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Ultrasound in Obstetrics & Gynecology

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https://www.readbyqxmd.com/read/28429561/cfdna-screening-performance-accounting-for-and-reducing-test-failures
#1
EDITORIAL
H Cuckle
Over several decades antenatal screening for Down's syndrome steadily evolved from the initial concept of a single second trimester maternal serum marker to complex protocols involving the combination of multiple serum and fetal ultrasound markers, determined within-trimester or sequentially across-trimesters.
April 21, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28425156/universal-versus-selective-ultrasonography-to-screen-for-large-for-gestational-age-infants-and-associated-morbidity
#2
Ulla Sovio, Alexandros A Moraitis, Hilary S Wong, Gordon C S Smith
OBJECTIVE: To compare the diagnostic effectiveness of selective versus universal ultrasonography as a screening test for large for gestational age (LGA) infants, and to determine whether previously described ultrasonic markers of excessive fetal growth could identify which suspected LGA fetuses were at increased risk of neonatal morbidity. METHODS: We analysed data from a prospective cohort study of nulliparous women, the Pregnancy Outcome Prediction study. All women had clinically indicated scans as per routine care...
April 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28401605/prediction-of-delivering-a-small-for-gestational-age-infant-and-adverse-perinatal-outcome-in-women-with-suspected-pre-eclampsia
#3
Melanie Griffin, Paul T Seed, Suzy Duckworth, Robyn North, Jenny Myers, Lucy Mackillop, Nigel Simpson, Jason Waugh, Maternal Medicine, Dilly Anumba, Louise C Kenny, Christopher W G Redman, Andrew H Shennan, Lucy C Chappell
OBJECTIVE: To evaluate the test performance of 47 biomarkers and ultrasound parameters to predict subsequent delivery of an SGA infant and adverse perinatal outcome in women presenting with suspected preeclampsia. METHODS: In a prospective, multicentre observational study, 47 biomarkers and ultrasound parameters were measured in 397 women presenting with suspected preterm preeclampsia, with the objective of evaluating them as predictors of subsequent delivery of an SGA infant and adverse perinatal outcome...
April 12, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28397385/reduced-physical-activity-in-pregnancy-reduces-maternal-vascular-resistance-and-improves-fetal-growth
#4
Barbara Vasapollo, Damiano Lo Presti, Giulia Gagliardi, Daniele Farsetti, Grazia Maria Tiralongo, Ilaria Pisani, Gian Paolo Novelli, Herbert Valensise
OBJECTIVE: To test the efficacy of maternal activity restriction in normotensive patients with TVR in the upper limits, evaluating the effect on fetal growth. METHODS: Thirty women were enrolled between 27 and 29 weeks gestation. All patients met the following criteria: normal blood pressure values before and during pregnancy, TVR between 1300 and 1400 dyne sec(-1) cm(-5) , normal fetal Doppler parameters at enrolment, abdominal circumference between the 10th and 25th centile...
April 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28397377/yield-of-a-12-13-week-scan-for-the-early-diagnosis-of-fetal-congenital-anomalies-in-the-cell-free-dna-era
#5
M J A Kenkhuis, M Bakker, F Bardi, F Fontanella, M K Bakker, H Fleurke-Rozema, C M Bilardo
OBJECTIVE: Aim of the study was to assess the percentage and type of anomalies (structural and chromosomal) that can be detected at an early scan performed at 12-13 weeks' gestation, as opposed to the present screening policy (20 -week scan). METHODS: Sonographers accredited for the nuchal translucency (NT) measurement were asked, after additional training, to participate into the study. The early scans were performed according to a protocol, in six ultrasound practices and 2 referral centers in the Northeast of the Netherlands...
April 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28397366/changes-in-the-global-strain-of-the-puborectalis-muscle-during-pregnancy-and-postpartum
#6
Anique T M Grob, Niklas Hitschrich, Maria K van de Waarsenburg, Mariëlla I J Withagen, Karlijn J Schweitzer, Carl H van der Vaart
INTRODUCTION: One of the functional parameters that can be assessed by ultrasound is muscle strain. Strain represents the amount of deformation from its original shape when forces are applied to the tissue under study. We set out to assess the global strain of the puborectalis muscle during and after pregnancy. OBJECTIVE: To evaluate the effect of pregnancy and child-delivery on global strain of the puborectalis muscle. METHOD: This is a secondary analysis of a prospective observational study on the association between stress urinary incontinence and levator muscle avulsion after delivery...
April 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28397325/analysis-of-cell-free-dna-in-maternal-blood-in-screening-for-aneuploidies-updated-meta-analysis
#7
REVIEW
M M Gil, V Accurti, B Santacruz, M N Plana, K H Nicolaides
OBJECTIVE: To review clinical validation or implementation studies of maternal blood cell-free (cf) DNA analysis and define the performance of screening for fetal trisomies 21, 18 and 13 and sex chromosome aneuploidies. DATA SOURCES: Searches of PubMed, Embase and the Cochrane library were performed to identify all peer-reviewed articles on cfDNA testing in screening for aneuploidies between January 2011, when the first such study was published and 31 December 2016...
April 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28397323/anatomical-subgroup-analysis-of-the-meridian-cohort-posterior-fossa-abnormalities
#8
Paul D Griffiths, Karen Brackley, Michael Bradburn, Daniel Ja Connolly, Mary L Gawne-Cain, Mark D Kilby, Laura Mandefield, Cara Mooney, Stephen C Robson, Brigitte Vollmer, Gerald Mason
OBJECTIVE: To assess the diagnostic and clinical contribution of in utero magnetic resonance (iuMR) imaging in fetuses diagnosed with abnormalities of the posterior fossa as the only intracranial abnormality recognised on antenatal ultrasonography (USS). METHODS: We report a sub-group analysis of fetuses with abnormalities of the posterior fossa diagnosed on antenatal USS (with or without ventriculomegaly) from the MERIDIAN cohort who had iuMR imaging within 2 weeks of USS and outcome reference data were available...
April 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28397320/pregnancy-associated-plasma-protein-a-is-positively-correlated-to-first-trimester-skin-microvascular-reactivity
#9
C Iacobaeus, T Kahan, G Jörneskog, K Bremme, E Andolf, M Thorsell
OBJECTIVE: To investigate if there is a correlation between levels of circulating maternal pregnancy-associated plasma protein A (PAPP-A) and first trimester maternal vascular function. METHODS: A cross-sectional study of 53 healthy non-smoking, pregnant, nulliparous women in Stockholm, Sweden. PAPP-A and vascular function were assessed during gestational week 11-14. Forearm skin microcirculation was investigated by laser Doppler perfusion imaging during iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP) to assess endothelium dependent and endothelium independent microvascular vasodilatation, respectively...
April 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28386907/isuog-practice-guidelines-performance-of-fetal-magnetic-resonance-imaging
#10
D Prayer, G Malinger, P C Brugger, C Cassady, L De Catte, B De Keersmaecker, G L Fernandes, P Glanc, L F Gonçalves, G M Gruber, S Laifer-Narin, W Lee, A-E Millischer, M Molho, J Neelavalli, L Platt, D Pugash, P Ramaekers, L J Salomon, M Sanz, I E Timor-Tritsch, B Tutschek, D Twickler, M Weber, R Ximenes, N Raine-Fenning
No abstract text is available yet for this article.
April 6, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28370687/mid-trimester-sonographic-cervical-consistency-index-to-predict-spontaneous-preterm-birth-in-a-low-risk-population
#11
Núria Baños, Clara Murillo-Bravo, Carla Julià, Federico Migliorelli, Alvaro Perez-Moreno, Jose Ríos, Eduard Gratacos, Lil Valentin, Montse Palacio
OBJECTIVES: To estimate the ability of mid-trimester sonographic Cervical Consistency Index (CCI) to predict spontaneous preterm birth (sPTB) in low-risk pregnancies and to compare its performance with mid-trimester sonographic cervical length (CL). METHODS: This is a prospective cohort study including women with singleton pregnancies examined with ultrasound at 19 + 0 to 24 + 6 gestational weeks. All underwent transvaginal ultrasound examination of the cervix, but CCI and CL were measured off-line only in women without risk factors for sPTB...
March 31, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28370518/cost-effectiveness-of-diagnostic-testing-strategies-including-cervical-length-measurement-and-fibronectin-testing-in-women-with-symptoms-of-preterm-labor
#12
Gert-Jan van Baaren, Jolande Y Vis, Femke F Wilms, Martijn A Oudijk, Anneke Kwee, Martina M Porath, Hubertina Cj Scheepers, Marc Ea Spaanderman, Kitty Wm Bloemenkamp, Monique C Haak, Caroline J Bax, Jérôme Mj Cornette, Johannes J Duvekot, Bas Wa Nij Bijvanck, Jim van Eyck, Maureen Tm Franssen, Krystyna M Sollie, Frank Pha Vandenbussche, Mallory Woiski, Antoinette C Bolte, Joris Am van der Post, Patrick Mm Bossuyt, Brent C Opmeer, Ben Wj Mol
OBJECTIVE: To evaluate the cost-effectiveness of combining cervical length (CL) measurement and fetal fibronectin (fFN) tests for women with symptoms of preterm labor between 24 and 34 weeks gestation. METHODS: We performed a model-based cost-effectiveness analysis to evaluate seven test-treatment strategies based on CL and/or fFN in women with symptoms of preterm labor from a societal perspective, in which we weighted neonatal outcome and costs. Estimates of disease prevalence, test accuracy and costs, were based on two recently performed nationwide cohort studies in The Netherlands...
March 31, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28370497/cardiac-pathophysiology-in-twin-twin-transfusion-syndrome-new-insights-into-its-evolution
#13
Christoph Wohlmuth, David Boudreaux, Kenneth J Moise, Anthony Johnson, Ramesha Papanna, Michael Bebbington, Helena M Gardiner
OBJECTIVES: In twin-twin transfusion syndrome (TTTS) unbalanced transfer of vasoactive mediators and fluid from the 'donor' to the 'recipient' alters cardiovascular function. We evaluated cardiac function in 145 monochorionic-diamniotic (MCDA) pregnancies with and without TTTS. METHODS: Echocardiography was performed in uncomplicated MCDA, n = 26; TTTS stage I+II, n = 61; TTTS stage III+IV, n = 58, before selective fetoscopic laser photocoagulation (SFLP) in TTTS, and afterwards in 41 (34%) at a mean of 1...
March 31, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28345186/use-of-the-fetal-myocardial-performance-index-in-assessment-and-management-of-the-small-for-gestational-age-fetus-a-cohort-and-nested-case-control-study
#14
Amanda Henry, Jennifer Alphonse, Dominique Tynan, Alec W Welsh
OBJECTIVES: To assess the clinical utility of the fetal Myocardial Performance Index (MPI) in assessment and management of the fetus referred to Fetal Medicine services for Small for Gestational Age/Intrauterine Growth Restriction (SGA/IUGR). METHODS: Prospective cohort study in metropolitan Australia. Consenting patients referred at 24-38 weeks' gestation for suspected singleton SGA/IUGR (estimated fetal weight [EFW] <10(th) centile for gestation and/or abnormal umbilical artery [UA] Doppler) had MPI performed in addition to routine measures, and were followed through to birth...
March 27, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28337830/anatomical-subgroup-analysis-of-the-meridian-cohort-ventriculomegaly
#15
Paul D Griffiths, Karen Brackley, Michael Bradburn, Daniel Ja Connolly, Mary L Gawne-Cain, Daniel I Griffiths, Mark D Kilby, Laura Mandefield, Cara Mooney, Stephen C Robson, Brigitte Vollmer, Gerald Mason
OBJECTIVE: To assess the contribution of in utero magnetic resonance (iuMR) imaging in fetuses diagnosed with ventriculomegaly as the only abnormal intracranial finding on antenatal ultrasonography (USS) in the MERIDIAN cohort. METHODS: We report a sub-group analysis from the MERIDIAN study, of cases of fetal ventriculomegaly diagnosed on USS who then had iuMR imaging within 2 weeks of USS and for whom outcome reference data were available. The diagnostic accuracy of USS and iuMR are reported in relation to the severity of ventriculomegaly...
March 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28337810/electronic-stic-improves-four-dimensional-fetal-echocardiography
#16
F Guasina, F Bellussi, G Morganelli, G Salsi, G Pilu, G Simonazzi
OBJECTIVES: To compare the efficiency of electronic Spatio-Temporal Image Correlation (eSTIC) with conventional STIC to acquire fetal cardiac four-dimensional (4D) volumes of diagnostic quality METHODS: This was a randomized controlled trial of 100 patients at midgestation with normal sonograms. In half of the cases, STIC of the fetal heart were obtained with a conventional mechanical 4D probe, in the remaining eSTIC were obtained with an electronic 4D probe. Examinations were kept within the time frame allotted for a standard examination of fetal anatomy, with a maximum of 2 attempts at obtaining a 4D cardiac volume...
March 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28337808/the-use-of-low-molecular-weight-heparin-reduced-the-fetal-fraction-and-rendered-the-cell-free-dna-testing-for-trisomy-21-false-negative
#17
LETTER
Gwo-Chin Ma, Wan-Ju Wu, Mei-Hui Lee, Yi-Shing Lin, Ming Chen
Cell-free DNA (cfDNA) screening for fetal trisomy 21, 18, and 13 is now widely used in clinical practice. However, false-positives and false-negatives did occur(1,2) . Actually, the majority of fetal cfDNA in maternal blood is from placental trophoblasts.
March 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28332335/second-to-third-trimester-longitudinal-growth-assessment-for-the-prediction-of-sga-and-late-fgr
#18
J Caradeux, E Eixarch, E Mazarico, T R Basuki, E Gratacos, F Figueras
BACKGROUND: Detection of fetal growth restriction (FGR) remains poor. Most screening strategies rely on a cross-sectional evaluation of fetal size at one point during the third trimester. A longitudinal and individualized approach may allow a more appropriate evaluation. OBJECTIVES: To compare second to third trimester longitudinal growth assessment with cross-sectional evaluation at third trimester in the prediction of SGA and late FGR. METHODS: A cohort of 2696 unselected singletons pregnancies scanned at 21 ± 2 and 32 ± 2 weeks was created...
March 23, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28317207/hidden-high-rate-of-preeclampsia-in-twin-compared-to-singleton-pregnancies
#19
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
#20
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
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