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Ultrasound in Obstetrics & Gynecology

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https://www.readbyqxmd.com/read/28317207/hidden-high-rate-of-preeclampsia-in-twin-compared-to-singleton-pregnancies
#1
Carla Francisco, David Wright, Zsófia Benkő, Argyro Syngelaki, Kypros H Nicolaides
OBJECTIVE: To examine the gestational age at delivery with and without preeclampsia (PE) in dichorionic (DC) and monochorionic (MC) twin pregnancies and determine the relative risk for total and preterm-PE compared to singleton pregnancies. METHODS: This was a screening study for PE in twin pregnancies undergoing first-trimester combined screening for aneuploidy and subsequently delivering two phenotypically normal live or stillborn babies at ≥24 weeks' gestation...
March 19, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295809/a-new-method-to-predict-the-need-for-a-rashkind-procedure-in-fetuses-with-dextro-transposition-of-the-great-arteries
#2
Maciej Słodki, Roland Axt-Fliedner, Katarzyna Zych-Krekora, Aline Wolter, Andreea Kawecki, Christian Enzensberge, Ewa Gulczyńska, Maria Respondek-Liberska
OBJECTIVE: Prenatal congenital heart disease classification system specify critical d-TGA with restriction of the foramen ovale (which requires Rashkind procedure) and planned d-TGA. However, current prenatal diagnostic criteria for post-delivery foramen ovale (FO) restriction in d-TGA are inadequate, resulting in a high false negative rate. We aim to find an echocardiographic features to predict the need for Rashkind procedure. METHODS: 98 patients from 2 European centers diagnosed prenatally with fetal d-TGA from 2006 to 2013 were analyzed and two groups were compared: 1) those in which the Rashkind procedure was performed within the first 24 hours of life; and 2) those who did not undergo a Rashkind procedure before cardiac surgery...
March 14, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295801/cervical-length-measurement-at-mid-gestation-to-predict-spontaneous-preterm-birth-in-asymptomatic-triplet-pregnancies
#3
A Fichera, G Pagani, V Stagnati, S Cascella, S Faiola, C Gaini, M Lanna, L Pasquini, R Raffaelli, T Stampalija, A Tommasini, F Prefumo
OBJECTIVE: To assess the predictive value of cervical length (CL) measured at mid gestation for spontaneous preterm birth (PTB) in triplet pregnancies. METHODS: Retrospective study on asymptomatic triplet pregnancies followed at five Italian tertiary referral centres, between 2002 and 2015. CL was measured transvaginally between 18-24 weeks of gestation. Pregnancies with a medically indicated PTB were excluded. Demographic and pregnancy characteristics of pregnancies complicated with PTB were analysed and the distributions of CL measurements in these patients were calculated...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295796/uncommon-second-trimester-presentation-of-vein-of-galen-malformation
#4
LETTER
A Yukhayev, N Meirowitz, R Madankumar, I E Timor-Tritsch, A Monteagudo
Vein of Galen Malformation (VGM) constitutes a spectrum of arterio-venous malformations resulting in excess blood flow to the cerebral veins (1,2). Arteriovenous shunting caused by this malformation increases cardiac preload. Prenatal diagnosis is commonly made during the third trimester, with signs of cardiac failure (3,4). This report describes the challenges of prenatal diagnosis of VGM which presented as intracranial hemorrhage in the second trimester, prior to the onset of cardiac volume overload.
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295775/comparative-study-of-conventional-and-virtual-autopsy-using-postmortem-mri-in-the-phenotypic-characterization-of-stillbirths-and-malformed-fetuses
#5
Mohan Shruthi, Neerja Gupta, Manisha Jana, Asit R Mridha, Atin Kumar, Ramesh Agarwal, Raju Sharma, Dipika Deka, Arun Kumar Gupta, Madhulika Kabra
OBJECTIVE: To prospectively compare conventional and virtual autopsy using postmortem-MRI in the phenotypic characterization of stillbirths and malformed fetuses and their acceptability to parents. METHODS: We performed whole body postmortem-MRI (1.5T) prior to conventional autopsy in 43 fetuses/still births (≥20 weeks of gestation) after excluding maternal causes of fetal death. With conventional autopsy as gold standard, postmortem-MRI findings were assessed and compared...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295773/a-study-protocol-for-the-prospective-validation-study-screening-programme-for-pre-eclampsia-spree
#6
Min Yi Tan, Lemonia Koutoulas, David Wright, Kypros H Nicolaides, Liona C Poon
INTRODUCTION: Pre-eclampsia (PE), which affects about 2% of pregnancies, is a major cause of maternal and perinatal morbidity and mortality. Early detection of PE can improve pregnancy outcome by providing timely intervention and closer monitoring. The current guideline from the National Institute for Health and Care Excellence (NICE) recommends that at the booking visit, women identified with one major risk factor or more than one moderate risk factor for PE should be advised to take low-dose aspirin daily from 12 weeks until the birth of the baby...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295764/prenatal-diagnosis-of-cerebral-and-extra-cerebral-high-flow-lesion-revealing-unknown-familial-cm-avm-syndrome
#7
LETTER
A Lacalm, A Fichez, B Broussin, C Abel, D Lacombe, L Guibaud
High-flow lesions diagnosed in the prenatal period are mainly represented by rapidly involuting congenital hemangioma of the soft tissues(1) , hepatic hemangioma(2) and by Vein of Galen Aneurysmal Malformation (VGAM) in the central nervous system (CNS)(3) . We report two cases of prenatal diagnosis of cerebral (Case 1) and extra-cerebral (Case 2) high-flow lesion which led to diagnose unknown familial CM-AVM syndrome, related to RASA1 mutation.
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295759/morbid-adherence-of-the-placenta-lack-of-specificity-should-remind-us-that-ultrasound-is-a-screening-tool
#8
LETTER
Amar Bhide, Karin Leslie, Edwin Chandraharan, Kevin Hayes
Excellent performance has been reported with prenatal diagnosis of abnormal placental invasion using ultrasound. We describe a case which illustrates the validity of ultrasound features of abnormally invasive placentation in women without previous caesarean delivery. CASE: Ms. CB, a 27 year-old G3 P1+1 was seen in her pregnancy at 36 weeks of gestation. Her first pregnancy was uncomplicated and she gave vaginal birth to a normally grown baby at term. Before the current pregnancy, she suffered a miscarriage in the first trimester, and underwent surgical evacuation...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295742/prognosis-of-isolated-congenital-diaphragmatic-hernia-using-lung-to-head-circumference-ratio-variability-across-centers-in-a-national-perinatal-network
#9
Marie-Victoire Senat, Hanane Bouchghoul, Julien Stirnemann, Pascal Vaast, Julia Boubnova, Laetitia Begue, Elizabeth Carricaburu, Agnes Sartor, Jacques Jani, Alexandra Benachi, Jean Bouyer
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a severe congenital anomaly. The observed to expected lung area-to-head circumference ratio (o/e-LHR) has been shown to provide a useful prediction of subsequent survival in fetuses with CDH in reference centers with expertise and a large caseload. However, the accuracy of o/e-LHR measurements in unselected fetal medicine units or in centers with less expertise is not well known. OBJECTIVE: To evaluate o/e-LHR measurement in prognostic evaluation of postnatal survival when the measurement is performed in fetal medicine units with different levels of expertise...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295733/fifth-recurrent-cesarean-scar-pregnancy-a-case-report-and-historical-perspective
#10
LETTER
Terri-Ann Bennett, Jessica Morgan, Ilan E Timor-Tritsch, Cara Dolin, Margaret Dziadosz, Ming Tsai
The increase in the cesarean delivery (CD) rate, from 5% in 1970 to 32% in 2015, has been associated with an increase in cesarean scar pregnancies (CSP) approximately 1 in 1,800-2,500 pregnancies complicated by previous cesarean deliveries (CD). There is currently no consensus on the optimal management of CSP or recurrent CSP. We describe the case of a 35-year-old G7P2042 with two prior CD and four prior CSP with positive fetal heart activity, all treated with intra-gestational injection of methotrexate, in conjunction with the practice of favoring termination of CSP...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28294444/effect-of-change-in-posture-on-maternal-functional-hemodynamics-at-35-37-weeks-gestation
#11
Gavin P Guy, Hua Z Ling, Mirian Machuca, Liona C Poon, Kypros H Nicolaides
OBJECTIVE: To evaluate the effect of posture change from the supine to sitting position and before and after passive leg raising on maternal functional hemodynamics in pregnant women at 35-37 weeks' gestation and to compare the changes in pregnancies that subsequently developed preeclampsia (PE) and gestational hypertension (GH) to those who remained normotensive. METHODS: In 3,013 singleton pregnancies at 35-37 weeks' gestation maternal cardiovascular parameters were measured using an automated non-invasive cardiac monitor...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28294441/accuracy-of-pre-operative-real-time-dynamic-transvaginal-ultrasound-sliding-sign-in-prediction-of-pelvic-adhesions-in-women-with-previous-abdominopelvic-surgery-a-prospective-multicenter-double-blinded-study
#12
Amira Ayachi, Rim Bouchahda, Sadok Derouich, Lassaad Mkaouer, Mehdi Kehila, Hassine Abouda, Badis Channoufi, Maha Bouyahia, Marouen Braham, Fethi Zhioua, Haifa Bouchahda, Mechaal Mourali
OBJECTIVE: To highlight the role of the transvaginal ultrasound sliding sign in predicting pelvic adhesions in women with a previous history of abdominopelvic surgery. METHODS: Multicenter prospective, interventional, double blinded study. Patients were examined before the laparoscopy or laparotomy, in gynaecological position, with transvaginal ultrasound (TVU) probe to assess vesico uterine pouch, uterus, ovaries, pouch of Douglas by analysing the gliding between two structures...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28294442/prediction-of-adverse-perinatal-outcome-by-cerebroplacental-ratio-adjusted-for-estimated-fetal-weight
#13
Angelo Sirico, Anke Diemert, Peter Glosemeyer, Kurt Hecher
OBJECTIVES: The aim of our study was to evaluate the relationship between the cerebroplacental ratio (CPR) and estimated fetal weight (EFW). Furthermore, we evaluated the role of CPR in the prediction of adverse perinatal outcome and whether CPR measurements adjusted for EFW improve its predictive value. METHODS: This is a retrospective cohort study including pregnancies, where Doppler investigations of umbilical artery (UA) and middle cerebral artery (MCA) were performed after 30 weeks...
March 12, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295792/biventricular-impact-of-mild-to-moderate-pulmonary-valve-stenosis-in-fetal-life
#14
L Guirado, F Crispi, N Masoller, M Bennasar, E Marimon, J Carretero, E Gratacós, J M Martínez, M K Friedberg, O Gómez
OBJECTIVES: to define the pattern of fetal echocardiographic changes associated with isolated pulmonary valve stenosis (PS) and to correlate the echocardiographic findings with the neonatal outcome and the need of postnatal pulmonary valvuloplasty within the first 12 months of life. METHODS: a prospective cohort study was designed on 16 fetuses with isolated PS and 48 controls matched by gestational age at scan (+/- 2 weeks). Fetal standard ultrasound and comprehensive echocardiography, which included cardiovascular morphometric parameters, systolic and diastolic functional and timing-measurements, were performed in all cases...
March 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295782/multicenter-screening-for-preeclampsia-by-maternal-factors-and-biomarkers-at-11-13-weeks-gestation-comparison-to-nice-guidelines-and-acog-recommendations
#15
Neil O' Gorman, David Wright, Liona C Poon, Daniel L Rolnik, Argyro Syngelaki, Mercedes de Alvarado, Ilma F Carbone, Vivien Dutemeyer, Madgalena Fiolna, Alex Frick, Natalia Karagiotis, Sofia Mastrodima, Catalina de Paco Matallana, George Papaioannou, Andrea Pazos, Walter Plasencia, Kypros H Nicolaides
OBJECTIVE: To compare the performance of screening for preeclampsia (PE) based on risk factors from the medical history, as recommended by NICE and ACOG, with the method proposed by the Fetal Medicine Foundation (FMF), which uses Bayes theorem to combine the a priori risk from maternal factors, derived by a multivariable logistic model, with the results of various combinations of biophysical and biochemical measurements. METHODS: This was a prospective multicenter study of screening for PE in 8,775 singleton pregnancies at 11-13 weeks' gestation...
March 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295749/nitric-oxide-no-donors-and-haemodynamic-changes-in-fetal-growth-restriction
#16
G M Tiralongo, I Pisani, B Vasapollo, A Khalil, B Thilaganathan, H Valensise
OBJECTIVE: To evaluate maternal cardiovascular effects of nitric oxide (NO) donors in pregnancies complicated by fetal growth restriction (FGR) METHODS: 26 women with a diagnosis of FGR were treated with transdermal patches of NO donors and plasma volume expansion. We compared the treated group to a control historical FGR untreated group of patients evaluated longitudinally. We obtained haemodynamic indices using UltraSonic Cardiac Output Monitor system. RESULTS: At enrolment, the two groups were similar in terms of maternal and haemodynamic characteristics...
March 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295722/cerclage-for-short-cervix-on-ultrasound-in-singleton-gestations-without-prior-spontaneous-preterm-birth-a-systematic-review-and-meta-analysis-of-trials-using-individual-patient-level-data
#17
REVIEW
Vincenzo Berghella, Andrea Ciardulli, Orion A Rust, Meekai To, Katsufumi Otsuki, Sietske Althuisius, Kypros Nicolaides, Amanda Roman, Gabriele Saccone
OBJECTIVE: The aim of this systematic review and meta-analysis was to quantify the efficacy of cervical cerclage in preventing preterm birth (PTB) in asymptomatic singleton pregnancies with a mid-trimester short transvaginal ultrasound cervical length (TVU CL) and without prior spontaneous PTB. METHODS: Electronic databases were searched from inception of each database until February 2017. No language restrictions were applied. We included all randomized controlled trials (RCTs) of asymptomatic singleton pregnancies without prior spontaneous PTB screened with TVU CL, found to have a midtrimester short CL <25 mm, and then randomized to management with either cerclage (i...
March 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28236371/modified-diagnostic-criteria-for-twin-twin-transfusion-syndrome-prior-to-18-weeks-gestation-time-to-change
#18
LETTER
Asma Khalil
Twin-to-twin transfusion syndrome (TTTS) typically occurs between 16 and 26 weeks' gestation and is diagnosed based on sonographic criteria of amniotic fluid discordance (polyhydramnios in the recipient twin, with deepest vertical pocket (DVP) ≥ 8 cm prior to 20 weeks and ≥10 cm after 20 weeks; and oligohydramnios in the donor twin, with DVP ≤ 2 cm at any gestation) (Eurofoetus@eurofoetus.org). Monochorionic diamniotic (MCDA) twin pregnancies at 16 weeks' gestation with large (≥25%) estimated fetal weight discordance, oligohydramnios and abnormal fetal (umbilical and/or ductus venosus) Dopplers of the smaller twin, distended bladder +/- abnormal fetal Dopplers +/- tricuspid regurgitation or cardiomegaly, but with a DVP of 6-7 cm in the larger twin (i...
February 25, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28236365/a-longitudinal-follow-up-of-pelvic-floor-biometry-what-are-the-factors-affecting-it
#19
Symphorosa Sc Chan, Rachel Yk Cheung, L L Lee, Tony Kh Chung
OBJECTIVE: To evaluate pelvic floor biometry 3-5 years after first delivery. The effect of a second delivery and mode of delivery were studied. METHODS: Women, who had been assessed at first pregnancy, 8 weeks postnatally and one year after delivery, were invited for follow-up. Positions of the bladder neck (BN), cervix, anorectal junction and hiatal area (HA), were evaluated by translabial ultrasound. The effects of parity, mode of delivery and levator ani muscle (LAM) avulsion were studied...
February 25, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28236342/maternal-cardiac-output-in-early-labour-a-possible-link-with-obstetrics-risks
#20
Herbert Valensise, Grazia Maria Tiralongo, Ilaria Pisani, Daniele Farsetti, Damiano Lo Presti, Giulia Gagliardi, Ripalta Marica Basile, Gian Paolo Novelli, Barbara Vasapollo
OBJECTIVE: to verify if the hemodynamic assessment of "low risk" pregnant women at term can improve the identification of patients with a maternal or foetal-neonatal complication during labour MATERIALS AND METHODS: a prospective observational study was conducted on 77 pregnant women at term with diagnosis of initial labour. We obtained haemodynamic indices using the USCOM(®) system. Patients were followed until the end of labour to check for foetal-neonatal and maternal outcomes. RESULTS: Eleven patients (14...
February 25, 2017: Ultrasound in Obstetrics & Gynecology
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