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Ultrasound in Obstetrics & Gynecology

Kiyotake Ichizuka, Kohei Seo, Satoshi Dohi, Tetsuya Ishikawa, Akihiko Sekizawa, Masaaki Nagatsuka
Cervical cerclage is used to correct cervical insufficiency. The conventional method of transvaginal cervical cerclage may be difficult to perform in some patients, such as those who have previously undergone conization and those in whom almost none of the portio vaginalis uteri remains. Recently, such patients have been treated by cerclage of the cervical isthmus of the uterus, which is performed by either open or laparoscopic surgery.1-5 .
March 15, 2018: Ultrasound in Obstetrics & Gynecology
I P M Jordans, R de Leeuw, S I Stegwee, N N Amso, P N Barri-Soldevila, T van den Bosch, T Bourne, H A M Brolmann, O Donnez, M Dueholm, W J K Hehenkamp, N Jastrow, D Jurkovic, R Mashiach, O Naji, I Streuli, D Timmerman, L F Vd Voet, J A F Huirne
OBJECTIVES: To generate a uniform, internationally recognized guideline for detailed uterine niche evaluation by ultrasonography in non-pregnant women using a modified Delphi method amongst international experts. METHODS: Fifteen international gynecological experts were recruited by their membership of the European niche taskforce group. All experts were physicians with extensive experience in niche evaluation in clinical practice and/or authors of niche studies...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
Athena P Souka, Ioannis Papastefanou, Athanasios Pilalis, Dimitrios Kassanos, George Papadopoulos
OBJECTIVES: To assess the feasibility and the results of introducing a policy of universal screening for preterm delivery. METHODS: Transvaginal sonography for cervical length (CL) measurement was performed at 20-24 weeks of gestation. Vaginal progesterone therapy was offered to women with CL ≤ 15mm. RESULTS: 10,969 singleton pregnancies were assessed. The decline rate was 1.32%. Spontaneous preterm delivery at less than 32 weeks (SPD32), less than 34 weeks (SPD34) and less than 37 weeks (SPD37) occurred in 0...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
Greggory R DeVore, Berthold Klas, Gary Satou, Mark Sklansky
OBJECTIVES: The purpose of this study was to measure the fractional area change (FAC) of the right and left ventricles in normal fetal hearts between 20 and 40 weeks of gestation using speckle-tracking software. METHODS: The 4-chamber view of the fetal heart was obtained in 200 control fetuses between 20 and 40 weeks of gestation. The FAC was computed from the ventricular areas [((end-diastolic area) - (end-systolic area)/(end-diastolic area)) x 100] for the right and left ventricles and regressed against 7 independent biometric and age variables...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
M Y Tan, D Wright, A Syngelaki, R Akolekar, S Cicero, D Janga, M Singh, E Greco, A Wright, K Maclagan, L C Poon, K H Nicolaides
OBJECTIVE: To test the hypothesis that the performance of first-trimester screening for pre-eclampsia (PE) by a method that uses Bayes' theorem to combine maternal factors with biomarkers is superior to that defined by current National Institute for Health and Care Excellence (NICE) guidelines. METHODS: This was a prospective multicenter study (screening program for pre-eclampsia (SPREE)) in seven National Health Service maternity hospitals in England, of women recruited between April and December 2016...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
Ping Hu, Fengchang Qiao, Yan Wang, Lulu Meng, Xiuqing Ji, Chunyu Luo, Tianhui Xu, Ran Zhou, Jingjing Zhang, Bin Yu, Leilei Wang, Ting Wang, Qiong Pan, Dingyuan Ma, Dong Liang, Zhengfeng Xu
OBJECTIVES: This study aimed to determine the diagnostic yield of targeted next-generation sequencing (NGS) in prenatal diagnosis of congenital heart defects (CHDs) and for investigating the possible genetic etiology of prenatal CHD cases. METHODS: Forty-four fetuses with CHDs and normal molecular karyotypes underwent targeted NGS in this study. Fetal genomic DNA was directly extracted from amniotic fluid cells in each prenatal case. A customized targeted NGS panel containing 77 CHD-associated genes was designed to detect variants in the coding regions and the splicing sites of these genes...
March 13, 2018: Ultrasound in Obstetrics & Gynecology
Janine Hoffmann, Patrick Stumpp, Marc Exner, Matthias Grothoff, Holger Stepan
One of the main concerns in planning a vaginal birth after previous cesarean section is the risk for uterine rupture which is considered to be associated with the wall thickness in the scar area. Assuming the uterine scar to be located within the lower uterine segment (LUS), ultrasound diagnostic with LUS thickness measurement is widely used for prenatal risk assessment. Although intensively investigated there is a strong inhomogeneity of study results and reliable examination protocols and reference values are still missing1,2 ...
March 13, 2018: Ultrasound in Obstetrics & Gynecology
F Bellussi, L Alcamisi, G Guizzardi, D Parma, G Pilu
OBJECTIVES: to investigate the usefulness of visual biofeedback by transperineal ultrasound to improve the pushing coaching during the active second stage of labor in nulliparous women. METHODS: a randomized controlled trial of low risk nulliparous women in the active second stage of labor. Patients were allocated either to coaching aided by visual demonstration of the progress of the fetal head by transperineal ultrasound (sonographic coaching, Group A) or to classical coaching (Group B)...
March 13, 2018: Ultrasound in Obstetrics & Gynecology
Aly Youssef, Eleonora Margarito, Alberta Cappelli, Cristina Mosconi, Matteo Renzulli, Gianluigi Pilu
Vaginal hematoma is an uncommon complication of vaginal delivery, with potential serious consequences(1) . Its optimal management remains unclear. Caudal extension and maternal hemodynamic condition are the main determinants of the outcome. A high index of suspicion, appropriate and timely diagnosis management are fundamental. We present a case of a woman in which transperineal ultrasound was helpful in the diagnosis and management of a vaginal hematoma.
March 13, 2018: Ultrasound in Obstetrics & Gynecology
Giuseppe Cali, Francesco Forlani, Francesca Foti, Gabriella Minneci, Lamberto Manzoli, Maria Elena Flacco, Danilo Buca, Marco Liberati, Giovanni Scambia, Francesco D'Antonio
OBJECTIVES: To ascertain the diagnostic accuracy of ultrasound in detecting AIP during the first trimester (11-14 weeks of gestation) of pregnancy in women at risk of these conditions. METHODS: Retrospective analysis on prospectively collected data on women at risk for AIP based upon the presence of at least one prior CS and/or uterine surgery and placenta previa who had an ultrasound assessment for AIP since the 11-14 weeks scan. The ultrasound signs explored in the present study were: loss of clear zone, placental lacunae, bladder wall interruption, uterovescical hypervascularity...
March 13, 2018: Ultrasound in Obstetrics & Gynecology
G Xydopoulos, H Perry, E Sheehan, B Thilaganathan, R Fordham, A Khalil
BACKGROUND: Traditional monitoring of blood pressure in hypertensive pregnant women requires frequent visits to the maternity outpatient services. Home blood-pressure monitoring (HBPM) could offer a cost-saving alternative that is acceptable to patients. The main objective of this study was to undertake a health economic analysis of HBPM compared with traditional monitoring in hypertensive pregnant women. METHODS: This was a case-control study. Cases were pregnant women with hypertension who had HBPM with or without the adjunct of a smartphone app, via a specially designed pathway...
March 8, 2018: Ultrasound in Obstetrics & Gynecology
Enric Sabrià Bach, Paloma Lequerica-Fernández, Paula Lafuente-Ganuza, Edwin Eguia Ángeles, Ana I Escudero, Eduardo Martínez-Morillo, Carles Barceló Vidal, Francisco V Alvárez
OBJECTIVES: Short-term prediction of pre-eclampsia using the sFlt-1/PlGF ratio is characterized by frequent false positive results. As such, no treatment can be recommended to test positive patients. Multiple measurements are common in these patients. AIM: To evaluate the influence of NT-proBNP, uric acid and the sFlt-1/PlGF ratio in the prediction of delivery with pre-eclampsia within one week in singleton pregnancies from 24 weeks 0 days to 36 weeks 6 days of gestation, with signs and symptoms of pre-eclampsia and a sFlt-1/PlGF ratio above 38...
March 2, 2018: Ultrasound in Obstetrics & Gynecology
Maximilian Schmid, Karen White, Renee Stokowski, Danielle Miller, Patrick E Bogard, Venu Valmeekam, Eric Wang
OBJECTIVES: Various methods of fetal fraction measurement have been employed in conjunction with different approaches to cfDNA testing for fetal aneuploidy. In this study we evaluate the accuracy and reproducibility of fetal fraction measurement using polymorphic assays that are incorporated into test design as part the Harmony Prenatal Test® and confirm that the single nucleotide polymorphisms (SNPs) selected for and used in these assays can be applied broadly to all patient populations...
February 26, 2018: Ultrasound in Obstetrics & Gynecology
Silvia Carta, Andrea Kaelin Agten, Chiara Belcaro, Amarnath Bhide
OBJECTIVE: To quantify survival and neurodevelopmental outcome of fetuses with prenatally detected isolated severe bilateral ventriculomegaly form published literature. METHODS: Medline, Embase and the Cochrane Library were searched electronically. Only cases with prenatal diagnosis of apparently isolated severe ventriculomegaly and postnatal neurodevelopment assessment were selected and included. Severe ventriculomegaly was defined by the authors as enlargement of the ventricular atria, with a diameter greater than 15 mm on the transventricular plane while all cases where the investigators were unable to detect associated structural abnormality, chromosomal abnormality or fetal infections, and regarded the ventriculomegaly to be apparently isolated were included...
February 26, 2018: Ultrasound in Obstetrics & Gynecology
Karina Krajden Haratz, Sharon Leshem Shulevitz, Zvi Leibovitz, Dorit Lev, Shalev Josef, Mordechai Tomarkin, Gustavo Malinger, Tally Lerman-Sagie, Liat Gindes
OBJECTIVE: Prenatal diagnosis of midbrain-hindbrain malformations rely primarily on abnormal size and shape of the cerebellum and retrocerebellar space. The aim of this study was to present the 4th ventricle index (4VI), and to evaluate its role as a marker of severe vermian dysgenesis / agenesis cases without an open 4th ventricle (4v). METHODS: This prospective cross-sectional study included 384 healthy fetuses between 14 to 37 gestational weeks. Axial images of the 4v were obtained and the 4VI was calculated as the ratio between the latero-lateral and anteroposterior diameters...
February 26, 2018: Ultrasound in Obstetrics & Gynecology
L Herling, J Johnson, K Ferm-Widlund, F Bergholm, N Elmstedt, P Lindgren, S-E Sonesson, G Acharya, M Westgren
OBJECTIVES: Color tissue Doppler imaging (cTDI) is a promising tool for the assessment of fetal cardiac function. However, the analysis of myocardial velocity traces is cumbersome and time-consuming limiting its application in clinical practice. The aim of this study was to evaluate fetal cardiac function during the second half of pregnancy and to develop reference ranges using a newly developed automated method to analyze cTDI recordings from a cardiac four-chamber view. METHODS: This was a cross-sectional study including 201 normal singleton pregnancies between 18 and 42 weeks of gestation...
February 26, 2018: Ultrasound in Obstetrics & Gynecology
Antoni Borrell
Prenatal diagnosis of birth defects initially targeted Down syndrome and neural tube defects. Screening for fetal structural anomalies has expanded to screen any relevant malformation by means of a universal ultrasound scan. Although it is now apparent that clinically relevant genetic anomalies have a similar 3% birth prevalence, prenatal diagnosis programs still focus on Down syndrome. A new comprehensive paradigm is suggested, that provides information on all three groups of genetic disorders, chromosomal, submicroscopic and single-gene, causing intellectual and neurodevelopmental disability...
February 26, 2018: Ultrasound in Obstetrics & Gynecology
Marcelo Rodríguez, Alfonso Sprohnle, Javier Muñoz, Carlos Cadena, Rodrigo Corvalán, Alvaro Sepúlveda-Martínez
We described the case of first-degree fetal atrioventricular block in a patient with intrahepatic cholestasis of pregnancy treated with ursodeoxycholic acid (UDCA).
February 26, 2018: Ultrasound in Obstetrics & Gynecology
Alireza A Shamshirsaz, Ahmed A Nassr, Hadi Erfani, Olutoyin A Olutoye, Jimmy Espinoza, Oluyinka O Olutoye, Michael A Belfort
Ex-utero intra-partum treatment (EXIT) is an effective intra-partum fetal procedure that was developed to reduce mortality and morbidity at the time of delivery, which involves neonatal tracheal intubation while fetal oxygenation is maintained by the uteroplacental circulation in a partial fetal delivery under maternal general anesthesia. We describe the use of a novel antepartum fetoscopic laryngo-tracheoscopic procedure prior the delivery to avoid complications associated with an unnecessary EXIT procedure in a case where the fetus had a large neck mass (hemangioma) compressing the trachea...
February 26, 2018: Ultrasound in Obstetrics & Gynecology
Nicola Volpe, Costanza Migliavacca, Andrea Dall'Asta, Salvatore Politi, Giovanni Battista Luca Schera, Gianluigi Pilu, Tiziana Frusca, Tullio Ghi
A prospective observational study was conducted on 31 low risk pregnant women at term in the second stage of labor with singleton gestation and uncomplicated labor. Following spontaneous delivery of the fetal head in vertex presentation and left occiput anterior (LOA) position suprapubic ultrasound was performed with a portable machine to assess the orientation of the anterior fetal shoulder.
February 26, 2018: Ultrasound in Obstetrics & Gynecology
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