bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal outcome in pregnancies defined as post‐term according to the last menstrual period estimate, but not according to the ultrasound estimate
Authors: Tunón K. , Eik‐Nes S. H. , Grøttum P. 
Published: March 2003

AbstractObjectiveTo study the risk of adverse fetal outcome in fetuses that were post‐term according to the last menstrual period estimate but not according to the ultrasound estimate.DesignA total of 11 510 women with singleton pregnancies, reliable last menstrual period and delivery after 37 weeks were divided into four groups: women who delivered at term, i.e. within 259–295 days according to both the ultrasound and the last menstrual period estimate; women who delivered post‐term according to the last menstrual period estimate but not according to the ultrasound estimate; women who delivered post‐term according to the ultrasound estimate but not according to the last menstrual period estimate; and women who delivered post‐term according to both the ultrasound and the last menstrual period estimates. Stepwise logistic regression was used to test whether the risk of Apgar score of < 7 after 5 min and transfer to the neonatal intensive care unit increased in any of the post‐term groups.ResultsThere was no significant difference in mortality between the term group and the three study groups. There was no significant increase in the risk for Apgar score of < 7 after 5 min or transfer to the neonatal intensive care unit for pregnancies that were defined as post‐term according to the last menstrual period estimate but not according to the ultrasound estimate. There was, however, an increased risk for Apgar score of < 7 after 5 min in the group that was post‐term according to the ultrasound estimate but not according to the last menstrual period estimate. There was also an increased risk for transfer to the neonatal intensive care unit in the group that was post‐term according to both estimates.ConclusionThe effect of ultrasound in changing the estimated day of delivery to a later date leading to pregnancies becoming post‐term according to the last menstrual period estimate but not according to the ultrasound estimate does not have any adverse consequences for the fetal outcome. However, there seems to be an increased risk for adverse consequences for pregnancies that are post‐term according to the ultrasound estimate. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Fetal peripheral bronchial fluid flow during breathing movement in normal pregnancies: a preliminary study
Authors: Nakai Y. , Nishio J. , Mine M. , Imanaka M. , Ogita S. 
Published: March 2003

AbstractObjectiveTo determine the fluid flow velocity waveforms in the fetal peripheral bronchus during fetal breathing movement by means of pulsed Doppler ultrasonography.DesignA preliminary cross‐sectional study.SubjectsTwenty‐eight normal pregnant women between 32 and 38 weeks of gestation.MethodsVelocity waveforms from fetal peripheral respiratory fluid flow were acquired from the segmental bronchus (B6 or B8) which runs along the segmental artery (A6 or A8). The maximum velocity of the intrabronchial fluid flow and duration of inspiratory and expiratory phases were quantified.ResultsThe flow velocity signal from the fluid in the fetal segmental bronchus of 17 of the 28 fetuses was detected. We observed two types of fetal breathing movement.ConclusionDuring fetal breathing movement, the fluid in the fetal respiratory tract moves in the fetal segmental bronchus. This movement can be detected by pulsed Doppler velocimetry aided by power Doppler ultrasonography. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
On‐to‐on versus on‐to‐out nuchal translucency measurements
Authors: Herman A. , Dreazen E. , Samandarov A. , Bukovsky Y. , Weinraub Z. , Maymon R. 
Published: March 2003

Objective To analyze variables affecting the differences between on‐to‐on and on‐to‐out methods of nuchal translucency measurement.
Design Prospective comparison of two methods of caliper placement.
Subjects A total of 245 women undergoing transabdominal and 37 women undergoing transvaginal nuchal translucency scanning.
Methods Nuchal translucency was measured using both on‐to‐on and on‐to‐out methods of caliper placement on the same frozen images. Differences between the methods were evaluated according to fetal size, nuchal thickness and mode of examination. Regression analysis was performed for the calculation of the expected difference between the methods at various combinations. Results among 1254 singleton pregnancies were used to set 50th, 95th and 97.5th centiles for the on‐to‐on method. The calculated differences were used to set 50th, 95th and 97.5th centiles for the on‐to‐out method.
Results The mean difference between on‐to‐out and on‐to‐on nuchal translucency, using transabdominal scanning, was 0.95 ± 0.14 mm. The differences were shown to correlate directly with fetal size and with nuchal thickness. In addition, scans performed transvaginally exhibited a smaller difference between the methods (0.90 mm vs. 0.94 mm; P < 0.05).
Conclusion The difference between on‐to‐on and on‐to‐out nuchal translucency measurements may have a considerable effect on the calculated risk for aneuploidy.
Klippel–Trenaunay–Weber syndrome presenting as massive lymphangiohemangioma of the thigh: prenatal diagnosis
Authors: Gonçalves L. F. , Muñoz Rojas M. V. , Vitorello D. , Ternes Pereira E. , Pereima M. , Saab Neto J. A. 
Published: March 2003

AbstractWe report a case of Klippel–Trenaunay–Weber syndrome presenting prenatally as a massive congenital lymphangiohemangioma of the thigh. Routine ultrasonographic examination revealed multiple distorted cystic areas extending from the right flank through the right lower extremity of a 30‐week fetus. A diagnosis of cystic lymphangioma of the thigh was suspected prenatally. Neonatal evaluation confirmed the prenatal findings. Neonatal color Doppler imaging revealed blood vessels within the tumor. The differential diagnosis is discussed together with available therapeutic procedures. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Fetal cerebral blood flow redistribution in late gestation: identification of compromise in small fetuses with normal umbilical artery Doppler
Authors: Hershkovitz R. , Kingdom J.C.P. , Geary M. , Rodeck C.H. 
Published: March 2003

Objective To evaluate the role of middle cerebral artery Doppler in small fetuses during the late third trimester.Design Prospective observational study of structurally normal fetuses with an estimated fetal weight < 5th percentile for gestation. Perinatal outcome was determined using a structured datasheet sent to each referring obstetrician.Subjects Structurally normal fetuses at 35 or more weeks of gestation referred during a 2‐year period to the fetal growth clinic of a regional fetal medicine unit in North London. Fetuses with aneuploidy and/or major structural abnormalities were excluded.Methods Umbilical artery and middle cerebral artery (MCA) Doppler waveforms were recorded and considered abnormal if above 95th or below 5th percentiles, respectively. Amniotic fluid was considered reduced if the maximum vertical cord‐free pool was < 2 cm. The placenta was considered mature if the Grannum grade was II or III. The head circumference (HC)/abdominal circumference (AC) ratio was considered abnormal if > 95th percentile for gestation. Fetal growth, amniotic fluid, biophysical profile score and umbilical artery Doppler were used to advise the referring obstetrician about fetal well‐being and he/she independently decided both the timing and mode of delivery.Results Forty‐seven fetuses fulfilled the entry criteria. Thirty‐four (72%) demonstrated normal umbilical artery Doppler waveforms. Sixteen (34%) demonstrated middle cerebral artery redistribution, of which nine (56%) had normal umbilical artery Doppler waveforms. MCA blood flow redistribution was associated with an increased incidence of cesarean delivery and need for neonatal admission. Of all gray‐scale parameters, an elevated HC/AC ratio has the strongest association with MCA blood flow redistribution (15/16 vs. 1/31; P < 0.01).Conclusions MCA Doppler may be a useful tool to assess the health of small fetuses in the late third trimester. Redistribution may occur in the presence of normal umbilical artery Doppler and should be suspected when the HC/AC ratio is elevated.
Prediction of preterm birth by second trimester cervical sonography in twin pregnancies
Authors: Yang J.H. , Kuhlman K. , Daly S. , Berghella V. 
Published: March 2003

AbstractObjectivesTo determine the predictive value of sonographic cervical length and of funneling for spontaneous preterm delivery (PTD) in twin pregnancies under 26 weeks' gestation.MethodsWomen with twin pregnancies were studied prospectively with transvaginal or translabial ultrasound of the cervix from 18 to 26 weeks' gestation. Exclusion criteria were: signs of preterm labor, prophylactic cervical cerclage, placenta previa, or severe congenital fetal anomaly. The primary outcome was spontaneous preterm birth at < 35 weeks' gestation.ResultsSixty‐five twin pregnancies were analyzed, of which 23% (15/65) delivered preterm. Cervical ultrasound examination was performed by 22 weeks' gestation in 75% and by 24 weeks' gestation in 91% of women. Cervical length ≤ 25 mm and ≤ 30 mm was associated with sensitivities of 27% and 53%, respectively, and with 67% and 62% rates of PTD, respectively (R.R. 4.6, C.I. 2.0–10.3 and R.R. 3.6, C.I. 1.6–7.8, respectively). A cervical length > 35 mm was associated with only a 4% rate of PTD (R.R 0.13; C.I. 0.02–0.93). Of 10 women (15%) with any cervical funneling, 70% delivered preterm, all under 32 weeks' gestation. By logistic regression analysis, both short cervix ≤ 30 mm and any funneling were strongly predictive of PTD.ConclusionsBoth cervical length ≤ 30 mm and cervical funneling in twin pregnancies under 26 weeks' gestation are independently and strongly associated with high risk for preterm birth. A long cervix, of length > 35 mm, is associated with very low risk (4%) for preterm birth. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Intra‐ and interoperator repeatability of the nuchal translucency measurement
Authors: Pajkrt E. , Mol B.W.J. , Boer K. , Drogtrop A.P. , Bossuyt P.M.M. , Bilardo C.M. 
Published: March 2003

AbstractObjectiveThe aim of this study was to assess the repeatability of nuchal translucency measurement by well‐trained sonographers either experienced or inexperienced with the measurement.MethodsThe nuchal translucency was measured three times by two out of nine operators in 161 pregnant women attending two teaching hospitals. Intra‐operator and inter‐operator variation was assessed by calculating the standard deviation (SD). Intraclass Correlation Coefficients (ICC) with a 95% lower confidence limit (95% CL) were calculated for each operator and for pairs of operators. Intra‐and inter‐operator kappa statistics were calculated, after dichotomising the results into a nuchal translucency smaller or larger than 3 mm.ResultsThe SD of intra‐operator difference was 0.35 mm. The intra‐operator repeatability showed ICCs varying from 0.83 to 0.95 for the experienced operators and from 0.47 to 0.83 for the inexperienced. The SD of inter‐operator differences was 0.56 mm, 0.46 mm and 0.44 mm, based on one, two and three measurements, respectively. The inter‐operator repeatability showed a variation in ICC from 0.74 to 0.95 in pairs of experienced sonographers to 0.51 in one pair inexperienced with the measurement. The kappa value expressing the intra and inter‐operator repeatability as being > 3 mm or < 3 mm was 0.88 and 0.85, respectively.ConclusionThis study supports the finding that the nuchal translucency measurement is reproducible, as long as it is performed by sonographers well trained in the technique of this measurement. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Trisomy 21: 91% detection rate using second‐trimester ultrasound markers
Authors: DeVore G. R. 
Published: March 2003

AbstractObjectivesTo examine cardiovascular and non‐cardiovascular prenatal ultrasound markers and determine which markers physicians of varying skill levels could use to identify fetuses with trisomy 21.MethodsEighty second‐trimester fetuses with trisomy 21 and 2000 controls underwent real‐time plus color Doppler examination of cardiovascular and non‐cardiovascular systems followed by amniocentesis. Non‐cardiac markers were central nervous system malformations (CNS); choroid plexus cysts (CPC); abnormal nuchal skin fold (NSF); hyperechoic bowel (HB); and pyelectasis (PY). Cardiac markers consisted of ventricular septal defect, right‐to‐left chamber disproportion (RL); tricuspid regurgitation; mitral regurgitation (MR); pericardial effusion; and outflow tract abnormalities (OFT). Multinomial logistic regression was used to identify interactivity between the markers. Logistic regression was utilized to identify which combinations of markers significantly contributed to the identification of fetuses with trisomy 21 and to compute the likelihood ratio.ResultsAll but three markers (CPC, MR, OFT) contributed significantly to the identification of 91% of fetuses with trisomy 21 with a false‐positive rate of 14%. When only non‐cardiovascular markers were examined, all but CPC contributed to the identification of 60% of fetuses with trisomy 21 with a false‐positive rate of 5.9%. Combining right‐to‐left chamber disproportion with CNS, NSF, HB and PY identified 75% of fetuses with trisomy 21 with a false‐positive rate of 6.4%. All markers were independent predictors of trisomy 21 except RL and NSF.ConclusionUltrasound can detect between 60 and 91% of fetuses with trisomy 21 depending upon which markers are selected for evaluation. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
First trimester diagnosis of monoamniotic twin pregnancies
Authors: Sebire N. J. , Souka A. , Skentou H. , Geerts L. , Nicolaides K. H. 
Published: March 2003

AbstractThis study reports the ultrasound findings and pregnancy outcome for a series of monoamniotic twin pregnancies diagnosed at 11–14 weeks' gestation. Of 315 monochorionic twin pregnancies examined, there were 12 (3.8%) monoamniotic, including four sets of conjoined twins (1.3%). The parents opted for termination of pregnancy in all cases of conjoined twins. In four other cases, there was discordancy for major structural fetal abnormality (kyphoscoliosis, anencephaly, body stalk defect, diaphragmatic hernia), and the co‒twin was structurally normal. In the four cases in which both twins were structurally normal, ultrasound examination demonstrated normal nuchal translucency thickness in all cases but cord entanglement was demonstrated from the first trimester. Two cases were managed expectantly; one resulted in livebirth of both twins at 31 weeks' gestation and the second in intrauterine death of both fetuses at 21 weeks. Two pregnancies were treated with Sulindac; one resulted in a single intrauterine death at 30 weeks and delivery of a normal co‒twin, the other, in intrauterine death of both fetuses at 31 weeks'. Monoamniotic twin pregnancies are associated with a high risk of fetal abnormalities and perinatal death and the mortality rate is higher than previously reported from series with recruitment later in gestation. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Limb reduction defects as the sonographic manifestation of hemoglobin Bart's disease at 10 weeks of gestation
Authors: Lam Y.H. , Tang M.H.Y. 
Published: March 2003

AbstractFetuses affected by hemoglobin Bart's disease are anemic and hypoxic from the first trimester. They develop cardiac and placental enlargement and have a high incidence of limb reduction defects and hypospadias. We present a fetus at risk for hemoglobin Bart's disease with multiple limb reduction defects detected at 10 weeks of gestation, which allowed a strong presumptive diagnosis of hemoglobin Bart's disease to be made at the time of ultrasound examination. The limb defects were verified by direct visualization via needle embryoscopy. The present case suggests that sonographic identification of limb reduction defects may be a specific marker of hemoglobin Bart's disease at 10 weeks. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Deriving a local normal range for nuchal translucency measurement: implications for practice
Authors: Mulvey S. F. , Thirunavukarasu P. , Shekleton P. , Oldham J. , Edwards A. , Wallace E. M. 
Published: March 2003

Purpose:  To derive a local normal range for nuchal translucency (NT) measurement, including exploring possible variations with ethnicity and to compare this with a normal range widely used internationally.Methods:  All data were recorded as part of an ongoing prospective study (the FaST Study) of first and second trimester Down syndrome screening methods. NT was measured at 11–14 weeks of gestation according to Fetal Medicine Foundation guidelines. The relationship between the largest NT and gestation (CRL) was modelled using a line of best fit applied to a logarithmic transformation of NT. The best fitting equation modelling a linear relationship between NT and gestation: log10(NT) = −0.2844 + 0.006 441CRL. This equation was derived from Caucasian women only. Ethnic comparisons were derived for Vietnamese, Cambodian, Chinese and Indian women by dividing the measured NT value by the expected NT value using the preceding equation. Median NTs from each ethnic group was then calculated and between group differences analyzed using Mann–Whitney U‐test. Significance was accorded if P < 0.05. The local normal range for NT was also compared with published data from the Fetal Medicine Foundation, UK which forms the basis of widely used risk calculation software.Results:  The median NT MoMs for Caucasian, Vietnamese, Cambodian, Chinese and Indian women were 1.0, 1.04, 1.08, 1.1 and 0.99, respectively. The median NT measurements were significantly higher in Vietnamese, Cambodian and Chinese women when compared with median NT measurements in Caucasian women (P = 0.0019, 0.0005 and <0.0001, respectively). At all gestations, the expected NT in our population was approximately 20% less than that reported by the Fetal Medicine Foundation.Conclusions:  The significantly higher NT measurements in South‐East Asian women suggest that correction for ethnicity would optimize screening performance in this group. Furthermore, all centers should ensure that the NT normal range used to calculate risks is appropriate for their population.Acknowledgements:  The FaST Study is a collaborative research project funded by the Department of Human Services, Victoria Government and Monash University.
Influence of acupuncture on Doppler ultrasound in pregnant women
Authors: Zeisler H. , Eppel W. , Husslein P. , Bernaschek G. , Deutinger J. 
Published: March 2003

AbstractObjectiveTo evaluate the influence of acupuncture on the blood flow in the umbilical artery (UA), fetal aorta and uterine artery and on the fetal heart rate using two different acupuncture points (SP‐6 (Sanyinjiao) and LI‐4 (Hegu)).MethodsIn group A (n = 50), measurements (Doppler ultrasound and fetal heart rate) were performed at term after an uneventful pregnancy (#1) followed by acupuncture treatment using the acupuncture‐point SP‐6 bilaterally. The treatment time lasted 15 min after which the next measurement (#2) was carried out. The needles were then inserted into the LI‐4 acupuncture point for a further 15 min. A third measurement at the end of acupuncture treatment (#3) completed the session. In group B (n = 25), measurements were made before (#1) and after (#4) acupuncture at LI‐4 acupuncture points only.ResultsIn group A, the mean systolic/diastolic (S/D) ratios of UA #1, UA #2 and UA #3 were 2.45, 2.38 and 2.22, respectively (P = 0.0012). The difference in mean S/D ratios between UA #1 and UA #3 as well as that between UA #2 and UA#3 were statistically significant (P = 0.0002 and P = 0.008, respectively). There was no difference between the mean S/D ratios of the uterine artery and between the mean resistance indices of the fetal aorta. In group B, the only significant difference between measurements following acupuncture treatment was in fetal heart rate (139 vs. 143 bpm, P = 0.02).ConclusionOur study indicates a positive influence of acupuncture treatment on umbilical artery waveforms when using a combination of SP‐6 (Sanyinjiao) and LI‐4 (Hegu) acupuncture points. Acupuncture performed at these sites either individually or in combination does not seem to affect blood flow in the fetal aorta or uterine artery. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Antenatal diagnosis of fetal intra‐abdominal umbilical vein dilatation
Authors: Prefumo F. , Thilaganathan B. , Tekay A. 
Published: March 2003

AbstractDilatation of the intra‐abdominal portion of the fetal umbilical vein is a rare abnormality. We describe here a new case diagnosed at 31 weeks of gestation and discuss the clinical features and management of this abnormality. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Perinatal diagnosis of cardiac tumors
Authors: Geipel A. , Krapp M. , Germer U. , Becker R. , Gembruch U. 
Published: March 2003

AbstractObjectiveAs fetal cardiac tumors are a rare condition, we report the perinatal diagnosis and ultrasound findings of 12 cases.MethodsIn 10 cases the tumors were identified prenatally by fetal echocardiography; gestational age at detection ranged from 22 to 34 weeks. In two symptomatic infants cardiac tumors were diagnosed on the first day postpartum; prenatal ultrasound evaluation at 26 and 38 weeks of gestation did not reveal a cardiac lesion.ResultsSix fetuses had singular tumors, in six fetuses they were multifocal. The left ventricle was most often affected. Termination of pregnancy was chosen in three cases, one in association with trisomy 21 and tuberous sclerosis. One intrauterine and three neonatal deaths due to cardiac failure occurred. Histopathologic examination revealed cardiac rhabdomyoma in six fetuses and fibroma in one case. In the five surviving fetuses the size of the tumors spontaneously decreased postpartum. Rhabdomyomata were associated with tuberous sclerosis in four out of 11 cases.ConclusionCardiac tumors are detectable as early as 22 weeks of gestation. Presenting symptoms may be arrhythmia, dysfunction of the atrioventricular valves, pericardial effusion and fetal hydrops. The most common perinatal diagnosis is rhabdomyoma, which is often associated with tuberous sclerosis. Sequential examination in high risk patients should be considered as most tumors increase in size during pregnancy and may become evident in late second and third trimester of pregnancy. Postpartum, however, regression of tumor size is common. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology