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Ultrasound in Obstetrics & Gynecology

Argyro Syngelaki, Aymen Hammami, Sarah Bower, Vita Zidere, Ranjit Akolekar, Kypros H Nicolaides
OBJECTIVE: To examine the performance of the routine 11-13 weeks scan in detecting fetal non-chromosomal abnormalities. METHODS: This was a retrospective study of prospectively collected data from 100,997 singleton pregnancies attending for a routine ultrasound examination for fetal anatomy, according to a standardized protocol, at 11-13 weeks' gestation. All continuing pregnancies had an additional scan at 18-24 weeks and 71,754 had a scan at either 30-34 or 35-37 weeks...
August 13, 2019: Ultrasound in Obstetrics & Gynecology
Ohad Rotenberg, Dmitry Fridman, Georgios Doulaveris, Malte Renz, Julie Kaplan, Juliana Gebb, Xianhong Xie, Gary L Goldberg, Pe'er Dar
OBJECTIVE: To assess the long-term outcome of post-menopausal women diagnosed with non-atypical endometrial hyperplasia (NEH). METHODS: It is a retrospective study of women aged 55 and older who underwent endometrial sampling in our large academic medical center between 1997 and 2008. Women diagnosed with NEH were included in the study group and were compared to women diagnosed with atrophic endometrium on endometrial sampling. Outcome data was obtained through February 2018...
August 7, 2019: Ultrasound in Obstetrics & Gynecology
Shabnam Bobdiwala, Evangelia Christodoulou, Jessica Farren, Nicola Mitchell-Jones, Christopher Kyriacou, Maya Al-Memar, Francis Ayim, Baljinder Chohan, Emma Kirk, Osama Abughazza, Bramara Guruwadahyarhalli, Sharmistha Guha, Veluppillai Vathanan, Cecilia Bottomley, Debbie Gould, Catriona Stalder, Dirk Timmerman, Ben Van Calster, Tom Bourne
INTRODUCTION: The M6 risk prediction model has been shown to have good triage performance for stratifying women with a PUL as being at low or high-risk of harboring an ectopic pregnancy. There is evidence that M6 has better overall test performance than the hCG ratio (serum hCG at 48 hours/hCG at presentation) and older models such as the M4 model. M6 was published as part of a two-step protocol using an initial progesterone ≤2nmol/l to identify likely failing pregnancies (step 1), followed by M6 (step 2)...
August 6, 2019: Ultrasound in Obstetrics & Gynecology
Jenny Carter, Paul T Seed, Helena A Watson, Anna L David, Jane Sandall, Andrew H Shennan, Rachel M Tribe
OBJECTIVE: To develop enhanced prediction models to update the QUiPP app, a tool for predicting spontaneous preterm birth in women with symptoms of threatened preterm labour (TPTL), incorporating risk factors, transvaginal ultrasound assessment of cervical length (CL, mm) and cervicovaginal fluid quantitative fetal fibronectin test results (qfFN). METHODS: Participants were pregnant women between 23+0 and 34+6 weeks' gestation with symptoms of TPTL, recruited as part of four prospective cohort studies carried out at 16 UK hospitals between October 2010 and October 2017...
August 6, 2019: Ultrasound in Obstetrics & Gynecology
Emeline Maisonneuve, Camille Sauvee, Agnès Mailloux, Anne Cortey, Jean-Marie Jouannic
No abstract text is available yet for this article.
August 5, 2019: Ultrasound in Obstetrics & Gynecology
Helen Perry, Henriette Lehmann, Elena Mantovani, Basky Thilaganathan, Asma Khalil
OBJECTIVE: Pregnancies complicated by fetal growth restriction (FGR) have worse outcomes than pregnancies with a small for gestational age (SGA) fetus. There is increasing evidence of a maternal cardiovascular role in the pathophysiology. We aimed to compare the maternal hemodynamic indices (cardiac output and systemic vascular resistance) in pregnancies complicated by FGR and pregnancies with an SGA fetus using a non-invasive device (USCOM-1A®). METHODS: This was a prospective study of normotensive pregnancies complicated by FGR (defined as pregnancies with a birthweight <3rd centile or with Doppler evidence of impaired placental-fetal blood flow), pregnancies with an SGA fetus (defined as pregnancies with a birthweight <10th centile) and control pregnancies (defined as having an appropriately-grown fetus)...
August 5, 2019: Ultrasound in Obstetrics & Gynecology
Liangpu Xu, Hailong Huang, Na Lin, Yan Wang, Deqin He, Min Zhang, Meihuan Chen, Lingji Chen, Yuan Lin
OBJECTIVE: To follow up the noninvasive prenatal testing (NIPT) results of 31515 singleton pregnancies in Fujian province, southeastern China and assess its performance in low-, moderate- and high-risk pregnancies. METHODS: Cell-free plasma DNA was subjected to low-coverage whole-genome sequencing. Standard Z-score analysis of the mapped sequencing reads was used to call fetal aneuploidies, including trisomies 21, 18 and 13 (T21, T18, T13) and sex chromosome aneuploidies (SCAs)...
July 31, 2019: Ultrasound in Obstetrics & Gynecology
Yan Wang, Yifan Li, Yangyi Chen, Ran Zhou, Zeling Sang, Lulu Meng, Jianxin Tan, Fengchang Qiao, Qinmin Bao, Donghong Luo, Chunfang Peng, Yaoshen Wang, Chunyu Luo, Ping Hu, Zhengfeng Xu
OBJECTIVES: Early pregnancy loss, also known as miscarriage, is the most frequent complication in first-trimester pregnancy, occurring in 10-15% of all clinically recognized pregnancies. Embryonic numerical and structural chromosomal abnormalities are the most common cause of early pregnancy loss. However, the role of submicroscopic copy number variations (CNVs) in early pregnancy loss is still unclear. Besides, little is known about the critical regions and candidate genes for miscarriage because of the large size of structural chromosomal abnormalities...
July 31, 2019: Ultrasound in Obstetrics & Gynecology
Zsófia Benkő, Petya Chaveeva, Catalina de Paco Matallana, Emilie Zingler, David Wright, Kypros H Nicolaides
BACKGROUND: We have previously proposed that the competing risk model for prediction of preeclampsia (PE) based on maternal characteristics and medical history (prior model), developed in singleton pregnancies, can be extended to risk assessment for twins; in dichorionic (DC) and monochorionic (MC) twin pregnancies with the same characteristics as singleton pregnancies the distribution of gestational age of delivery with PE was shifted to the left by 8 and 10 weeks, respectively. However, in a subsequent validation study we found that in both the training and validation datasets the observed incidence of PE was lower than the predicted one and such overestimation of risk was particularly marked for early-PE...
July 31, 2019: Ultrasound in Obstetrics & Gynecology
Aidan J Kashyap, Philip L J DeKoninck, Karyn A Rodgers, Marta Thio, Erin V McGillick, Benjamin J Amberg, Sasha M Skinner, Alison M Moxham, Francesca M Russo, Jan A Deprest, Stuart B Hooper, Kelly J Crossley, Ryan J Hodges
OBJECTIVES: Infants with congenital diaphragmatic hernia (CDH) are predisposed to pulmonary hypertension after birth, due to lung hypoplasia that impairs fetal pulmonary vascular development. Antenatal sildenafil treatment attenuates abnormal pulmonary vascular and alveolar development in rabbit and rodent CDH models, but whether this translates to functional improvements after birth remains unknown. We aimed to evaluate the effect of antenatal sildenafil on neonatal pulmonary haemodynamics and lung function in lambs with a diaphragmatic hernia (DH)...
July 31, 2019: Ultrasound in Obstetrics & Gynecology
Anne Ego, Isabelle Monier, Kristina Skaare, Jennifer Zeitlin
BACKGROUND: Antenatal surveillance of intrauterine growth aims to detect growth restricted fetuses who face higher risks of stillbirth. Improving detection could be an effective strategy for stillbirth prevention. The REPERE study was conducted to estimate the association between antenatal detection of small for gestational age (SGA) and stillbirth risk in France. METHODS: REPERE is a case-control study performed in 3 French districts with approximately 30,000 births annually...
July 31, 2019: Ultrasound in Obstetrics & Gynecology
Chivon Verger, Alexandros A Moraitis, Lauren Barnfield, Ulla Sovio, Jacqueline Esther Akua Korang Bamfo
OBJECTIVES: To examine the performance of different fetal growth charts in the prediction of large-for-gestational-age (LGA) and neonatal morbidity at term in a multi-ethnic, obese population. METHODS: Our retrospective cohort study included 253 non-anomalous, singleton, term pregnancies who underwent serial third trimester ultrasound scans because of maternal BMI 35 and above. We compared the Hadlock, GROW, INTERGROWTH-21st (IG-21), World Health Organisation (WHO), and Fetal Medicine Foundation (FMF) fetal growth reference charts...
July 31, 2019: Ultrasound in Obstetrics & Gynecology
Giuseppe Rizzo, Ilenia Mappa, Victoria Bitsadze, Maciej Słodki, Jamilya Khizroeva, Alexander Makatsarya, Francesco D'Antonio
OBJECTIVE: To describe umbilical vein (UV) hemodynamic in macrosomic fetuses at 11+0 13+6 weeks of gestation and to build a multiparametric prediction model including pregnancy and ultrasound characteristics able to detect fetal macrosomia in the first trimester. METHODS: Matched case-control study including pregnancies who underwent ultrasound examination at 11+0 to 13+6 weeks for aneuploidy screening at a single centre over a four years period. Cases were women who gave birth a newborn with a BW >90th centile for gestational age and sex according to local birthweight standards, while controls those who delivered newborns with a BW ranging between the 10th and 90th centiles matched by a ratio of 1:3 for maternal age and gestational age...
July 25, 2019: Ultrasound in Obstetrics & Gynecology
Giuseppe Rizzo, Ilenia Mappa, Victoria Bitsadze, Maciej Słodki, Jamilya Khizroeva, Alexander Makatsarya, Francesco D'Antonio
OBJECTIVE: Pregnancies complicated by late-onset fetal growth restriction (FGR) are at increased risk of short- and long-term morbidities. Despite this, identification of cases at higher risk of adverse perinatal outcome when FGR is diagnosed is challenging. The aims of this study were to elucidate the strength of association and predictive accuracy of maternal and fetal Dopplers in predicting perinatal outcome of fetuses affected by late-onset FGR at the time of diagnosis. METHODS: Prospective study of consecutive singleton pregnancies complicated by late-onset FGR...
July 25, 2019: Ultrasound in Obstetrics & Gynecology
Tor Skibsted Clemmensen, Martin Christensen, Brian Bridal Løgstrup, Camilla Jensenius Skovhus Kronborg, Ulla Breth Knudsen
OBJECTIVES: This study evaluates differences in coronary microvascular function between women with early onset preeclampsia (EOPE) and late onset preeclampsia (LOPE) and age-matched normotensive controls approximately 12 years after index pregnancy and the relation between microvascular function and myocardial deformation in these subjects. METHODS: We evaluated the coronary flow velocity reserve (CFVR) by Doppler echocardiography in 88 women who gave birth at Department of Gynecology and Obstetrics, Randers Regional Hospital between 1998-2008...
July 25, 2019: Ultrasound in Obstetrics & Gynecology
José Antonio García-Mejido, Alicia Martín-Martínez, Enrique González-Diaz, Camino Fernández-Fernández, Ismael Ortega, Margarita Medina, Alfonso Fernández-Corona, Ana Fernández-Palacín, José Antonio Sainz
OBJECTIVES: To determine whether differences exist in the rates of avulsion of the levator ani muscle (LAM) between Malmström's vacuum delivery (MVD) and Kielland's forceps delivery (KFD), according to the characteristics of instrumentation, at different hospital centers. METHODS: Prospective, observational, in two different hospital centers study that included 414 nulliparous women after instrumental delivery with Malmström's vacuum extractor or Kielland's forceps...
July 23, 2019: Ultrasound in Obstetrics & Gynecology
Amir Aviram, Paula Quaglietta, Chelsie Warshafsky, Arthur Zaltz, Eran Weiner, Nir Melamed, Eugene Ng, Jon Barrett, Stefania Ronzoni
OBJECTIVES: To evaluate the utility of ultrasound markers in the management of pregnancies complicated with PPROM between 230/7 and 336/7 weeks of gestation, and to assess their predictability of adverse neonatal outcomes. METHODS: A retrospective cohort study of all patients with PPROM between 230/7 and 336/7 weeks of gestation and latency period > 24 hours, who were admitted to a tertiary referral center between 2005 and 2017. All patients had an NST daily, and an ultrasound scan twice a week for assessment of amniotic fluid volume, biophysical profile and umbilical artery pulsatility index (UA PI) measurement...
July 23, 2019: Ultrasound in Obstetrics & Gynecology
Hang Wun Raymond Li, Jennifer Ka Yee Ko, Vivian Chi Yan Lee, Sofie Shuk Fei Yung, Estella Yee Lan Lau, William Shu Biu Yeung, Pak Chung Ho, Ernest Hung Yu Ng
OBJECTIVES: To compare the proportion of women having a desired ovarian response following ovarian stimulation with gonadotrophin dosing determined based on AFC versus serum AMH level in women undergoing IVF using the GnRH antagonist protocol. METHODS: This was a randomised double-blinded trial carried out in a university-affiliated assisted reproduction unit. A total of 200 women undergoing the first IVF cycle between April 2016 and February 2018 were randomised to algorithms for gonadotrophin dosing based on either AFC or AMH in the pre-treatment cycle...
July 20, 2019: Ultrasound in Obstetrics & Gynecology
Ori Shen, Eyal Mazaki, Alexander Ioscovich, Hen Y Sela, Arnon Samueloff, Orna Reichman
OBJECTIVE: The objective was to evaluate whether intra-operative ultrasonography during elective uncomplicated cesarean delivery is effective in depicting ureteral jets in the urinary bladder. If the technique proves useful in cases with damaged or obstructed ureters, it will be a valuable addition to the toolkit of modalities for intra-operative assessment of ureteral integrity. METHODS: In thirty patients undergoing uncomplicated elective cesarean delivery, intra-operative trans-vesical sonography was performed to demonstrate the ureteral jets within the maternal bladder...
July 20, 2019: Ultrasound in Obstetrics & Gynecology
Helena A Watson, Paul T Seed, Jenny Carter, Natasha L Hezelgrave, Katy Kuhrt, Rachel M Tribe, Andrew H Shennan
Accurate mid-pregnancy prediction of spontaneous preterm birth (sPTB) is essential to ensure appropriate surveillance of high-risk women. Advancing the QUiPP prototype, QUiPP 2 aimed to provide individualised risk of delivery based on cervical length, quantitative fetal fibronectin (qfFN), or both tests combined, taking into account further risk factors, such as multiple pregnancy. Validation of the QUiPP 2 predictive models using a distinct dataset aims to confirm the accuracy and transportability of QUiPP overall and within certain clinically relevant timeframes...
July 20, 2019: Ultrasound in Obstetrics & Gynecology
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