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Ultrasound in Obstetrics & Gynecology

Florian Prayer, Martin Metzelder, Wilfried Krois, Peter C Brugger, Gerlinde M Gruber, Michael Weber, Anke Scharrer, Alexander Rokitansky, Georg Langs, Daniela Prayer, Ewald Unger, Gregor Kasprian
OBJECTIVES: To assess the clinical feasibility and validity of fetal MRI-based 3D reconstructions to localize, classify, and quantify diaphragmatic defects in congenital diaphragmatic hernia (CDH). METHODS: Manual segmentation of the diaphragm based on 65 in vivo and four postmortem fetal MRI scans of 46 CDH cases (gestational age 16 - 38 gestational weeks (GW)) was performed using SSFP, T2-weighted, and T1-weighted sequences and ITK-Snap. The resultant 3D models of the fetal diaphragm and its defect(s) were validated by postmortem MRI segmentation in four cases and/or comparison to a reference classification based on autopsy and surgery reports...
April 15, 2019: Ultrasound in Obstetrics & Gynecology
R Townsend, J M N Duffy, A Khalil
Once awarded Archie Cochrane's infamous 'wooden spoon' for the limited application of randomised controlled trial evidence to questions of clinical practice, obstetricians were inspired to action and ultimately became leaders in the development of evidence based medicine.(1) This article is protected by copyright. All rights reserved.
April 13, 2019: Ultrasound in Obstetrics & Gynecology
Jaroslaw Beta, Wei Zhang, Samar Geris, Vira Kostiv, Ranjit Akolekar
OBJECTIVE: The objective of our study was to estimate the procedure-related risks of miscarriage following CVS and amniocentesis in a large unselected screened and to determine whether these risks are consistent with those reported in systematic reviews and meta-analysis. METHODS: This was a retrospective cohort study undertaken at a large Fetal Medicine Unit in the United Kingdom during the period of January 2009 to May 2018. We included all singleton pregnancies that booked at our unit before 20 weeks after excluding those with multiple pregnancies, major fetal defects, terminations and lost to follow-up...
April 12, 2019: Ultrasound in Obstetrics & Gynecology
Ray Bahado-Singh, Sangeetha Vishweswaraiah, Nitish Kumar Mishra, Chittibabu Guda, Uppala Radhakrishna
OBJECTIVES: To determine whether the methylation level of cytosine nucleotides in placental DNA can be used to predict Tetralogy of Fallot (TOF) and provide insights into its mechanism of development. METHODS: The Illumina HumanMethylation450 BeadChips assay was used to measure cytosine ('CpG' or 'cg') methylation (i.e. the addition 'methyl group') levels at loci throughout the placental genome. Area under the ROC curve (AUC) and 95% CI was calculated for TOF detection for CpG loci with significant methylation changes in TOF...
April 12, 2019: Ultrasound in Obstetrics & Gynecology
Jennifer Goldkamp, Laura Vricella, Dorothea Mostello, Tracy Tomlinson
OBJECTIVE: To evaluate the impact of an immediate ultrasound feedback intervention on trainee accuracy in vaginal examination-based assessment of fetal head position. METHODS: This was a prospective cohort study conducted at a single tertiary care center. Six third year and six fourth year residents were the study subjects. The third-year residents underwent a training intervention in which fetal head position was first assessed by resident transvaginal digital exam, then by ultrasound...
April 11, 2019: Ultrasound in Obstetrics & Gynecology
Lin Li, Zhiming He, Xuan Huang, Shaobin Lin, Jianzhu Wu, Linhuan Huang, Ye Wang, Qun Fang
OBJECTIVE: To evaluate the incidence and types of chromosomal abnormalities in twins with structural anomalies and compare the characteristics among twins with different chorionicities and amnionicities. The added value of chromosomal microarray analysis (CMA) over conventional karyotyping in these twins was also estimated. METHOD: A single-center, retrospective analysis was performed over an eleven-year period on 534 twin pregnancies in which one or both fetuses had congenital structural anomalies...
April 11, 2019: Ultrasound in Obstetrics & Gynecology
Artur Ludwin, Inga Ludwin, Marcela A Coelho Neto, Carolina O Nastri, Bala Bhagavath, Steven R Lindheim, Wellington P Martins
OBJECTIVE: To estimate the differences in frequency of septate uterus diagnosis and the association with infertility and previous miscarriage using three different criteria. METHODS: Secondary data-driven analysis of data from prospective study was performed based on data-set of 261 consecutive women of reproductive age from daily clinical practice in private clinic focused on diagnosis and treatment of congenital uterine malformations. Re-analysis of datasets was performed using following definitions of septate uterus: ASRM-2016, ESHRE/ESGE-2016, and CUME-2018 (Congenital Uterine Malformation by Experts)...
April 11, 2019: Ultrasound in Obstetrics & Gynecology
Fred Ushakov, Adalina Sacco, Elena Andreeva, Stefania Tudorache, Thomas Everett, Anna L David, Pranav P Pandya
OBJECTIVES: To describe a new first trimester sonographic sign associated with open fetal spina bifida ("crash sign") where there is posterior displacement and deformation of the mesencephalon against the occipital bone in the axial view, and to evaluate its clinical usefulness in the first trimester diagnosis of spina bifida. METHODS: This was a retrospective review of patients referred to three fetal medicine centres in the first trimester (11-13+6 weeks) with suspected spina bifida...
April 11, 2019: Ultrasound in Obstetrics & Gynecology
Slavyana Galeva, María Del Mar Gil, Liountmila Konstantinidou, Ranjit Akolekar, Kypros H Nicolaides
OBJECTIVES: To examine factors affecting the failure rate to obtain a result from (cf) DNA testing of maternal blood for fetal trisomies 21, 18 and 13 in singleton and twin pregnancies in the first trimester of pregnancy. METHODS: This was a prospective study in 23,495 singleton and 928 twin pregnancies undergoing screening for fetal trisomies by targeted cfDNA testing at 10+0 -14+1 weeks' gestation. Multivariate regression analysis was used to determine significant predictors of failure to obtain a result after first sampling...
April 11, 2019: Ultrasound in Obstetrics & Gynecology
Ahmed A Nassr, Alireza A Shamshirsaz, Hadi Erfani, Jimmy Espinoza, Magdalena Sanz Cortes, Chester J Koh, David R Roth, Joseph R Angelo, George T Mandy, Michael C Braun, Rodrigo Ruano, Michael A Belfort
OBJECTIVE: Congenital lower urinary tract obstruction (LUTO) is a rare condition with high perinatal mortality and morbidity when associated with severe oligohydramnios or anhydramnios in the second trimester of pregnancy. Severe pulmonary hypoplasia and end-stage renal disease are the underlying causes of poor neonatal outcomes in these cases. However, little is known about the subset of fetal LUTO with a normal amount of amniotic fluid at mid-gestation. The objectives of the current study were to describe the natural history, underlying causes, survival and postnatal renal function outcomes of LUTO with normal amniotic fluid volume during the second trimester of pregnancy...
April 11, 2019: Ultrasound in Obstetrics & Gynecology
Stefano Guerriero, Silvia Ajossa, M Angela Pascual, Ignacio Rodriguez, Alba Piras, Maura Perniciano, Luca Saba, Anna Maria Paoletti, Valerio Mais, Juan Luis Alcazar
OBJECTIVES: Due to the reported high sensitivity and specificity of ultrasound in the detection rate of rectosigmoid (RS) endometriosis when performed by an ultrasonographic (US) expert, this test should be considered a gold standard comparable to laparoscopy. No information is available regarding US soft markers in this disease. The aim of this study was to evaluate the use of US soft markers as "first level" examination in the suspicion of RS endometriosis. METHODS: We included in this prospective study all patients with clinical suspicion of deep endometriosis submitted to ultrasonographic evaluation in our academic center for ultrasonographic diagnosis of endometriosis at the Academic Department of Obstetrics and Gynecology, University of Cagliari, Policlinico Universitario Duilio Casula, Monserrato, Cagliari, Italy from January 2016 to February 2017...
April 11, 2019: Ultrasound in Obstetrics & Gynecology
Ilan E Timor-Tritsch, Christine E Foley, Caroline Brandon, Esther Yoon, Jeannine Ciaffarrano, Ana Monteagudo, Kushbakhat Mittal, Leslie Boyd
OBJECTIVE: Accurate diagnosis of borderline ovarian tumors (BOTs) is important to ensure timely and appropriate management, especially in women desiring to preserve fertility. Transvaginal ultrasound (TVUS) is considered the best modality to diagnose adnexal tumors. Sonographic features of BOTs described in the literature include septa, solid components, mural nodules (papillae) and blood vessels within these structures. However, there is no single signature that differentiates BOTs from other adnexal masses...
April 4, 2019: Ultrasound in Obstetrics & Gynecology
Erdogan Nohuz, Olivier Rivière, Karen Coste, Françoise Vendittelli
OBJECTIVE: To assess whether prenatal identification of small-for-gestational-age (SGA) fetuses would reduce the rates of the primary composite outcome of 'stillbirths and neonatal complications', and secondary outcomes of stillbirth and low 5-min Apgar score. METHODS: This historical cohort study was conducted with women who had singleton delivery (≥ 32 weeks), in 247 French maternity units. Medical terminations of pregnancy, infants with malformations, and women with missing delivery data were excluded...
April 4, 2019: Ultrasound in Obstetrics & Gynecology
Jaroslaw Beta, Naila Khan, Ahmed Khalil, Magdalena Fiolna, Ghada Ramadan, Ranjit Akolekar
OBJECTIVES: To determine accurate estimates of maternal and neonatal risks of fetal macrosomia by undertaking a systematic review and meta-analysis METHODS: A search of MEDLINE, EMBASE, CINHAL and The Cochrane Library was performed to review relevant citations reporting maternal and neonatal complications of pregnancies with macrosomia with birthweight (BW) >4,000g and >4,500g. We selected prospective and retrospective cohort and population studies that provided data regarding both, cases and controls...
April 2, 2019: Ultrasound in Obstetrics & Gynecology
Jaroslaw Beta, Naila Khan, Magdalena Fiolna, Ahmed Khalil, Ghada Ramadan, Ranjit Akolekar
OBJECTIVE: To estimate risks of maternal and neonatal complications in pregnancies with macrosomia. METHOD: This was a retrospective cohort study undertaken at a large maternity unit in United Kingdom between January 2009-December 2016. We compared the incidence of complications in pregnancies with macrosomia, defined by birthweight (BW)>4,000 g and severe macrosomia with BW>4,500 g, to those in pregnancies with normal BW 2,500-4,000 g. Regression analysis was undertaken to determine odds ratios (OR) [95% confidence interval (CI)] for pregnancy complications in macrosomic compared to normal BW group...
April 2, 2019: Ultrasound in Obstetrics & Gynecology
Maria Schøler Nørgaard, Ritu Mogra, Jason Pinner, Karl Oliver Kagan, Mette Warming Jørgensen, Vibike Gjørup, Olav Bjørn Petersen, Puk Sandager, Ida Vogel
This is a description of similar prenatal ultrasound findings in five cases of fetal Costello syndrome from 3 countries. We suggest that Costello syndrome (CS) may be recognizable prenatally, is more prevalent in utero than previously described, and that cases diagnosed prenatally have a more severe phenotype and a high risk of intrauterine death compared with cases diagnosed postnatally. This article is protected by copyright. All rights reserved.
April 2, 2019: Ultrasound in Obstetrics & Gynecology
Chris Abousleiman, Aurore Lismonde, Jacques C Jani
The high performance of cell-free DNA (cfDNA) analysis of maternal blood in screening for trisomies 21, 18 and 13 in high- and low-risk pregnancies in now well established.1 In May 2017, our Minister of Public Health announced the reimbursement of non-invasive prenatal testing (NIPT) as a first-line screening tool for all pregnant women in Belgium. Patients have to pay 8.68 € out of their pocket. The decision took effect on the 1st of July 2017. Prior to the above announcement, the National Advisory Committee on Bioethics was asked to give its opinion on ethical issues that NIPT could raise, notably in matters of informed consent and patient counseling...
April 2, 2019: Ultrasound in Obstetrics & Gynecology
B A Virgilio, I D E Blasis, P Sladkevicius, F Moro, G F Zannoni, D Arciuolo, F Mascilini, F Ciccarone, D Timmerman, Kaijser J, R Fruscio, C V A N Holsbeke, D Franchi, E Epstein, F P G Leone, S Guerriero, A Czekierdowski, G Scambia, A C Testa, L Valentin
OBJECTIVES: To describe the clinical and ultrasound characteristics of serous cystadenofibromas in the adnexa. METHODS: This is a retrospective study. From the International ovarian tumor analysis (IOTA) database we identified patients with a histological diagnosis of serous cystadenofibroma, who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2012. In the IOTA database containing prospectively collected data, the tumors were described using the terms and definitions of the International Ovarian Tumor Analysis (IOTA) group...
April 1, 2019: Ultrasound in Obstetrics & Gynecology
Agnieszka Glazewska-Hallin, Lisa Story, Natalie Suff, Andrew Shennan
Preterm deliveries have multiple aetiologies and management is dependent on cause. Recent studies have shown that caesarean sections performed late in labour have been associated with recurrent, early premature births and late miscarriages (Figure 1). Both the prediction and management of these under-recognised high-risk cases needs to be elucidated. This article is protected by copyright. All rights reserved.
April 1, 2019: Ultrasound in Obstetrics & Gynecology
W M Dooley, P Chaggar, L V De Braud, C Bottomley, E Jauniaux, D Jurkovic
OBJECTIVES: The aim of this study was to assess the overall accuracy of the transvaginal ultrasound scan (TVS) diagnosis of all types of extrauterine ectopic pregnancy (EUEP) in a large group of women who were managed surgically. We also examined the positive predictive value (PPV) of the different ultrasound morphological types of EUEP, using visual confirmation of ectopic pregnancy on surgery as the reference standard. METHODS: We performed a retrospective observational study of all pregnant women who underwent emergency surgery following ultrasound diagnosis of EUEP in a single Early Pregnancy Unit between January 2009 and December 2017...
April 1, 2019: Ultrasound in Obstetrics & Gynecology
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