bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal sexing by ultrasound in the second trimester: maternal preference and professional ability
Authors: Harrington K. , Armstrong V. , Freeman J. , Aquilina J. , Campbell S. 
Published: March 2003

AbstractThe study was planned to determine the proportion of parents that wish to know the sex of their fetus at the 20‐week anomaly scan, and to investigate our ability to diagnose correctly the sex of the fetus when undertaken as part of a routine scan. A total of 472 patients gave their informed consent. An attempt was made to identify the genitalia as part of the routine scan. No extra time was allowed to determine the sex of the fetus. Altogether 353 (74.7%) women wanted to know the sex, of which four (0.9%) wanted to know but did not want their partners to know. In 50 (10.6%) cases, it was not possible to determine the fetal sex in the time allowed. When the sex was identified, it was correct in 408 (96.7%) cases, and incorrect in 14 (3.3%) cases. Where the parents wanted to know the sex of the fetus, 24 (6.8%) scans were inconclusive, 319 (97%) were correctly identified, and ten (3%) were incorrectly identified (six male, four female). There were no terminations of pregnancy. The majority of prospective parents wish to know the sex of their child, and, in most cases, it is possible to determine the fetal sex at the time of the routine anomaly scan. During the time allowed, the fetal sex was undetermined in one in ten cases, and 3% were sexed incorrectly. If parents wish to know the gender of their fetus, it would appear reasonable to provide this information, provided that the parents are aware of the failure and error rates of sex identification using ultrasound. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasound screening for anencephaly at 10–14 weeks of gestation
Authors: Johnson S. P. , Sebire N. J. , Snijders R. J. M. , Tunkel S. , Nicolaides K. H. 
Published: March 2003

AbstractIn an ongoing study involving seven hospitals in London and surrounding areas, 55 237 fetuses were examined by ultrasound at 10–14 weeks of gestation. There were 47 fetuses (1 in 1175) with anencephaly which presented with acrania with varying degrees of cerebral degeneration. The first audit of results was performed in April 1995. During the first phase of the study 34 830 fetuses were examined and in eight of the 31 with anencephaly the diagnosis was not made at the 10–l4‐week scan. Following the audit, 20 407 fetuses were examined and in all 16 with anencephaly the diagnosis was made at the 10–14‐week scan (p = 0.03). These findings demonstrate that anencephaly can be reliably diagnosed at the routine 1O–l4‐week ultrasound scan, provided a specific search is made for the sonographic features for this condition. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Harmonic imaging of porcine intraovarian arteries using sonographic contrast medium: initial findings
Authors: Ragavendra N. , Chen H. , Powers J. E. , Nilawat C. , Robert J. M. , Carangi C. , Laifer‐Narin S. L. 
Published: March 2003

AbstractThe purpose of this study was to visualize, using harmonic gray‐scale imaging, blood flow in porcine intraovarian arteries after intravenous injections of a bubble‐based sonographic contrast medium. Five female pigs underwent laparotomy. Surgically isolated ovaries were scanned intraperitoneally by an ultrasound system reconfigured with software changes to accomplish harmonic imaging. The transmission and receiving frequencies were set at 3.75 and 7.5 MHz, respectively. After injection of the sonographic contrast medium (Aerosomes®) into a peripheral vein, the ovaries were imaged in the harmonic mode. Ten minutes later, another contrast injection was administered and conventional gray‐scale imaging of the ovary performed. In all five pigs, intraovarian arteries were clearly identified upon harmonic imaging as brightly echogenic moving columns. The arterial blood pool appeared brighter during systole than diastole. Upon ultrasound contrast‐assisted conventional gray‐scale imaging, intraovarian arteries were not visualized in four pigs and poorly visualized in one. We conclude that contrast‐assisted harmonic imaging can adequately visualize blood flow in intraovarian arteries of surgically exposed porcine ovaries. Clinically, harmonic imaging may facilitate early detection of tumor‐induced angiogenesis in the human ovary. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Doppler assessment of the uterine and uteroplacental circulation in the second trimester in pregnancies at high risk for pre‐eclampsia and/or intrauterine growth retardation: comparison and correlation between different Doppler parameters
Authors: Zimmermann P. , Eiriö V. , Koskinen J. , Kujansuu E. , Ranta T. 
Published: March 2003

AbstractDuring a 20‐month period we studied 175 pregnant women at high risk for hypertensive disorders of pregnancy or intrauterine growth retardation, and 172 patients at low risk, in a prospectively designed cross‐sectional trial. Using duplex pulsed wave Doppler ultrasound, we recorded blood velocity waveforms from both main uterine arteries, the uteroplacental arteries in the region of placental implantation and the umbilical artery at 21–24 weeks of gestation. Persistent notches in the main stem uterine arteries and elevated resistance indices of > 0.68 in the uterine arteries and > 0.38 in the uteroplacental arteries were defined as abnormal waveforms. The incidence of proteinuric pregnancy‐induced hypertension (PPIH) and intrauterine growth retardation (IUGR) were recorded as main outcome measures.Doppler proved to be more efficient at predicting a complicated pregnancy in those patients who were at high risk: a positive medical history alone was associated with a three‐fold greater risk of developing PPIH and/or IUGR. In the high‐risk group a single pathological Doppler sign accounted for an additional three‐ to four‐fold increased risk, and the combination of all three pathological signs, a seven‐fold additional risk for later disease. In this group PPIH and/or IUGR was found in 58.3%, compared to 8.3% if Doppler results were normal.The criterion for the definition of pathological Doppler results, whether persistent notching, the resistance index (RI) of the main stem uterine artery, or the RI in the arteries of the uteroplacental bed, was of minor importance, as all Doppler parameters were strongly correlated. However, the combination of all parameters was superior to a single parameter, and a bilateral notch was superior to a unilateral notch in terms of minimizing false‐positive results.However, Doppler was less powerful in the population at low risk. Here PPIH and/or IUGR was seen in 6.1–6.4% in the group with abnormal Doppler findings compared to 5.2% in pregnancies with normal findings. None of the patients showed bilateral notching.In conclusion, pathological Doppler velocimetry of the uterine and uteroplacental circulation was a powerful predictor of PPIH and/or IUGR in high‐risk pregnancies, identifying a group in which 58.3% would suffer from disease later in pregnancy. A combination of several Doppler parameters was superior to a single parameter, although the parameters were strongly correlated with each other. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Mild pyelectasis ascertained with prenatal ultrasonography is pediatrically significant
Authors: Persutte W. H. , Koyle M. , Lenke R. R. , Klas J. , Ryan C. , Hobbins J. C. 
Published: March 2003

AbstractIsolated ‘mild renal collecting system dilatation’ (mild pyelectasis) is a common prenatal sonographic finding. An association between mild pyelectasis and fetal aneuploidy has been established, but in the absence of a concomitant anomaly, mild pyelectasis is usually regarded as benign and of no clinical consequence, and, follow‐up is often not obtained after the initial ascertainment. To test this, we investigated the relationship between mild pyelectasis and (1) progression to hydronephrosis; (2) postnatal vesicoureteral reflux (VUR.); and (3) postnatal surgery.Between 1 January 1992 and 1 January 1995, we performed 453 prenatal sonographic examinations of 306 patients with mild fetal pyelectasis and no other anomalies. During the course of a routine sonographic examination, we performed a detailed evaluation of the fetal genitourinary tract. Mild pyelectasis was defined as a pelvocalyceal fluid‐filled space with the smallest of two transverse perpendicular sonographic measurements of ≥ 4 mm and < 10 mm. Hydronephrosis was defined similarly, but with a measurement of ≥ 10 mm. Postnatal urological assessment was obtained with routine renal ultrasonography, and voiding cystourethrography (VCUG), measurement of 99mTc‐labelled diethylenetriamine pentaacetic acid (DPTA) mercaptacetyltriglycerine (MAG3), and intravenous pyelogram, as necessary.After exclusion criteria were applied, 294 (96%) patients with isolated fetal pyelectasis were considered. A total of 251 (82%) of these were followed with ultrasonography prenatally and during the postnatal period. Two or more prenatal examinations were carried out in 129 patients (51%) and in 35 (27%) of these cases the biometry progressed to frank hydronephrosis (> 10 mm). In only six (5%) of the cases followed prenatally did the measurement diminish to < 4 mm. We found a greater variability in prenatal renal biometry throughout gestation in infants found to have VUR, when compared with those who had no VUR. On postnatal follow‐up, 84 patients had VCUG. Sixteen of these patients (6% of all patients [16/251] and 19% [16/84] of those who had the test) were found to have an abnormal finding.Whereas the prenatal appearance of mild pyelectasis improved in only a small number of cases, we found that it progressed to hydronephrosis in 27% of cases. Postnatal evaluation found VUR to be common in apparent uncomplicated mild prenatal pyelectasis. Although postnatal surgery was necessary in only a small number of cases, surgical intervention was necessary in 33% (four of 12) of those with VUR. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Sonographic prediction of malignancy in adnexal masses using multivariate logistic regression analysis
Authors: Tailor A. , Jurkovic D. , Bourne T. H. , Collins W. P. , Campbell S. 
Published: March 2003

AbstractThe aim of the study was to assign a probability of malignancy for any patient with an adnexal tumor by the application of multivariate logistic regression analysis to variables recorded at the time of pelvic sonography. Sixty‐seven women with known adnexal masses were examined using transvaginal B‐mode and color Doppler imaging. For each patient the variables included: (1) age, (2) maximum tumor diameter, (3) tumor volume, (4) unilocularity (presence (0) or absence(1)), (5) papillary projections (presence (1) or absence (0)), (6) random echogenicity (presence (1) or absence (0)), (7) highest peak systolic velocity (PSV), (8) time‐averaged maximum velocity (TAMXV), (9) pulsatility index (PI) and (10) resistance index (RI). The TAMXV, PI and RI were those associated with the highest PSV. These ten independent variables and the final histological diagnosis for each patient (the dependent variable) were used for the regression analysis. Approximately 75% of the entire dataset was randomly selected for generating the regression model. The remaining 25% was used as the testing set for cross‐validation of the model. In the entire dataset there were 52 women with benign, three with borderline and 12 with invasive ovarian tumors. Regression analysis on the ten variables resulted in the retention of only ‘age’, ‘papillary projection score’ and ‘TAMXV’ as significantly contributing to predicting the presence or absence of malignancy. The probability of malignancy for any patient was given by solving the equation: Probability = 1/(1 + e−Z) where e is the base value for natural logarithms and z = (0.1273 × Age) + (0.2794 × TAMXV) + (4.4136 × Papillary projections score) − 14.2044. Cross‐validation of the model on the test set of data gave a 100% sensitivity and specificity. However, for the entire dataset the best sensitivity and specificity were 93.3 and 90.4%, respectively, at a cut‐off value of 25% probability of malignancy. In conclusion, multivariate logistic regression analysis enables the calculation of probability of malignancy for any patient with a known adnexal mass. The accuracy of this prediction appears to be better than that of morphological or Doppler criteria when the latter are used independently. The value of this model needs to be tested prospectively. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Psychological outcomes following missed abortions and provision of follow‐up care
Authors: Nikcevic A. V. , Tunkel S. A. , Nicolaides K. H. 
Published: March 2003

AbstractThis cross‐sectional study of 204 women who had experienced a missed abortion, diagnosed at 10–14 weeks of pregnancy, examined the availability and desirability of routine follow‐up care, and whether such care is associated with reduced psychological morbidity in the aftermath of miscarriage. Clinically elevated anxiety and depression were observed in 45% and 15% of women, respectively, and the mean score of grief was 2.52 which is similar to that observed in people who suffer death of a close relative. A follow‐up appointment after the miscarriage was thought to have been desirable by 92% of women but was offered to only 30%. No significant association between such care and reduced psychological morbidity was identified. However, there were significantly more women with clinically elevated levels of anxiety among those who felt that they were not provided with an opportunity to discuss their feelings during the follow‐up, suggesting that such a follow‐up either had a deleterious effect on women's psychological state or the distress itself led to such a perception of care. One‐third of women in our sample would have liked psychological counselling to help them deal with the emotional aspects of their loss. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Diagnosis of adnexal malignancies by using color Doppler energy imaging as a secondary test in persistent masses
Authors: Guerriero S. , Ajossa S. , Risalvato A. , Lai M. P. , Mais V. , Angiolucci M. , Melis G. B. 
Published: March 2003

AbstractThe purpose of this prospective study was to compare the accuracy of B‐mode transvaginal ultrasonography alone and in combination with color Doppler energy (or power Doppler) imaging in differentiating benign from malignant adnexal masses. A total of 192 consecutive persistent adnexal masses (159 benign, 33 malignant) were studied before surgery by B‐mode transvaginal ultrasonography with and without color Doppler energy. In addition, CA‐125 plasma levels were determined and spectral Doppler analysis was performed. By color Doppler energy imaging, a mass was considered malignant when arterial flow was visualized in an echogenic portion of a mass defined as malignant by B‐mode. Intratumoral arterial blood flow could be readily detected by color Doppler energy imaging in all malignant tumors and in 94% of the benign tumors. The combined use of transvaginal B‐mode ultrasonography and color Doppler energy imaging has greater accuracy in the diagnosis of ovarian malignancies than transvaginal ultrasonography alone (value of kappa: 0.81 and 0.63, respectively), reducing the number of false‐positive results. The use of spectral Doppler analysis was of limited diagnostic value, with a kappa value of 0.17 for the pulsatility index (< 1) and of 0.41 for the resistance index (< 0.4). Also, the association with CA‐125 increased the number of false‐negative results. In conclusion, the use of color Doppler energy imaging seems to be a useful secondary test when a mass is suspected to be malignant by B‐mode ultrasonography. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Unfused amnion and chorion after 14 weeks of gestation: associated fetal structural and chromosomal abnormalities
Authors: Ulm B. , Ulm M. R. , Bernaschek G. 
Published: March 2003

AbstractObjectiveTo assess possible associations between delayed chorioamniotic fusion after the end of the first trimester and fetal structural and/or chromosomal abnormalities.DesignWe prospectively studied 492 fetuses from high‐risk pregnancies between 14 and 18 weeks of gestation by transabdominal ultrasonography. Of these, 60 (12%) had unfused amnion and chorion.ResultsNo additional abnormalities were detected in 28/60 fetuses (47%). Karyotyping was performed in 27/28 cases, and one fetus had trisomy 13 (4%). Ten of 24 fetuses (42%) of this group attending a second mid‐trimester scan after 18 weeks of gestation had abnormal sonographic findings not noted at the initial scan. Thirty‐two of 60 (53%) fetuses had additional abnormalities at the initial scan: cystic hygroma (n = 12), increased nuchal translucency (n = 10) and other abnormalities (n = 10). Karyo‐typing revealed aneuploidy in 13 of 28 fetuses (46%) tested: trisomy 21 (n = 5), Turner's syndrome (n = 3), trisomy 18 (n = 3) and trisomy 13 (n = 2). Additional fetal abnormalities were detected only at the second scan after 18 weeks of gestation in three of eight fetuses (38%).ConclusionsThese preliminary data suggest that the sonographic finding of unfused amnion and chorion after 14 weeks of gestation may be associated with fetal structural and/or chromosomal abnormalities. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
P103Effect of uterine contraction on preload index1 in recipient fetus of feto–fetal transfusion syndrome: case report
Authors: Takahashi Y. , Kawabata I. 
Published: March 2003

A case of monochorionic‐diamnionic twin was diagnosed as feto‐fetal transfusion at 19 weeks gestation. We performed amniocentesis to reduce the fluid and amnioseptostomy. The discodancy of amniotic fluid was remarkably dissolved for long period. At 25 weeks gestation, we started tocolysis by ritodrine and magnesium sulfate drip infusion. During the uterine contraction, we detected increased preload index on recipient fetus by evaluation of the flow of inferior caval vein and reverse end‐diastolic flow of umbilical artery on donor fetus and these unfavorable findings disappeared a few minutes after the uterine contraction improved. These findings suggest that uterine contraction is absolute risk factor for feto–fetal transfusion syndrome because they worsen blood flow on both fetuses.(1) Kanzaki T, Chiba Y. Evaluation of the preload condition of the fetus by inferior vena caval blood flow pattern. Fetal Diagn Ther 1990; 5(3–4):168–74.
P104 Ultrasonic fetal and placental tissue characterization and the role of Doppler ultrasound in lung maturity
Authors: Podobnik M. , Podgajski M. , Breyer B. , Gebauer B. 
Published: March 2003

ObjectivesThe aim of this study is to known the relationship between the gestational age and quantitative assessment of ultrasonic signs of placental tissue, fetal lungs and liver tissue and to correlate Doppler parameters from main stems of the pulmonary arteries for determining fetal lung maturity in normal pregnancy and pregnancy with preeclampsia and diabetes.MethodThe placenta, fetal lungs and fetal liver in 300 normal pregnancies, 100 preeclamptic pregnancies and 100 diabetic pregnancy were examined by ultrasound at 30–41 weeks of gestation. The coefficients of variation (the standard deviation divided by the mean value) were used to characterise the tissue in different groups during pregnancy. Doppler velocimetry was performed in the main stems of pulmonary arteries in normal pregnancies and pregnancies with preeclampsia and diabetes.ResultsThe coefficients of variation in mature foetuses were greater than 29% for placentas in‐vivo, greater than 34% for placentas in‐vitro, greater than 28% for liver tissue and greater than 30% for lung tissue. Placental, lung and liver tissue of diabetic pregnancy tended to have lower coefficients of variation throughout their pregnancies. We found in mature foetuses mean peak systolic velocity higher than 40 cm/sec. and PI lower than 3,00. In mature foetuses with preeclampsia we found higher mean peak systolic velocity in comparing with normotensive patients.ConclusionThe coefficient of variation values for placentas in‐vivo and in‐vitro, and fetal lungs and liver increase during pregnancy in normal and preeclamptic patients with increasing gestational age and decrease in diabetic patients.
P105Umbilical vein blood flow changes in normal and growth retarded fetuses
Authors: Di Naro E. , Ghezzi F. , Raio L. , Franchi M. , Romano F. , Clericò L. , Lanzilotti G. , Bolla D. , Balestreri D. 
Published: March 2003

BackgroundThe aim of this study was to assess whether changes of UV flow volume over time in late (third trimester) growth retarded fetuses (IUGR) are different than those in normal fetuses.MethodUmbilical morphometric characteristics and UV blood flow parameters of 15 women whose fetus was diagnosed to be IUGR without umbilical artery Doppler abnormality were compared to those of 30 women whose fetus was healthy. Gestational age and parity were used as matching criteria. Digital color Doppler velocity profile integration was used. For each patient, two scans were performed in a period of 3 weeks.ResultsThe umbilical cord area was significantly smaller in IUGR than in healthy fetuses at each examination (P < 0.05). The umbilical artery areas were not different between groups. The UV blood flow normalized for estimated fetal weight was lower in IUGR than in healthy fetuses 115 ± 41 vs. 145 ± 39, P < 0.05). The UV flow increase between two consecutive exams was significantly lower in IUGR than in healthy fetuses (P < 0.05).ConclusionThe umbilical cord area and the uv blood flow of IUGR were reduced in comparison to healthy fetuses. The normalized UV blood flow difference between IUGR and healthy fetuses increases with advancing gestation.
109Transcranial‐duplex‐Doppler US findings and neurodevelopmental outcome of infants with perinatal cerebral infarction
Authors: Ðuranović V. , Mejaški‐Bošnjak V. , Marušić‐Della Marina B. , Duplanćić R. , Lujić L. , Babic‐Polak J. , Huzjan R. 
Published: March 2003

ObjectivesWe recorded cerebral flow velocities by TCDD in 10 infants diagnosed with cerebral infarction (CI) of the irrigational area of the middle cerebral artery (MCA), with special reference to the etiology and pathogenesis of CI. We correlated the hemispheral localization and the distribution of the lesion with neurodevelopmental outcome of the children affected.Patients and methodsTwo children were preterms and other eight were full terms. The diagnosis was obtained in all children by using cranial US, CT and MRI. Because of vascular etiology of lesion cerebral circulation was investigated by TCDD. Perinatal risk factors were assessed and patients underwent neurodevelopmental follow‐up for 1–14 years.ResultsCerebral infarction involved the irrigational area of MCA. Asymmetric flow between the left and right MCA was the main finding on the TCDD. Lower velocities were found in the MCA on the affected side. These side‐to‐side differences were present at subsequent Doppler measurements. The lesion was more often found on left size. The distribution of the infarction was classified as the area of the lesion determines the neurological sequels. All infants had delayed psychomotoric development: contralateral hemiparesis, persistent seizures and language delay. The level of cognitive functioning was variable.ConclusionsBased on clinical and diagnostical follow‐up the results showed no simple and clear connection between lesion parameters and neurodevelopmental outcome. We suppose that the time when lesion occurred is crucial for the possible neurodevelopmental outcome. The data indicates that beside brain US, CT and MR, TCDD can be useful method for identifying and following infants with suspected cerebral infarction.