the increased frequency of EIF as a normal finding in the Asian population. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Sonographic appearance of first trimester complete hydatidiform moles
Authors: Benson C. B. , Genest D. R. , Bernstein M. R. , Soto‐Wright V. , Goldstein D. P. , Berkowitz R. S. 
Published: March 2003

AbstractObjectiveComplete hydatidiform moles are now being diagnosed earlier in gestation, thus the clinical presentation and pathologic findings of complete molar pregnancy have changed. We studied the sonographic appearance of first trimester moles and the ability of ultrasound to detect them.MethodsWe reviewed the sonographic interpretation and sonograms, when available, from all patients with first trimester complete moles diagnosed at our institution from January 1988 to March 1996.ResultsOf the 24 patients in our study, the mean gestational age at time of the sonogram was 8.7 ± 2.0 weeks (mean ± SD) with a range of 5.7–12.3 weeks. The initial sonographic interpretation was a complete mole in 17 (71%) cases, partial mole versus failed pregnancy in two (8%), and failed pregnancy in five (21%) cases. Of the 22 patients with sonograms available for review, interpretation on review of the images was a complete mole in 18 (82%) cases, partial mole versus failed pregnancy in one (5%), and failed pregnancy in three (14%) cases. The typical sonographic appearance of a first trimester complete mole was a complex, echogenic, intra‐uterine mass containing many small cystic spaces.ConclusionThe majority of first trimester complete moles demonstrate a typical ultrasound appearance such that the diagnosis can be made with ultrasound in most cases. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
A malformed fetus in a rudimentary uterine horn pregnancy
Authors: Has R. , Ermis H. , Yildirim A. 
Published: March 2003

AbstractWe present a case of a 13‐week pregnancy with a malformed fetus in a ruptured, non‐communicating rudimentary horn. The patient, a 21‐year‐old woman with pelvic and right‐sided abdominal pain, was admitted to the gynecology clinic of our institution. A ruptured rudimentary horn pregnancy was diagnosed by ultrasonography. The fetus in the gestation sac showed evisceration of the liver and intestines and an absent left femur. There was an amniotic band extending across the body of the fetus. The ruptured horn was excised by laparotomy. The factors associated with rudimentary horn pregnancy and related fetal abnormalities are discussed. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Classification of discordant fetal growth may contribute to risk stratification in monochorionic twin pregnancies
Authors: Van Gemert M. J. C. , Vandenbussche F. P. H. A. , Schaap A. H. P. , Zondervan H. A. , Nikkels P. G. J. , Van Wijngaarden W. J. , Van Zalen‐Sprock R. M. , Sollie‐Szarynska K. M. , Stoutenbeek P. H. 
Published: March 2003

AbstractObjectivesTo determine whether classification of discordant growth between fetal twins allows risk stratification in monochorionic twin pregnancies.MethodsIn 12 twin‐to‐twin transfusion syndrome (TTTS) pregnancies and 12 cases that were suspected of developing the syndrome, fetal growth was determined by serial standard sonography. Fetal growth was expressed as the difference‐average‐ratio (DAR), defined as the difference in estimated fetal weight between both twins divided by their average weight. In each case, we determined the maximum value of DAR and the rate of change of DAR using a least squares linear fit of the estimated fetal weights.ResultsFor the TTTS cases the maximum value of DAR was 0.44 ± 0.21 versus 0.52 ± 0.13 for the suspected TTTS cases (P = 0.25). The rate of change of DAR was 0.052 ± 0.034 per week for the TTTS versus 0.0055 ± 0.0092 for the suspected TTTS cases (P = 0.0004). After laser therapy, DAR decreased in four successful cases, with a rate of change of −0.0146 ± 0.0093 per week, but increased further in one unsuccessful case, due to patent anastomoses. In the seven TTTS cases treated with amnioreduction, DAR did not decrease; in one of two suspected TTTS cases the DAR decreased slightly. In the nine amnioreduction cases, the average rate of change of DAR was 0.067 ± 0.083 per week. This was significantly different from the four successful laser cases (P = 0.01).ConclusionsThe rate of change of DAR, but not DAR itself, has prognostic value for the development of suspected TTTS pregnancies, for the onset and severity of TTTS and for the efficacy of therapy. This parameter is derived from routine sonography examination and may contribute to risk stratification in monochorionic twin pregnancies. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Does local anesthesia at mid‐trimester amniocentesis decrease pain experience? A randomized trial in 220 patients
Authors: Van Schoubroeck D. , Verhaeghe J. 
Published: March 2003

AbstractObjectivesTo evaluate whether local anesthesia decreases patients' pain experience during mid‐trimester amniocentesis.MethodsIn a randomized trial, one group did not receive local anesthesia while, in another group, lignocaine 1% was injected subcutanously prior to amniocentesis. Five different scoring systems were used to evaluate patients' pain experience.ResultsTwo hundred and twenty women entered the study: 114 received local anesthesia, while 106 did not. The mean (SD) Visual Analog Scale was 1.4 (1.5) on a 0–10 scale (range 0–7.6). Some 97% of patients described the procedure as not painful or bearable, 79% had expected the procedure to be more painful and 59% reported the amniocentesis to have a comparable discomfort as venous blood sampling; 98% of women declared they would undergo an amniocentesis again if indicated. There were no statistical differences between both randomization groups.ConclusionsMid‐trimester amniocentesis is not a painful procedure. Local anesthesia does not affect pain experience during amniocentesis. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Uterine artery Doppler perfusion in the first and second pregnancies
Authors: Hafner E. , Schuchter K. , Metzenbauer M. , Philipp K. 
Published: March 2003

AbstractObjectiveTo compare blood perfusion expressed as pulsatility index (PI) and ‘notching’ of the left and right uterine arteries measured in the same woman in her first and second pregnancies.MethodsData from 1102 women's uterine perfusion in their first and second pregnancies were evaluated. Bilateral data, PI and early diastolic notch in both pregnancies were collected. A notch and a PI ≥ 1 were deemed to be pathologic. Statistical mean and standard deviation together with the frequency of pathological uterine perfusion in the first and second pregnancies were compared (t‐test, χ2‐test).ResultsPI values did not differ significantly in the first and second pregnancies whereas there was a small but marked difference in the right uterine artery compared to the left. Early diastolic notch behaved differently, being more frequently found in the first pregnancy. This discrepancy was highly significant. However in subsequent pregnancies a notch was found more frequently on the left than on the right side. Women with pathologic flow patterns in the first pregnancy were significantly more likely to develop pathologic flow patterns in their second pregnancy.ConclusionAlthough uterine perfusion in the same woman is similar in the first and second pregnancies, ‘notching’ appears much more frequently in the first pregnancy reflecting the fact that the decidual embedding of the trophoblast is less problematic in the second pregnancy. Nevertheless the subgroup with an early diastolic notch in their first pregnancy is four times more likely to develop a notch in a second pregnancy. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of Bardet–Biedl syndrome by targeted second‐trimester sonography
Authors: Dar P. , Sachs G. S. , Carter S. M. , Ferreira J. C. , Nitowsky H. M. , Gross S. J. 
Published: March 2003

AbstractBardet–Biedl syndrome (BBS) is an autosomal recessive disorder characterized by mental retardation, obesity, retinal degeneration, polydactyly and syndactyly, diabetes mellitus, hypogenitalism, renal dysplasia and short stature.Definitive molecular diagnosis for BBS is not currently available and counseling of affected families is based on the 25% recurrence risk consistent with autosomal recessive inheritance.Our case presents the first successful use of second trimester targeted sonographic anatomy scanning to prospectively identify a fetus affected with BBS, and indicates that ultrasound can be of critical importance in providing precise as well as timely prenatal diagnosis for families at risk for this serious disorder. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
The significance of crown–rump length measurement for predicting adverse pregnancy outcome of threatened abortion
Authors: Reljič M. 
Published: March 2003

AbstractObjectivesTo determine if in women with threatened miscarriage the measurement of fetal crown–rump length (CRL) is a useful predictor of spontaneous miscarriage and small for gestational age (SGA) infants.MethodsFetal CRL was measured in 310 singleton pregnancies with live fetuses, presenting with threatened miscarriage before 13 weeks of gestation. The relationship between fetal CRL and pregnancy outcome was investigated.ResultsIn fetuses with CRL < 18 mm there was a significant positive association between the deficit in CRL for gestation and the incidence of subsequent spontaneous miscarriage. In those cases with CRL deficit more than 2 standard deriations (SDs) the incidence of miscarriage was 13.7%, whereas if the CRL was between the mean and −2 SDs the incidence of miscarriage was 8.3%. In fetuses with CRL ≥ 18 mm there was a significant positive association between the deficit in CRL for gestation and the incidence of SGA. In those cases with CRL deficit of more than 2 SD the incidence of SGA was 27.3%, whereas if the CRL was between the mean and −2 SDs the incidence of SGA was 18.9%.ConclusionsThe findings of this study suggest that the measurement of fetal CRL may be a useful predictor of spontaneous miscarriage and SGA in pregnancies with threatened miscarriage. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Changes in fetal hemodynamics with ritodrine tocolysis
Authors: Gokay Z. , Ozcan T. , Copel J. A. 
Published: March 2003

AbstractObjectiveTo evaluate the effect of ritodrine on the fetal cardiovascular system.MethodsCardiac and extracardiac Doppler waveforms were recorded in 12 fetuses prior to and during ritodrine therapy used for preterm labor. Maternal and fetal heart rates, the Doppler pulsatility indices of the umbilical artery, middle cerebral artery, descending thoracic aorta and renal artery, and time velocity integrals of the atrioventricular valves and the ductus arteriosus, were measured.ResultsRitodrine infusion caused an increase in maternal and fetal heart rates, the left cardiac output as measured by the product of time velocity integral and heart rate, and the pulsatility index of the middle cerebral artery, and a decrease in the pulsatility index of the umbilical artery.ConclusionsRitodrine infusion may alter placental and cerebral blood flow and may have a selective effect on the left side of the heart. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Nomogram of Wharton's jelly as depicted in the sonographic cross section of the umbilical cord
Authors: Ghezzi F. , Raio L. , Di Naro E. , Franchi M. , Balestreri D. , D'Addario V. 
Published: March 2003

AbstractObjectivesTo generate a nomogram for the sonographic measurement of Wharton's jelly area (WJA) during gestation and to investigate whether WJA is related to fetal biometric parameters.MethodThe sonographic cross‐sectional area of the umbilical cord and of its vessels was measured in 659 fetuses between 15 and 42 weeks of gestation. The WJA was calculated by subtracting the vascular area from the umbilical cord area. The conventional biometric parameters were measured and correlated with the WJA. Polynomial regression analysis was utilized for statistical purposes.ResultsThe WJA increased as a function of gestational age (r = 0.63, P < 0.001). The regression equation for the mean WJA (y) according to gestational age (x) was y = −114.7 + 4.142x − 0.01x2 and for the standard deviation (y′) was y′ = −7.567 + 1.319x. There was a strong correlation between the WJA and the umbilical cord area (r = 0.97, P < 0.001). A significant correlation was also found between the WJA and fetal biometric parameters before 32 weeks of gestation (WJA and biparietal diameter: r = 0.82, P < 0.001; WJA and abdominal circumference: r = 0.79, P < 0.001; WJA and femur length: r = 0.81, P < 0.001) while after 32 weeks of gestation no correlations were found between WJA and fetal anthropometric parameters.ConclusionA nomogram for the WJA has been generated. The WJA increases as a function of gestational age and it is correlated with fetal size up to 32 weeks of gestation. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology