bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrauterine sling: a complication of the stuck twin syndrome
Authors: Al‐Kouatly H. B. , Skupski D. W. 
Published: March 2003

AbstractStuck twin syndrome usually presents with polyhydramnios in the recipient sac and severe oligohydramnios in the donor sac. The donor is displaced against the uterine wall and remains adherent in that position. We present a case in which the diagnosis was more complicated, owing to the suspension of the stuck twin by a sling within the sac of the recipient.A monochorionic diamnionic twin gestation was complicated by twin–twin transfusion syndrome at 18 weeks of gestation. In our example, the stuck twin was suspended by a sling from the placenta. The sling band represented the intertwin membrane that was folded upon itself. Amniotic fluid from the recipient twin was present in three dimensions around the stuck twin, except for the sling band.The suspension of the stuck twin by a sling within the amniotic fluid of the recipient is an unusual manifestation of the stuck twin syndrome. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
WS06‐05Disproportion of the four chamber view of the fetal heart: what does it mean?
Authors: Respondek‐Liberska M. 
Published: March 2003

BackgroundThe aim of the study was a retrospective analysis of fetal heart disproportion.MethodFrom the database of 3941 fetuses disproportion based on 4 chamber view was diagnosed in 136 fetuses (3.5%). There were 96 fetuses with the complete neonatal follow‐up.ResultsFifty‐nine fetuses presented with different extracardiac malformations. Three other fetuses presented with heart defects. Thirty‐four fetuses with disproportion had ‘normal heart anatomy’ and no extracardiac malformations. Gestational age at the time of diagnosis was 26–40 weeks (mean 35).Out of 34 fetuses with ‘pure’ disproportion, 15 cases (44%) did not have any clinical or postnatal ECH0 abnormalities. In 19 cases (54%) structural or functional abnormalities were found: 6 neonates presented with ASD secundum, 4 with CoA, 2 with lungs abnormalities (cong. pneumonia and cong. lung emphysema), one neonate had PDA, one had aorto‐pulmonary window + PDA. In other 5 neonates tricuspid insuffciency was diagnosed.ConclusionsDisproportion in fetal heart was the relatively frequent abnormality at the referral center for fetal echocardiography (3.5%) and in majority of cases it was related to the presence of structural or functional abnormalities. In 44% of neonates fetal disproportion had no clinical implications. The most common neonatal heart defect in cases who prenatally presented with disproportion was ASD sac, followed by CoA (4/19, 21%).
The application of three‐dimensional ultrasound to nuchal translucency measurement in early pregnancy (10–14 weeks): a preliminary study
Authors: Chung B.L. , Kim H.J. , Lee K.H. 
Published: March 2003

Objectives The aims of this prospective screening study were to calculate the success rate and to assess the intra‐operator variability of fetal nuchal translucency measurement by using three‐dimensional ultrasound.
Subjects  and methods Eighty‐six women, each with a singleton pregnancy undergoing routine nuchal translucency measurement between 10 weeks and 14 weeks plus 6 days gestational age. Three‐dimensional transvaginal sonography was performed. A new method of nuchal translucency measurement was applied from three volumetric data sets using four steps.
Results In all cases good sagittal views of the fetus were obtained, the fetal skin could be distinguised from the amnion and the nuchal translucency thickness could be measured. The new measurement procedure could be standardized. The overall time required for the examination was 5 min. The procedure caused no discomfort to the woman and was easily performed by the examiner. Intra‐operator variability was low (P = 0.862).
Conclusion Three‐dimensional ultrasound is a useful and easily applicable tool for nuchal translucency measurement during early pregnancy (10–14 weeks plus 6 days). Its advantages still need further evaluation.
Ultrasound screening in the 2nd trimester. The pregnant woman's background knowledge, expectations, experiences and acceptances
Authors: Larsen T. , Nguyen T. H. , Munk M. , Svendsen L. , Teisner L. 
Published: March 2003

AbstractObjectiveUltrasound screening in the second trimester is widely used in maternal health care. To secure the pregnant woman's autonomy, it is essential to obtain information relating to her understanding and wishes as a starting point for the provision of information. The aim of the study was to explore the pregnant woman's background knowledge, expectations, experiences, and acceptances of second trimester ultrasound screening.DesignFive‐hundred consecutive, unselected pregnant woman, of gestational age between 16 and 20 weeks were asked to fill in a questionnaire containing defined and open ended questions.ResultsApproximately 70% of the women recruited had undergone a pregnancy‐related ultrasound examination previously. Ninety percent answered that they had received information, either from the family doctor or as written material from the hospital (or both), concerning the purpose of the examination. Literature/newspaper/TV, family and friends played an important role as sources for general information. The pregnant women wished to undertake the ultrasound examination to ensure that the fetus was alive, healthy and without any malformation. Few answers were clinically irrelevant. The womens' expectations were fulfilled in 96% of cases, 86% felt ‘more secure’ after the examination while 2% did not have their expectations fulfilled. Only 0.8% felt more insecure after the examination. The vast majority of both pregnant women and their partners reported a positive experience from the event.ConclusionPregnant women have a good knowledge of ultrasound examination although the quality of information could be improved. Expectations are fulfilled and are clinically relevant. The acceptability and experiences of the examination are very high. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Color Doppler imaging in the diagnosis and management of chorioangiomas
Authors: Jauniaux E. , Ogle R. 
Published: March 2003

AbstractColor Doppler imaging was used to investigate nine consecutive cases of placental tumors referred for evaluation to a tertiary referral unit.Gray‐scale ultrasound findings were of a chorioangioma which was subsequently confirmed on pathologic examination. On color Doppler imaging (CDI), three tumors appeared avascular and the pregnancies were uncomplicated, two had only a few vessels in their periphery, and four contained numerous vessels. These vascular chorioangiomas were complicated by polyhydramnios and premature labor (n = 3), isolated polyhydramnios (n = 1), fetal growth restriction (n = 1) and generalized non‐immune fetal hydrops (NIHF) (n = 1). The maximum diameter of the tumors ranged between 3 and 10 cm. There was no direct association between the size and location of the tumor and the development of complications. Successful amnioreduction was performed in the three cases of polyhydramnios and premature onset of labor. Vascular sclerosis was attempted unsuccessfully in the case complicated by severe NIHF.Our data indicate that the vascularization of the tumor is a pivotal determinant factor of pregnancy outcome. Where the tumor is avascular, no specific complications should be expected. Where the tumor is vascularized, and in particular if it contains numerous large vessels, serial ultrasound and Doppler examinations are warranted to detect polyhydramnios and early features of fetal congestive heart failure. © 2000 British Journal of Surgery Society Ltd
Sonographic visualization of normal‐size ovaries during pregnancy
Authors: Shalev J. , Blankstein J. , Mashiach R. , Lampley C. E. , Bar‐Hava I. , Vardimon D. , Ben‐Rafael Z. , Meizner I. 
Published: March 2003

AbstractObjectiveTo assess the ability of ultrasound to detect ovaries of normal size during pregnancyMethodsA prospective study of 329 women with a normal pregnancy course was undertaken; 68 were excluded from analysis because of an enlarged, cystic ovary. Of the remainder, 60 pregnancies were examined in the first trimester and 201 in the second or third trimester. The first group underwent transvaginal (TVS) and transabdominal (TAS) scanning. The second group underwent TAS examination only.ResultsIn the first‐trimester group, TVS identified both ovaries in 57 patients (95%) and transabdominal ultrasound in 20 (33.3%). In the second‐ and third‐trimester patients, TAS visualized both ovaries in 33 patients (16.4%), and neither ovary in 120 (59.7%). Both ovaries were less visible with advancing gestational age. The right ovary showed a significant change in position during pregnancy, from about 1 cm (at 15–24 weeks) to 2.5 cm (at 30–41 weeks) cranial to the iliac spine. The left ovary was found 1 cm above the iliac spine throughout pregnancy.ConclusionsTransvaginal sonography is adequate for the visualization of both ovaries in the first trimester of pregnancy. With advanced gestational age, the ovaries were significantly less visible by TAS. Sonographic scanning of the ovaries in second and third trimester should be concentrated mainly at the level of the iliac spine. Poor sonographic visualization of both ovaries in late gestation may mandate the use of other imaging modalities. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
The coronary sinus in the fetus
Authors: Rein A. J. J. T. , Nir A. , Nadjari M. 
Published: March 2003

AbstractIntroductionThe normal coronary sinus drains venous blood from the cardiac veins to the right atrium. In some instances, the coronary sinus may be dilated due to volume or more rarely pressure overload.AimsTo assess the feasibility of detecting the coronary sinus in the fetus and to establish the normal values of the coronary sinus dimensions throughout gestation.Subjects and methodsFetal echocardiography was performed in 78 normal fetuses from the 16th to the 40th week of gestation (median 25 week). The coronary sinus was measured in four‐chamber view (87% of cases) or in parasternal short axis view equivalent (13%). A second group of nine fetuses with a dilated coronary sinus was compared to the normal group.ResultsAdequate imaging of coronary sinus was obtained in 97.4% of the normal fetuses. The diameter of the coronary sinus ranged from 1 to 3.2 mm (2 mm ± 0.13 mm, mean ± 5% confidence interval) and correlated well with the age of pregnancy (r = 0.86). The length‐to‐diameter ratio of 24% (± 6%) did not vary throughout pregnancy. All nine fetuses with a dilated coronary sinus had a persistent left superior vena cava which drained into it.The diameter of the coronary sinus was approximately three times larger in the abnormal group with a diameter‐to‐length ratio of approximately 83% (P < 0.0001).ConclusionThe coronary sinus is readily identified in the fetus. It gradually increases during pregnancy. An abnormal coronary sinus is easily diagnosed and should prompt the sonographer to look for a persistent left superior vena cava. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Fetal biometry at 4300 m compared to sea level in Peru
Authors: Krampl E. , Lees C. , Bland J. M. , Espinoza Dorado J. , Moscoso G. , Campbell S. 
Published: March 2003

AbstractObjectivesThe aim of this study was to compare ultrasound fetal size at high altitude and sea level.MethodsThree hundred and thirty‐four women in Cerro de Pasco at 4300 m (14 100 ft) altitude and 278 women in Lima (sea level) were recruited to the study. Ultrasound fetal biometry was carried out between 14 and 42 weeks of gestation. Biparietal diameter, occipitofrontal diameter, abdominal circumference and femur length were measured and head circumference and estimated fetal weight were derived from these data. Two hundred and seventy‐seven women (82.9%) in Cerro de Pasco and 216 (77.7%) in Lima had normal singleton pregnancies and certain menstrual dates. These women were selected for statistical analysis. Fractional polynomial regression analysis on gestational age was performed, controlling for maternal height and parity.ResultsFetal biometry measurements were significantly smaller in Cerro de Pasco compared with Lima. When gestation bands were compared this effect was present from 25 to 29 weeks onwards, and was greater in the abdominal circumference than in the head circumference and femur length (ratios Cerro de Pasco: Lima, 0.96, 0.97 and 0.98, respectively). Estimated fetal weight was also significantly lower in Cerro de Pasco (ratio 0.88), as were birthweights (ratio 0.88). If the centiles derived from the Lima population were applied for Cerro de Pasco, 11.2% of all estimated fetal weights would be below the fifth centile, and 1.08% above the ninety‐fifth.ConclusionsThese data suggest that at high altitude, all fetal biometry measurements follow a lower trajectory than at sea level. Specific biometry charts should therefore be used for obstetric ultrasound at high altitude. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Fetal cleft lip and palate detection by three‐dimensional ultrasonography
Authors: Lee W. , Kirk J. S. , Shaheen K. W. , Romero R. , Hodges A. N. , Comstock C. H. 
Published: March 2003

AbstractObjectivesTo demonstrate a standardized approach for the evaluation of cleft lip and palate by three‐dimensional (3D) ultrasonography.DesignThis was a retrospective study of seven fetuses with confirmed facial cleft anomalies. Post‐natal findings were compared to a blinded review of 3D volume data from abnormal fetuses with seven other normal fetuses that were matched for gestational age. Upper lip integrity was examined by 3D multiplanar imaging. Sequential axial views were used to evaluate the maxillary tooth‐bearing alveolar ridge contour and anterior tooth socket alignment. Alveolar ridge disruption suggested cleft palate. Premaxillary protrusion, either by multiplanar imaging or surface rendering, indicated bilateral cleft lip and palate.ResultsPost‐natal findings confirmed bilateral cleft lip and palate (four cases), unilateral cleft lip and palate (one case), and unilateral cleft lip (two cases). Multiplanar review identified all three fetuses with unilateral cleft lip, three of four fetuses with bilateral cleft lip, one fetus with unilateral cleft palate, and three of four fetuses with bilateral cleft palate. Surface rendering correctly identified all cleft lips, with the exception of one fetus, who was thought to have a unilateral cleft lip and palate, despite the actual presence of a bilateral lesion. One cleft palate defect was directly visualized by 3D surface rendering. No false‐positives occurred.ConclusionInteractive review of standardized 3D multiplanar images allows one to evaluate labial defects, abnormalities of the maxillary tooth‐bearing alveolar ridge, and presence of premaxillary protrusion for detecting cleft lip and palate anomalies. Surface rendering may increase diagnostic confidence for normal or abnormal studies. This technology provides an array of visualization tools that may improve the prenatal characterization of facial clefts, particularly of the palate. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Three‐dimensional multiplanar transvaginal ultrasound of the cervix in pregnancy
Authors: Bega G. , Lev‐Toaff A. , Kuhlman K. , Berghella V. , Parker L. , Goldberg B. , Wapner R. 
Published: March 2003

AbstractObjectivesTo develop a standard technique for using three‐dimensional ultrasound (3D US) to study and evaluate the cervix in pregnant women at high risk for premature delivery, comparing the findings on 3D US with those on conventional two‐dimensional ultrasound (2D US).Study DesignTwenty‐one pregnant women at high risk for premature delivery had a total of 37 transvaginal 2D and 3D US examinations of the cervix between 11 and 32 weeks' gestation. A 3D US vaginal probe (5.0–8.0 MHz, Voluson 530D, Medison, Pleasanton, CA, USA) was used. Measurements made from the 2D and 3D US were compared.ResultsOf the 37 cervical length measurements in 3D US sagittal plane, seven were shorter and three were longer than on 2D US (varying by 5–15 mm) indicating that the true mid‐sagittal plane was not obtained in ten (27%) of the 37 2D US examinations. Of 21 examinations showing funneling, funneling was seen on both 2D and 3D US in 15, but was seen only on 3D US in six. There was a significant (P < 0.05) difference between funnel width as measured in the coronal 3D plane versus 2D US, as well as between funnel width in the coronal 3D US plane versus sagittal 3D US plane (P < 0.05). The cerclage was seen in its entirety in nine of 10 examinations; the 3D US axial plane was most valuable for imaging the cerclage.Conclusions3D US appears to offer a more complete assessment of the cervix than 2D US. Multiplanar correlation shows that the standard 2D US sagittal view may under‐ or over‐estimate cervical length. Our preliminary data suggest that 3D US has the potential to improve our understanding of cervical morphology. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Characterization and natural history of ventricular septal defects in the fetus
Authors: Paladini D. , Palmieri S. , Lamberti A. , Teodoro A. , Martinelli P. , Nappi C. 
Published: March 2003

AbstractObjectiveTo characterize and describe the evolution of ventricular septal defects (VSD) from intra‐uterine diagnosis to infancy in a population of fetuses with isolated defects.MethodsSixty‐eight fetuses with isolated VSD represented the study population. Of these, 28 underwent termination of pregnancy, 14 died in utero or after birth and 26 reached 1 year of age. In this population, the following variables were evaluated: presence of extra‐cardiac or chromosomal anomalies, site and size of the defect, pregnancy outcome. These variables were assessed against closure of the VSD up to 1 year of age. Necropsies were available for all fetuses following termination of pregnancy. All surviving neonates were followed up directly or by telephone until documented echocardiographic closure of the defect or until 1 year of age.ResultsThere was a significant correlation between type of VSD and type of aneuploidy (P < 0.001). A total of 26 surviving fetuses reached 1 year of age: 46.1% (n = 12) of all defects closed in utero, 23.1% (n = 6) closed during the first year of life and 30.8% (n = 8) remained patent. Only three (15.8%) of the 19 VSDs < 3 mm remained patent in comparison with five (71.4%) of the seven defects > 3 mm (P < 0.05). None of the malalignment VSDs closed, in comparison to 69% of the peri‐membranous and 60% of the muscular defects.ConclusionVentricular septal defect can undergo spontaneous closure during intra‐uterine life and this process depends upon the site and the size of the defect. These data may provide useful additional information to aid prenatal counseling. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasound assessment of the endometrium in healthy, asymptomatic early post‐menopausal women: saline infusion sonohysterography versus transvaginal ultrasound
Authors: Neele S. J. M. , Marchien Van Baal W. , Van Der Mooren M. J. , Kessel H. , Coen Netelenbos J. , Kenemans P. 
Published: March 2003

AbstractObjectiveTo exclude pre‐existing endometrial pathology in asymptomatic early post‐menopausal women before starting hormone replacement therapy by transvaginal ultrasound (TVS) and saline infusion sonohysterography (SIS).MethodsIn a cross‐sectional study, 148 healthy women (mean age, 51.1 years; range, 46–59 years) underwent ultrasound evaluation of the endometrium before participation in a clinical trial. TVS was used to measure double‐layer endometrial thickness. SIS was performed at the same visit to measure anterior and posterior single‐layer endometrial thickness, and to identify endometrial abnormalities when present. Ultrasound results were defined as informative if the endometrium could be adequately visualized. Findings on TVSs were defined as abnormal if a double‐layer endometrial measurement >5.0 mm was obtained. Findings on SIS were defined as abnormal if one or both single layers of the endometrium measured >2.5 mm, or if focal endometrial thickening or a polyp was present.ResultsOf the 148 eligible women, informative TVS results were obtained from 134 women, SIS results from 133 women and both procedures combined from 119 women. TVS scans gave abnormal results in 8.2% of women (11 of 134) and SIS gave abnormal results in 36.8% of women (49 of 133). Of the 14 women with a non‐informative TVS, eight had abnormal SIS results. Of the 15 women with a non‐informative SIS, three had abnormal TVS results. In the 119 women with both informative TVS and SIS, abnormal TVS scans were found in 6.7% of women (eight of 119) and abnormal SIS in 34.5% of women (41 of 119). All eight women with abnormal TVS had an abnormal SIS, whereas 29.7% (33 of 111) of the women with a normal TVS had an abnormal SIS.ConclusionsUltrasound evaluation demonstrated endometrial abnormalities in 34.5% (41 of 119) of asymptomatic post‐menopausal women. SIS is more accurate than TVS in the detection of endometrial abnormalities. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Reverse flow in the umbilical vein in a case of trisomy 9
Authors: Murta C. , Moron A. , Ávila M. , França L. , Vargas P. 
Published: March 2003

AbstractThis report describes a case of reverse flow in the umbilical vein and ductus venosus during atrial contraction of a fetus at 12 weeks of gestation with increased nuchal translucency (9.1 mm). In addition, Doppler velocimetry detected high retrograde flow in the inferior vena cava. Cytogenetic analysis of chorionic villi revealed trisomy 9. We suggest that these findings may be a first trimester sign of chromosomal and cardiac abnormalities in the fetus. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Isolated echogenic foci in the fetal heart as marker of chromosomal abnormality
Authors: Huggon I. C. , Cook A. C. , Simpson J. M. , Smeeton N. C. , Sharland G. K. 
Published: March 2003

AbstractObjectiveTo assess the effect of echogenic foci in the fetal heart on the risk for Down's syndrome.DesignProspective evaluation of fetal echocardiograms at a fetal cardiology referral center and systematic postnatal follow‐up. A relative risk was calculated from the prevalence of echogenic foci in fetuses subsequently demonstrated to have trisomy 21 divided by that in normal fetuses. For a subgroup of 548 fetuses with echogenic foci but otherwise normal detailed anomaly scans, the expected number of trisomy 21 fetuses calculated from maternal age risks was compared with the observed number to derive a relative risk for isolated echogenic foci.ResultsEchogenic foci occurred in 905 of 6904 fetuses scanned, but after excluding those referred specifically because of an echogenic focus and those with heart defects, the incidence was 9.5%. Overall, echogenic foci were more frequent in fetuses with trisomy 21 than those without by a factor of 2.93. For the 548 fetuses with echogenic foci but otherwise normal detailed anomaly scans, the actual number of trisomy 21 fetuses exceeded that expected on the basis of maternal age risks by a factor of 5.54. Combination with data from several previous studies suggests a consensus relative risk of about 3.0.ConclusionsEchogenic foci are associated with increased risk of trisomy 21 even when present as an isolated finding. Their significance in an individual should be interpreted in the light of prior risk assessment based on maternal age and results of any first‐trimester screening tests. We suggest that the prior risk is increased by a factor of 3.0. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology