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Ultrasound in Obstetrics & Gynecology

Tsukasa Torigoe, Wadi Mawad, Mike Seed, Greg Ryan, Davide Marini, Fraser Golding, Tim van Mieghem, Edgar Jaeggi
A circular shunt (CS) is a life-threatening condition consisting of massive shunting of systemic arterial blood via the ductus arteriosus to the left ventricle without traversing the lungs. In the prenatal circulation, it mainly occurs in severe Ebstein anomaly (EA) from unrestricted ductal flow and significant pulmonary and tricuspid regurgitation. We aimed to improve the fetal hemodynamics and chances of survival of affected fetuses by inducing ductal constriction with transplacental non-steroidal anti-inflammatory drugs (NSAIDs)...
October 31, 2018: Ultrasound in Obstetrics & Gynecology
Ray O Bahado-Singh, Jiri Sonek, David McKenna, David Cool, Buket Aydas, Onur Turkoglu, Trent Bjorndahl, Rupasri Mandal, David Wishart, Perry Friedman, Stewart F Graham, Ali Yilmaz
OBJECTIVE: To evaluate the utility of Artificial Intelligence i.e. Deep Learning (DL) and other machine learning techniques for the prediction of important pregnancy outcomes in asymptomatic short cervical length (CL). METHOD: The amniotic fluid (AF) had been obtained from second trimester patients with asymptomatic women with short cervical length (<15 mm). CL, funneling and the presence of AF 'sludge' were assessed in all cases. Combined targeted metabolomic and proteomic analysis of amniotic fluid (AF) was performed...
October 31, 2018: Ultrasound in Obstetrics & Gynecology
Liona C Poon, Daljit Sahota, Piya Chaemsaithong, Takako Nakamura, Megumi Machida, Katsuhiko Naruse, Isabella Y M Wah, Tak Yeung Leung, Ritsuko K Pooh
OBJECTIVE: To (i) evaluate the normal development of the Sylvian fissures in the anterior coronal view of the fetal brain at 18-30 weeks' gestation by transvaginal 3D ultrasound; (ii) develop reference ranges of measurements of the right and left Sylvian fissure angles during normal pregnancy at 18-30 weeks' gestation; and (iii) examine the intra-observer and inter-observer repeatability of the measurements of the right and left Sylvian fissure angles. METHODS: This was a prospective cross-sectional study of 422 women with singleton pregnancy attending an ultrasound-based research clinic between March 2017 and December 2017...
October 31, 2018: Ultrasound in Obstetrics & Gynecology
Bigna S Buddeberg, Rajan Sharma, Jamie M O'Driscoll, Andrea Kaelin Agten, Asma Khalil, Baskaran Thilaganathan
OBJECTIVES: Obesity is an increasing problem worldwide with well-recognized detrimental effects on cardiovascular health. However, very little is known about the effect of obesity on cardiovascular adaptation to pregnancy, as existing studies are small and show conflicting results. The aim of the present study is to compare biventricular cardiac function at term in obese pregnant women and pregnant women of normal body weight utilizing conventional echocardiography indices and speckle tracking assessment...
October 31, 2018: Ultrasound in Obstetrics & Gynecology
M Tavares de Sousa, K Hecher, J Yamamura, F Kording, C Ruprecht, K Fehrs, C Behzadi, G Adam, B P Schoennagel
OBJECTIVES: To investigate the diagnostic performance of dynamic fetal cardiac MRI using a MR compatible Doppler Ultrasound (DUS) device for fetal cardiac gating to differentiate normal fetal hearts from fetuses with congenital heart disease in comparison to fetal echocardiography. METHODS: This was a prospective study including 8 fetuses with a normal heart and four with a congenital heart defect (CHD) at a median of 34 weeks (range 28 - 36). Dynamic fetal cardiac MRI was performed using a DUS device for direct cardiac gating...
October 31, 2018: Ultrasound in Obstetrics & Gynecology
Ritsuko K Pooh, Megumi Machida, Takako Nakamura, Koutaro Uenishi, Hideaki Chiyo, Kyoko Itoh, Jun Yoshimatsu, Hatsue Ueda, Keiko Ogo, Piya Chaemsaithong, Liona C Poon
OBJECTIVES: To evaluate Sylvian fissure development by assessing Sylvian fissure angles in cases with malformations of cortical development (MCD). METHODS: This was a retrospective study of 22 cases of MCD. 7/22 cases had extracranial abnormalities such as cardiac, renal, gastrointestinal and/or digital anomalies, and 5/22 had minor abnormalities such as micrognathia, lowset ear and single umbilical artery. Cases with stored three-dimensional (3D) brain volume acquired at 18+0 and 30+6 weeks of gestation at an ultrasound-based research clinic between January 2010 and December 2017 were identified through a database...
October 31, 2018: Ultrasound in Obstetrics & Gynecology
Ebony B Carter, Jennifer Stockburger, Methodius G Tuuli, George A Macones, Anthony O Odibo, Amanda S Trudell
OBJECTIVE: Our aim was to investigate the association between LGA and stillbirth to determine if the LGA fetus may benefit from antenatal testing. METHODS: We performed a retrospective cohort study of singleton ongoing pregnancies at 24 weeks gestation undergoing routine second trimester anatomy ultrasound from 1990-2009. Pregnancies complicated by fetal anomalies, aneuploidy, missing birthweight information and small for gestational age were excluded. Appropriate for gestational age (AGA) and LGA were defined as birthweight 10th -90th percentile and >90th percentile by the Alexander growth standard, respectively...
October 24, 2018: Ultrasound in Obstetrics & Gynecology
Aly Youssef, Elisa Montaguti, Maria Gaia Dodaro, Rasha Kamel, Nicola Rizzo, Gianluigi Pilu
OBJECTIVES: to assess the effect of levator ani muscle (LAM) co-activation in nulliparous women at term on labor outcomes. METHODS: We prospectively recruited 284 low-risk nulliparous at term before the onset of labor. Each woman underwent a transperineal ultrasound measuring the anteroposterior diameter of the levator hiatus. LAM co-activation was defined as reduction of the anteroposterior diameter of the levator hiatus under Valsalva in comparison with that at rest...
October 24, 2018: Ultrasound in Obstetrics & Gynecology
B A Virgilio, G Pontrelli, P Trevisan, D Sacchi, T Bernardini, M Scioscia
Ultrasound evidence of pelvic cysts in women of reproductive age is a quite frequent event in gynecological practice. In the clear majority of cases, they derive from the ovary, the tubes, or the uterus (i.e. cystic adenomyomas, colliquated myomas) while a small part of them can originate from the bowel. This article is protected by copyright. All rights reserved.
October 24, 2018: Ultrasound in Obstetrics & Gynecology
Michael A Belfort, Shaine A Morris, Jimmy Espinoza, Alireza A Shamshirsaz, Magda Sanz Cortez, Henri Justino, Nancy A Ayres, Athar M Qureshi
Absence of atrial communication in hypoplastic left heart syndrome (HLHS) produces severe obstruction of pulmonary blood flow frequently causing vascular injury. Any surviving fetuses suffer high neonatal mortality (50%) from profound hypoxemia since oxygenated blood cannot exit the left atrium (LA). (1,2) Postnatal interventions are suboptimal due to progressive hypoxemia/acidosis that occurs until such time as the inter-atrial septum (IAS) is opened and a left to shunt created. This article is protected by copyright...
October 24, 2018: Ultrasound in Obstetrics & Gynecology
Juan José Hidalgo, Francisco Ros, María Aubá, Tania Errasti, Begoña Olartecoechea, Álvaro Ruiz-Zambrana, Juan Luis Alcázar
OBJECTIVES: To perform the external validation of the three-step strategy proposed by the International Ovarian Tumor Analysis Group to evaluate its diagnostic performance for classifying adnexal masses as benign or malignant, when ultrasound is performed by non-expert sonographers. As secondary objective, to assess the diagnostic performance of an alternative strategy using Simple Rules Risk as second step instead of Simple Rules. METHODS: Prospective observational study conducted from September 2015 to August 2017 in two university hospitals including a consecutive series of patients diagnosed as having an adnexal mass...
October 24, 2018: Ultrasound in Obstetrics & Gynecology
Anca Ciobanu, Alan Wright, Argyro Syngelaki, David Wright, Ranjit Akolekar, Kypros H Nicolaides
OBJECTIVE: To develop reference ranges with gestational age for the pulsatility index in the umbilical artery (UA-PI) and fetal middle cerebral artery (MCA-PI and the cerebroplacental ratio (MCA-PI / UA-PI) and examine the maternal characteristics and medical history that affect these measurements. PATIENTS AND METHODS: This was a cross-sectional study of 72,417 pregnancies undergoing routine ultrasound examination at 20+0 to 22+6 weeks' gestation (n=3,712), or at 31+0 to 33+6 weeks (n=29,035) or at 35+0 to 36+6 weeks (n=37,282) or at 41+0 to 41+6 weeks (n=2,388)...
October 24, 2018: Ultrasound in Obstetrics & Gynecology
S Galeva, L Konstantinidou, M M Gil, R Akolekar, K H Nicolaides
OBJECTIVE: To report on the routine clinical implementation of cell-free (cf)DNA analysis of maternal blood for trisomies 21, 18 and 13 contingent on the results of the first-trimester combined test in twin pregnancies. METHODS: Screening for trisomies 21, 18 and 13 was carried out by a combination of maternal age, fetal nuchal translucency (NT) thickness, and serum free ß-hCG and PAPP-A at 11-13 weeks' gestation in 959 twin pregnancies in two UK NHS hospitals...
October 24, 2018: Ultrasound in Obstetrics & Gynecology
Simone Jhaveri, Rukmini Komarlu
A cervical aortic arch (CAA), often described as an arch that is supraclavicular in nature, is an extremely rare entity with isolated case reports diagnosed postnatally.1 We describe the first prenatal diagnosis of a unique constellation of findings including right CAA with aberrant left subclavian artery (LSCA) in a patient with TOF and 22q11 deletion using fetal echocardiography. This article is protected by copyright. All rights reserved.
October 18, 2018: Ultrasound in Obstetrics & Gynecology
Teresa M MacDonald, Lisa Hui, Alice J Robinson, Kirsten M Dane, Anna L Middleton, Stephen Tong, Susan P Walker
OBJECTIVES: Fetal growth restriction (FGR) is a major risk factor for stillbirth and most commonly arises from uteroplacental insufficiency. Despite clinical examination and third trimester fetal biometry, cases of FGR often remain undetected antenatally. Placental insufficiency is known to be associated with altered blood flow resistance in maternal, placental, and fetal vessels. We evaluated the performance of individual, and combined Doppler blood flow resistance measurements for the prediction of term FGR...
October 18, 2018: Ultrasound in Obstetrics & Gynecology
Ilaria Fantasia, Walkyria Andrade, Argyro Syngelaki, Ranjit Akolekar, Kypros H Nicolaides
OBJECTIVES: To investigate the relationship between fetal congenital heart defects (CHD) and placental perfusion assessed by uterine artery pulsatility index (UtA-PI) in relation to development of preeclampsia (PE). METHODS: This was a prospective screening study in singleton pregnancies at 19-24 weeks' gestation. Transvaginal ultrasound was used to measure the UtA-PI and the values were converted into multiples of the normal median (MoM). Median MoM values in pregnancies with fetuses with isolated major CHD were compared to those without CHD in relation to development of PE...
October 17, 2018: Ultrasound in Obstetrics & Gynecology
Anne S Siegmund, Marlies A M Kampman, Martijn A Oudijk, Barbara J M Mulder, Gertjan Tj Sieswerda, Steven V Koenen, Yoran M Hummel, Monique W M de Laat, Krystyna M Sollie-Szarynska, Henk Groen, Arie P J van Dijk, Dirk J van Veldhuisen, Caterina M Bilardo, Petronella G Pieper
OBJECTIVE: Pregnant women with congenital heart disease (CHD) have an increased chance of abnormal uteroplacental flow (UPF) measured from second trimester onwards. This is related to pregnancy complications affecting mother and baby. Maternal right ventricular (RV) dysfunction has been suggested as predisposing factor. First trimester UPF screening, followed by therapeutic strategies, is effective in preventing pregnancy complications. The study aim was to relate first trimester UPF measurements to pre-pregnancy maternal cardiac function and pregnancy complications...
October 17, 2018: Ultrasound in Obstetrics & Gynecology
Maia Brik, Irene Fernández-Buhigas, Aránzazu Martin-Arias, Marina Vargas Terrones, Rubén Barakat, Belén Santacruz
OBJECTIVE: to evaluate differences in maternal weight gain and fetal cardiac function according to exercise during pregnancy METHODS: A randomized controlled trial was performed at Hospital de Torrejón, Madrid, including 120 pregnant women, allocated into Exercise Group (EG) and Control Group (CG). The primary outcome was maternal weight. Secondary outcomes included caesarean section, preterm delivery, induction of labor, birth weight and fetal cardiac function parameters. A sample size of 45 (90 both groups) was planned to detect differences in maternal weight gain of at least 1 Kg, with a power of >80% (>0...
October 17, 2018: Ultrasound in Obstetrics & Gynecology
Federico Migliorelli, Claudia Rueda, Martina Aida Angeles, Núria Baños, David Eduardo Posadas, Eduard Gratacós, Montse Palacio
OBJECTIVE: To evaluate the association between cervical consistency index (CCI) and the risk of cesarean delivery after planned induction of labor (IOL). METHODS: We designed an observational prospective study, including women admitted for IOL at term. Ultrasonographic images were obtained before IOL and CCI was calculated offline once recruitment was completed. Main outcome was defined as cesarean delivery due to failed IOL or due to arrest of labor. Univariate statistical analysis was performed using Fisher's exact test for categorical variables and Student's T-test for continuous characteristics...
October 17, 2018: Ultrasound in Obstetrics & Gynecology
A Sotiriadis, E Hernandez-Andrade, F da Silva Costa, T Ghi, P Glanc, A Khalil, W P Martins, A O Odibo, A T Papageorghiou, L J Salomon, B Thilaganathan
No abstract text is available yet for this article.
October 15, 2018: Ultrasound in Obstetrics & Gynecology
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