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Ultrasound in Obstetrics & Gynecology

Kate Navaratnam, Zarko Alfirevic
Evidence-based guidelines have previously quoted relatively high procedure-related risks of miscarriage with chorionic villus sampling and amniocentesis of 2% and 1%, respectively. Randomised controlled trials in this area are unlikely to be repeated, but contemporaneous observational data suggest much lower procedure-related risks. We were asked to update the evidence for the new, 5th edition of the RCOG Green-Top Guideline and provide new estimates of risks. In this editorial, we describe some of the methodological issues we faced which are relevant to anyone carrying out a meta-analysis and should help specialists to assess the applicability of meta-analysis findings to their clinical practice...
May 22, 2019: Ultrasound in Obstetrics & Gynecology
B H Kahrs, S Usman, T Ghi, A Youssef, E A Torkildsen, E Lindtjørn, T B Østborg, S Benediktsdottir, L Brooks, L Harmsen, K Å Salvesen, C C Lees, T M Eggebø
OBJECTIVES: To investigate if descent of the fetal head during active pushing was associated with duration of operative vaginal delivery, delivery mode and neonatal outcome in nulliparous women with prolonged second stage of labor. METHODS: We conducted a prospective cohort study between November 2013 and July 2016 in five European countries. Fetal head descent was measured with transperineal ultrasound. Head-perineum distance (HPD) was measured between contractions and at maximum contraction during active pushing, and the difference was calculated as delta-HPD...
May 22, 2019: Ultrasound in Obstetrics & Gynecology
Cristina Paules, Lina Youssef, Carlota Rovira, Francesca Crovetto, Alfons Nadal, Anna Peguero, Francesc Figueras, Elisenda Eixarch, Fatima Crispi, Jezid Miranda, Eduard Gratacós
OBJECTIVES: The aim of this study was to describe placental histopathological findings in a large cohort of pregnancies complicated by preeclampsia and/or fetal growth restriction, and to investigate its association with fetoplacental Doppler. METHODS: This was a prospective observational study including pregnancies complicated by: 1) normotensive FGR defined as birthweight <10th centile (n=184); 2) PE with normally growth fetuses (n=102); 3) PE&FGR (n=120); and 4) uncomplicated pregnancies (n=202)...
May 22, 2019: Ultrasound in Obstetrics & Gynecology
Buechel Johanna, Bruder Elisabeth, Manegold-Brauer Gwendolin
No abstract text is available yet for this article.
May 22, 2019: Ultrasound in Obstetrics & Gynecology
T Suekane, D Tachibana, R K Pooh, T Misugi, M Koyama
Vasa previa is a catastrophic condition which, if unrecognized before rupture of the membrane or labor onset, leads to fetal exsanguination due to the laceration of fetal vulnerable blood vessels without protection of Wharton's jelly1 . This article is protected by copyright. All rights reserved.
May 22, 2019: Ultrasound in Obstetrics & Gynecology
Pierre Sinajon, David Chitayat, Maian Roifman, Syed Wasim, Sergio Carmona, Greg Ryan, Abdul Noor, Elena Kolomietz, Karen Chong
OBJECTIVE: To determine the incidence of chromosome abnormalities, submicroscopic chromosomal microarray (CMA) abnormalities and RASopathy Disorders (RD) pathogenic variants in a cohort of pregnant patients with a nuchal translucency (NT) ≥3.5mm. We propose a clinical protocol for surveillance of this group of patients. METHODS: A retrospective chart review was performed on patients seen at The Prenatal Diagnosis and Medical Genetics Program between January 2013 - December 2015 for NT ≥3...
May 22, 2019: Ultrasound in Obstetrics & Gynecology
Anca Ciobanou, Salma Jabak, Hila De Castro, Laurence Frei, Ranjit Akolekar, Kypros Nicolaides
OBJECTIVE: To investigate the potential value of uterine artery pulsatility index (UtA-PI) and serum levels of the angiogenic placental growth factor (PlGF) and antiangiogenic factor soluble fms-like tyrosine kinase-1 (sFLT-1) in the prediction of adverse perinatal outcome in small for gestational age (SGA) and non-SGA neonates at 35 - 37 weeks' gestation. METHODS: This was a prospective observational study in 19,209 singleton pregnancies attending for a routine hospital visit at 35+0 - 36+6 weeks' gestation...
May 17, 2019: Ultrasound in Obstetrics & Gynecology
Noboru Inamura, Ritsuko K Pooh
We experienced fetal tachyarrhythmia at 12th gestational week. We recorded the four-chamber view by the spatio-temporal image correlation (STIC) method with color Doppler and diagnosed short ventriculo-atrial (VA) tachyarrhythmia. The STIC method may be clinically useful for diagnosing arrhythmia at the first trimester. This article is protected by copyright. All rights reserved.
May 13, 2019: Ultrasound in Obstetrics & Gynecology
Natalia Prodan, Philipp Wagner, Jiri Sonek, Harald Abele, Markus Hoopmann, Karl Oliver Kagan
OBJECTIVE: To examine the effectiveness of the first and second cervical length measurement in the prediction of preterm delivery in symptomatic women with twin pregnancies. METHODS: Retrospective study at the perinatal unit at the University Hospital of Tuebingen, Germany which included women with twin gestations with painful and regular uterine contractions at 24+0 to 33+6 weeks of gestation. The cervical length was measurement at the time of admission and several days later after cessation of the contractions...
May 8, 2019: Ultrasound in Obstetrics & Gynecology
F Moro, V Bertoldo, R Borzi, G F Zannoni, A C Testa
No abstract text is available yet for this article.
May 7, 2019: Ultrasound in Obstetrics & Gynecology
Moshe Gillor, Hans Peter Dietz
OBJECTIVE: Urethral diverticulum is an uncommon cause of urinary dysfunction in women with often significant delay to diagnosis. Urethroscopy and/or MRI are widely used for its identification. Translabial ultrasound is an alternative, particularly since the introduction of 3D/4D imaging. The aim of our study was to review ten years of experience of urethral diverticula evaluated by translabial ultrasound. METHODS: We have reviewed 4121 patients seen in a tertiary urogynecologic unit between 2008 and 2018...
April 30, 2019: Ultrasound in Obstetrics & Gynecology
Danilo Buca, Carlotta Iacovella, Asma Khalil, Giuseppe Rizzo, Meeli Sirotkina, Alexander Makatsariya, Marco Liberati, Claudia Silvi, Ganesh Acharya, Francesco D'Antonio
OBJECTIVES: To report perinatal outcome of singleton pregnancies complicated by placental choriangioma diagnosed on prenatal ultrasound. METHODS: Medline, Embase, Cinahl and databases were searched. Inclusion criteria were singleton pregnancies complicated by placental chorioangioma with no other associated structural anomalies. Primary outcome was perinatal mortality; secondary outcomes included associated non-structural anomalies detected on prenatal ultrasound (including fetal hydrops, anemia, polyhydramnios or other signs of hyperdynamic circulation), small for gestational age (SGA) at birth, composite perinatal morbidity and preterm birth (PTB)...
April 29, 2019: Ultrasound in Obstetrics & Gynecology
B Karmegaraj, R Rajeshkannan, M Kappanayil, B Vaidyanathan
Isolated tortuosity of proximal descending aorta is a rare form of congenital disorder. Its association with ductus arteriosus aneurysm (DAA) has not been reported in fetal life1 . We are reporting the utility of 4-dimensional spatiotemporal image correlation (4D STIC) rendering in diagnosing this rare association in a 23-week fetus. This article is protected by copyright. All rights reserved.
April 25, 2019: Ultrasound in Obstetrics & Gynecology
Fumiko Torigoe, Hidekazu Ishida, Yoichiro Ishii, Ryo Ishii, Jun Narita, Yukiko Kawazu, Futoshi Kayatani, Noboru Inamura
OBJECTIVES: Tricuspid valve malformation and Ebstein anomaly (TVM/EA) diagnosed by fetal echocardiography show a wide variety of clinical severity and prognosis. Celermajer index and Simpson Andrews Sharland (SAS) scores were previously reported as predictive scores for the prognosis in cases of TVM/EA; however, they do not reflect the hemodynamic impact of left ventricular function, which has been recently considered as important in TVM/EA physiology. In this study, we aimed to identify better predicting parameters and develop a scoring system that includes left ventricular function...
April 22, 2019: Ultrasound in Obstetrics & Gynecology
Mathew Leonardi, Wellington P Martins, Mercedes Espada, Mohan Arianayagam, George Condous
Deep endometriosis (DE) of the uterosacral ligaments (USLs) has been reported to be the most common site of DE in the pelvis 1 . A nodule within the USL may infiltrate the parametrium, increasing the complexity of surgical resection and larger nodules noted on transvaginal ultrasound (TVS) (≥17mm) should raise suspicion for ureteral involvement 2 . Nodules may also invade the torus uterinus, the thickening between the insertion of the USLs behind the posterior cervix. The diagnostic test accuracy of TVS for USL-DE is not very good with sensitivity/specificity of 67%/86% 3 ...
April 22, 2019: Ultrasound in Obstetrics & Gynecology
Andres F Espinoza, Michael A Belfort, Alireza A Shamshirsaz, Kayla M Hudson, Xenia Parisi, Ahmed A Nassr, Magdalena Sanz-Cortez, Hadi Erfani, Jimmy Espinoza
OBJECTIVE: This study compares infant survival according to patterns of impedance to blood flow in the umbilical arteries (UA) among patients with twin-to-twin transfusion syndrome (TTTS). METHODS: This retrospective study included women who underwent laser surgery for TTTS between January 2012 and May 2018 at a single institution. Absolute Inter-twin difference in umbilical artery pulsatility index (DUAPI) was measured prior to laser surgery. Twins with intermittent or persistent absent/reversed UA end-diastolic flow (EDF) were analyzed separately...
April 22, 2019: Ultrasound in Obstetrics & Gynecology
Nicolas Vinit, David Grevent, Anne-Elodie Millischer-Bellaiche, Viral M Pandya, Pascale Sonigo, Alessandro Delmonte, Sabine Sarnacki, Yves Aigrain, Nathalie Boddaert, Bettina Bessières, Gabriel Benchimol, Laurent J Salomon, Julien J Stirnemann, Thomas Blanc, Yves Ville
OBJECTIVES: Inadequacy between currently available fetoscopes and anatomical constraints of the fetal bladder account for most technical difficulties during fetal cystoscopies (FC) in lower urinary tract obstruction (LUTO). The aim of this anatomical study was to assess by magnetic resonance imaging (MRI) the variations in three bladder angles (bladder-neck angle (BNA), vesicourethral angle (VUA), dome-urethra angle (DUA)) with gestational age (GA), bladder volume or the presence of LUTO...
April 22, 2019: Ultrasound in Obstetrics & Gynecology
Alicia Le Bras, Laurent J Salomon, Laurence Bussières, Valérie Malan, Caroline Elie, Houman Mahallati, Yves Ville, Michel Vekemans, Isabelle Durand-Zaleski
OBJECTIVE: To evaluate the cost-effectiveness of five prenatal screening strategies for trisomies (13/18/21) and other unbalanced chromosomal abnormalities (UBCA) following the introduction of cfDNA. METHOD: A model-based cost-effectiveness analysis was constructed to estimate the prevalence, safety, screening program costs, and healthcare costs from a virtual cohort of 652,653 pregnant women in France. Data were derived from the French Biomedicine Agency and published articles...
April 22, 2019: Ultrasound in Obstetrics & Gynecology
Doron Kabiri, Roberto Romero, Dereje W Gudicha, Edgar Hernandez-Andrade, Percy Pacora, Neta Benshalom-Tirosh, Dan Tirosh, Lami Yeo, Offer Erez, Sonia S Hassan, Adi L Tarca
OBJECTIVE: To compare the predictive ability of estimated fetal weight (EFW) percentiles, according to seven growth standards, to detect fetuses at risk for adverse perinatal outcomes. METHODS: This retrospective cohort study included 3,437 African-American women. Population-based (Hadlock, INTERGROWTH-21st, WHO, FMF), ethnic specific (NICHD), customized (GROW) and African American customized (PRB/NICHD) growth standards were applied to the last available scan prior to delivery...
April 22, 2019: Ultrasound in Obstetrics & Gynecology
Katsusuke Ozawa, Marcus G Davey, Zhiyun Tian, Matthew A Hornick, Ali Y Mejaddam, Patrick E McGovern, Alan W Flake, Jack Rychik
OBJECTIVE: EXTrauterine Environment for Neonatal Development (EXTEND) is a system to support ongoing fetal growth and organ development in an extrauterine environment, utilizing a pumpless low resistance oxygenator circuit. The purpose of this study is to evaluate hemodynamics and cardiac function in fetal lambs sustained on the EXTEND system. METHODS: We studied fetal sheep supported for a minimum of 3 weeks on EXTEND. Hemodynamic parameters of heart rate, mean arterial pressure, Doppler echocardiography derived cardiac output, pulsatility indices of middle cerebral artery, umbilical artery, and ductus venosus, and cardiac function as gauged by speckle tracking derived global longitudinal strain and strain rate of right and left ventricles, were all measured weekly and compared...
April 15, 2019: Ultrasound in Obstetrics & Gynecology
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