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Ultrasound in Obstetrics & Gynecology

Erkan Kalafat, Ariana Laoreti, Asma Khalil, Fabricio Da Silva Costa, Basky Thilaganathan
OBJECTIVE: To determine the accuracy of ophthalmic artery Doppler in pregnancy for the prediction of preeclampsia. METHODS: MEDLINE (1947-2017), EMBASE (1974-2017), CINAHL (inception-2017) and the Cochrane Library (inception-2017) were searched for relevant citations without language restrictions. Two reviewers independently selected studies that evaluated the accuracy of ophthalmic artery Doppler to predict the development of preeclampsia and performed data extraction to construct 2 × 2 tables...
January 12, 2018: Ultrasound in Obstetrics & Gynecology
Ariel L Zimerman, Michael Moskovich, Efrat Barnea Levi, Ron Maymon, Josef Tobvin, Moshe Betser
Intrapartum angle of progression (AoP) is the leading sonographic parameter for the assessment of fetal head descent in labor. An AoP > 120° in the second stage of labor was correlated with spontaneous vaginal delivery and AoP > 145.5° with successful vacuum extraction.1-3.
January 12, 2018: Ultrasound in Obstetrics & Gynecology
Kirsten M Niles, Ally Murji, David Chitayat
Cell free fetal DNA (cffDNA) based aneuploidy screening has provided a highly accurate, non-invasive screening test in pregnancy. Cumulatively, NIPT has an approximately 1% false positive rate. Cases of co-twin demise result in as much as 42.1% of confirmed false positive NIPT results. To date, the longest documented duration of time following ultrasound identification of first trimester co-twin demise resulting in sex chromosome discrepancy or false positive NIPT is 8 weeks. We report a false positive NIPT for fetal sex at 21+3 weeks gestation by cffDNA secondary to a vanishing twin identified at 6+1 weeks gestation, which subsequently resolved on retesting at 28+6 weeks gestation...
January 12, 2018: Ultrasound in Obstetrics & Gynecology
Daniel L Rolnik, Fabricio da Silva Costa, Timothy J Lee, Maximilian Schmid, Andrew C McLennan
AIMS: To evaluate the association of fetal fraction on cell-free DNA (cfDNA) testing with first trimester markers for pre-eclampsia and to investigate a possible association of low fetal fraction with increased risk for pre-eclampsia (PE) and fetal growth restriction (FGR). METHODS: This was a retrospective cohort study including all women with singleton pregnancies who had risk calculation for PE and FGR between 11+0 and 13+6 weeks' gestation and also decided to have cfDNA as a primary or secondary screening test for chromosomal abnormalities at any gestational age in two Fetal Medicine clinics in Sydney and Melbourne, Australia, between March 2013 and May 2017...
January 10, 2018: Ultrasound in Obstetrics & Gynecology
Denise A Lapa Pedreira, Gregório L Acacio, Rodrigo T Gonçalves, Renato Augusto M Sá, Reynaldo A Brandt, Ramen Chmait, Eftichia Kontopoulos, Ruben A Quintero
OBJECTIVE: We have previously described our percutaneous fetoscopic technique for the treatment of open spina bifida (OSB). However, approximately 20-30% of OSB defects are too large to allow primary skin closure. We hereby describe a modification of our standard technique using a bilaminar skin substitute to allow closure of such large spinal defects. The aim of this study was to report our clinical experience with the use of a bilaminar skin substitute and a percutaneous fetoscopic technique for the prenatal closure of large spina bifida defects...
January 4, 2018: Ultrasound in Obstetrics & Gynecology
Matheus Roque, Marcello Valle, Marcos Sampaio, Selmo Geber
OBJECTIVES: To evaluate whether the freeze-all strategy affects in vitro fertilization (IVF) outcomes in poor ovarian responders following the Bologna criteria. METHODS: We performed a retrospective cohort study conducted between January 2012 and December 2016. A total of 433 poor responders (per the Bologna criteria) fulfilled the inclusion/exclusion criteria and were included in the study, with 277 patients included in the fresh group and 156 in the freeze-all group...
December 27, 2017: Ultrasound in Obstetrics & Gynecology
Carolina Scala, Umberto Leone Roberti Maggiore, Annalisa Racca, Fabio Barra, Valerio Gaetano Vellone, Pier Luigi Venturini, Simone Ferrero
OBJECTIVES: Several studies investigated the correlation between endometriosis and adverse pregnancy and perinatal outcomes. However, the role of adenomyosis as a risk factor for adverse perinatal outcomes in women with endometriosis has yet to be established. The aim of this study was to explore if fetal and maternal outcomes, in particular the incidence of small for gestational age (SGA) infants, are different in pregnant women with endometriosis (E) and the concomitant presence of diffuse (EDA) and focal ademonyosis (EFA)...
December 20, 2017: Ultrasound in Obstetrics & Gynecology
Rossana Orabona, Edoardo Sciatti, Federico Prefumo, Enrico Vizzardi, Ivano Bonadei, Adriana Valcamonico, Marco Metra, Tiziana Frusca
Heart failure (HF) is a clinical syndrome characterized by signs (e.g., pulmonary crackles, peripheral edema, jugular turgor) and symptoms (e.g., breathlessness, fatigue, ankle swelling) caused by structural and/or functional cardiac abnormalities and leading to elevated intracardiac pressure and/or low cardiac output (CO) at rest or during stress.
December 20, 2017: Ultrasound in Obstetrics & Gynecology
Angelo Cavallaro, Manuela Veglia, Elena Svirko, Silvia Vannuccini, Grazia Volpe, Lawrence Impey
OBJECTIVES: To investigate whether using the abdominal circumference growth velocity (ACGV) improves the prediction of perinatal outcome in small for gestational age (SGA) fetuses beyond that afforded by estimated fetal weight (EFW) and cerebroplacental ratio (CPR). METHODS: A cohort of 235 singleton SGA fetuses at 36-38 weeks was examined. The AC growth velocity (ACGV), EFW and CPR centiles were calculated. The ACGV was determined from a large database of 19-21 and 36-38 week scans in an unselected population...
December 20, 2017: Ultrasound in Obstetrics & Gynecology
A A Baschat, D Dewberry, V Seravalli, J L Miller, D Block-Abraham, M G Blitzer
OBJECTIVE: To compare blood pressure trends throughout pregnancy between women with normal outcome and those developing pre-eclampsia (PE) despite initiating first trimester aspirin (ASA). METHODS: Women were prospectively enrolled at 9-14 weeks gestation. ASA 81 mg daily was started before 16 weeks for increased PE risk based upon maternal history and bilateral uterine artery notching. Enrollment characteristics, BP measurements throughout gestation were compared between women with normal outcome and PE...
December 20, 2017: Ultrasound in Obstetrics & Gynecology
F Fontanella, L K Duin, P N Adama van Scheltema, T E Cohen-Overbeek, E Pajkrt, M Bekker, C Willekes, C J Bax, V Gracchi, D Oepkes, C M Bilardo
OBJECTIVE: to propose a clinical score for the optimal antenatal diagnosis of Lower Urinary Tract Obstruction (LUTO) in the second trimester of pregnancy, as alternative to the commonly used ultrasound (US) triad (megacystis, keyhole sign and hydronephrosis). METHODS: This was a national retrospective study carried out at the eight tertiary Fetal Medicine Units (FMUs) in the Netherlands. Only cases referred for megacystis starting from the second trimester and with clear postnatal diagnosis were included in the study...
December 20, 2017: Ultrasound in Obstetrics & Gynecology
S Stoecklein, C Haberler, G Gruber, M Diogo, B Ulm, F A Laccone, D Prayer
We present the case of a 31-year-old, neurologically unremarkable woman who underwent fetal MRI for evaluation of suspected corpus callosum agenesis at 23+0 gestational weeks (GW). On fetal MRI, the corpus callosum appeared thin, but all portions could be clearly delineated (Fig. 1A). However, T2-weighted images revealed subependymal heterotopia and a megacisterna magna (Fig. 1B).
December 20, 2017: Ultrasound in Obstetrics & Gynecology
S L Collins, F Chantraine, T K Morgan, E Jauniaux
There is little doubt that the worldwide Cesarean delivery epidemic has led to an increased incidence of abnormally adherent and invasive placentation. The significant impact that this disorder has on maternal morbidity and mortality has led to a flurry of publications in the literature concerning all aspects of the condition. These papers have arisen from many sources, notably pathologists, epidemiologists, obstetricians and radiologists.
December 12, 2017: Ultrasound in Obstetrics & Gynecology
Larissa N Bligh, Amal A Alsolai, Ristan M Greer, Sailesh Kumar
OBJECTIVES: We sought to determine the screening performance of a low fetal cerebroplacental ratio (a marker of fetal adaptation to suboptimal growth) and maternal placental growth factor levels, respectively, both in isolation and in combination, for the detection of cesarean section for intrapartum fetal compromise and serious composite neonatal outcome. METHODS: A prospective cohort study was performed on low risk women with uncomplicated singleton pregnancies from 36 weeks to delivery...
December 11, 2017: Ultrasound in Obstetrics & Gynecology
Anthea Lindquist, Alice Poulton, Jane Halliday, Lisa Hui
OBJECTIVES: To perform a population-based analysis of a combined first trimester screening (CFTS) cohort for (i) changes in uptake of invasive prenatal diagnosis by CFTS risk, and (ii) prevalence and methods of ascertainment of atypical chromosome abnormalities. METHODS: Retrospective cohort study of state-wide prenatal datasets from Victoria, Australia. A three-step approach was undertaken: i) record-linkage between serum screening and diagnostic results; ii) comparison of rates of diagnostic testing by CFTS risk categories in a 2014-15 CFTS cohort with a historical cohort from 2002-04; (iii) detailed analysis of atypical abnormalities from 2014-15 by CFTS risk, individual serum analyte level and indications for diagnostic testing...
December 11, 2017: Ultrasound in Obstetrics & Gynecology
Marie L Weber, Wiebke Schaarschmidt, Ravi Thadhani, Holger Stepan
Preeclampsia (PE) is a serious complication in obstetrics that affects approximately 3-5% of all pregnancies and it constitutes the leading cause of maternal mortality and morbidity worldwide. Although PE appears to be a maternal disease, iatrogenic preterm birth shifts the burden on the neonate after delivery. Impaired throphoblast invasion and differentiation in the first trimester with high placental impedance is considered to be the pathogenetic pathway of early and severe PE. Maternal rise of blood pressure represents the counter-regulation to maintain fetal supply...
December 11, 2017: Ultrasound in Obstetrics & Gynecology
Andrea Dall'Asta, Harsha Shah, Giulia Masini, Gowrishankar Paramasivam, Joseph Yazbek, Tom Bourne, Christoph C Lees
Prenatal diagnosis of abnormally invasive placenta (AIP) and accurate characterization of its variants can contribute to reducing maternal morbidity and mortality by allowing optimal management in terms of timing and planning of delivery (1,2).
December 5, 2017: Ultrasound in Obstetrics & Gynecology
Caroline Diguisto, Norbert Winer, Guillaume Benoist, Helene Laurichesse Delmas, Jerome Potin, Aurélien Binet, Hubert Lardy, Baptiste Morel, Franck Perrotin
OBJECTIVES: To assess the efficacy and safety of in utero aspiration for anechoic fetal ovarian cysts. METHODS: This multicenter, prospective, randomized open trial with two parallel groups included women from nine outpatient fetal medicine departments with singleton pregnancies ≥ 28 weeks of gestation, a female fetus with an ultrasound-diagnosed simple ovarian cyst, defined as a single fully anechoic cystic structure measuring ≥ 30 mm. They were randomly allocated to in utero cyst aspiration under ultrasound guidance or expectant management...
December 5, 2017: Ultrasound in Obstetrics & Gynecology
M K Van de Waarsenburg, E A Verberne, C H van der Vaart, M I J Withagen
OBJECTIVE: To describe changes in the levator hiatus after vaginal delivery compared to pregnancy state by measuring dimensions of the levator hiatus, to map the regeneration in order to contribute to secondary prevention in symptoms of pelvic floor disorders. METHODS: Twenty nulliparous women with a singleton pregnancy received ultrasound assessment of the pelvic floor at rest, contraction and on Valsalva maneuver at 12 weeks' gestation and at 1 day and 1, 2, 3, 4, 6, 12, 18 and 24 weeks after vaginal delivery...
December 5, 2017: Ultrasound in Obstetrics & Gynecology
Izabele Vian, Paulo Zielinsky, Ana Maria Zílio, Maximiliano I Schaun, Camila Brum, Kenya Venusa Lampert, Nataly De Ávila, Giovana Baldissera, Tamires Mezzomo Klanovicz, Karina Zenki, Jesus Zurita-Peralta, Alessandro Olszewski, Antonio Piccoli, Luiz Henrique Nicoloso, Natássia Sulis, Luiza Van Der Sand, Melissa Markoski
OBJECTIVE: Anti-inflammatory substances that inhibit the synthesis of prostaglandins, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and polyphenol-rich foods, can cause constriction of the fetal ductus arteriosus. This study aimed to test the hypothesis that reversal of fetal ductal constriction after maternal restriction of polyphenol-rich foods, in the third trimester of pregnancy, is accompanied by increased prostaglandin E2(PGE2) plasma levels. METHOD: A controlled clinical trial was designed...
December 5, 2017: Ultrasound in Obstetrics & Gynecology
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