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Fetal doppler ultrasound protocol

Stephen A McAleavey, Kevin J Parker, Juvenal Ormachea, Ronald W Wood, Christopher J Stodgell, Philip J Katzman, Eva K Pressman, Richard K Miller
The placenta is the critical interface between the mother and the developing fetus and is essential for survival and growth. Despite the widespread use of ultrasound imaging and Doppler in obstetrics and gynecology and the recent growth of elastographic technologies, little is known about the biomechanical (elastic shear wave) properties of the placenta and the range of normal and pathologic parameters that are present. This study uses a well-developed protocol for perfusing whole placentas, post-delivery, to maintain tissue integrity and function for hours...
June 2016: Ultrasound in Medicine & Biology
Jelena Popić Ramac, Vinko Vidjak, Dinko Skegro, Zeljko Duić, Darko Blasković, Lidija Erdelez, Andrija Skopljanac-Macina, Slaven Suknaić, Marko Slavica, Nikola Ivan Leder
Imaging the pregnant patient presents a unique challenge to radiologist due to the risk of radiation to the conceptus (embryo/fetus). A rare case of a successfully recognized and treated pseudoaneurysm (PA) of the abdominal aorta is to be presented. The pseudoaneurysm occurred in the third trimester and had a favorable outcome for the mother and the baby. Emergent abdominal ultrasound (US) is the first modality in diagnostic algorithm for the rupture of aortic aneurysm in a pregnant woman. It provides the most rapid diagnostic information, although intestinal gas and abdominal tenderness may limit its accuracy...
September 2015: Collegium Antropologicum
N Bil, V Eggermann, A Roueli, J Nizard
OBJECTIVES: To assess the clinical, legal, and technical roles of ultrasound in an outpatient pregnancy assessment clinic, while evaluating the feasibility for these consultations to be performed at home. MATERIALS AND METHODS: We prospectively assessed all consultations from April 3 to May 31, 2013, at the outpatient pregnancy assessment clinic of La Pitié-Salpêtrière, Paris, France. We recorded all procedures and the number and type of ultrasound examination performed, according to their indication...
January 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Jamie O Lo, Matthias C Schabel, Victoria H J Roberts, Terry K Morgan, Juha P Rasanen, Christopher D Kroenke, Sophie R Shoemaker, Eliot R Spindel, Antonio E Frias
OBJECTIVE: We previously demonstrated that prenatal nicotine exposure decreases neonatal pulmonary function in nonhuman primates, and maternal vitamin C supplementation attenuates these deleterious effects. However, the effect of nicotine on placental perfusion and development is not fully understood. This study utilizes noninvasive imaging techniques and histological analysis in a nonhuman primate model to test the hypothesis that prenatal nicotine exposure adversely effects placental hemodynamics and development but is ameliorated by vitamin C...
March 2015: American Journal of Obstetrics and Gynecology
Eric Hildebrand, Madeleine Abrandt Dahlgren, Catarina Sved, Tomas Gottvall, Marie Blomberg, Birgitta Janerot-Sjoberg
BACKGROUND: Studies of prenatal detection of congenital heart disease (CHD) in the UK, Italy, and Norway indicate that it should be possible to improve the prenatal detection rate of CHD in Sweden. These studies have shown that training programs, visualization of the outflow tracts and color-Doppler all can help to speed up and improve the detection rate and accuracy. We aimed to introduce a more accurate standardized fetal cardiac ultrasound screening protocol in Sweden. METHODS: A novel pedagogical model for training midwives in standardized cardiac imaging was developed, a model using a think-aloud analysis during a pre- and post-course test and a subsequent group reflection...
2014: BMC Medical Imaging
Joshua A Copel, Mert Ozan Bahtiyar
Fetal growth restriction is one of the most complex problems encountered by obstetricians. Ultrasound-estimated fetal weight less than the 10th percentile for the gestational age is the most widely accepted diagnostic criterion. Management protocols vary from institution to institution. Doppler velocimetry provides valuable information about fetal status. We offer a practical approach to management and timing of delivery based on available data in the literature.
May 2014: Obstetrics and Gynecology
Francesc Figueras, Eduard Gratacós
Small fetuses are defined as those with an ultrasound estimated weight below a threshold, most commonly the 10th centile. The first clinically relevant step is the distinction of 'true' fetal growth restriction (FGR), associated with signs of abnormal fetoplacental function and poorer perinatal outcome, from constitutional small-for-gestational age, with a near-normal perinatal outcome. Nowadays such a distinction should not be based solely on umbilical artery Doppler, since this index detects only early-onset severe forms...
2014: Fetal Diagnosis and Therapy
Nicole O Alers, Graham Jenkin, Suzanne L Miller, Euan M Wallace
BACKGROUND: Fetal growth restriction complicates about 5% of pregnancies and is commonly caused by placental dysfunction. It is associated with increased risks of perinatal mortality and short-term and long-term morbidity, such as cerebral palsy. Chronic in utero hypoxaemia, inflammation and oxidative stress are likely culprits contributing to the long-term neurological sequelae of fetal growth restriction. In this regard, we propose that melatonin, a powerful antioxidant, might mitigate morbidity and/or mortality associated with fetal growth restriction...
2013: BMJ Open
Sebastian R Hobson, Rebecca Lim, Elizabeth E Gardiner, Nicole O Alers, Euan M Wallace
INTRODUCTION: Pre-eclampsia is a common pregnancy condition affecting between 3% and 7% of women. Unfortunately, the exact pathophysiology of the disease is unknown and as such there are no effective treatments that exist notwithstanding prompt delivery of the fetus and culprit placenta. As many cases of pre-eclampsia occur in preterm pregnancies, it remains a significant cause of maternal and perinatal morbidity and mortality. Recently, in vitro and animal studies have highlighted the potential role of antioxidants in mitigating the effects of the disease...
2013: BMJ Open
L G B Siqueira, V S Areas, A M Ghetti, J F Fonseca, M P Palhao, C A C Fernandes, J H M Viana
The objective was to determine the accuracy of a pregnancy test for predicting nonpregnant cattle based on the evaluation of corpus luteum (CL) blood flow at 20 d (CLBF-d20) after timed artificial insemination (TAI). Crossbred Holstein-Gir dairy heifers (n=209) and lactating cows (n=317) were synchronized for TAI using the following protocol: intravaginal implant (1.0 g of progesterone) and 2mg of estradiol benzoate i.m. on d -10, implant removal and 0.526 mg of sodium cloprostenol i.m. on d -2, 1mg of estradiol benzoate i...
October 2013: Journal of Dairy Science
Laurent J Salomon, Jean-Pierre Bernard, Anne-Elodie Millischer, Pascale Sonigo, Francis Brunelle, Nathalie Boddaert, Yves Ville
OBJECTIVE: A combination of magnetic resonance imaging (MRI) images with real time high-resolution ultrasound known as fusion imaging may improve prenatal examination. This study was undertaken to evaluate the feasibility of using fusion of MRI and ultrasound (US) in prenatal imaging. STUDY DESIGN: This study was conducted in a tertiary referral center. All patients referred for prenatal MRI were offered to undergo fusion of MRI and US examination. All cases underwent 1...
August 2013: American Journal of Obstetrics and Gynecology
D Iliescu, S Tudorache, A Comanescu, P Antsaklis, S Cotarcea, L Novac, N Cernea, A Antsaklis
OBJECTIVE: To assess the potential of first-trimester sonography in the detection of fetal abnormalities using an extended protocol that is achievable with reasonable resources of time, personnel and ultrasound equipment. METHODS: This was a prospective two-center 2-year study of 5472 consecutive unselected pregnant women examined at 12 to 13 + 6 gestational weeks. Women were examined using an extended morphogenetic ultrasound protocol that, in addition to the basic evaluation, involved a color Doppler cardiac sweep and identification of early contingent markers for major abnormalities...
September 2013: Ultrasound in Obstetrics & Gynecology
Erica O'Neill, John Thorp
Despite widespread use of many methods of antenatal testing, limited evidence exists to demonstrate effectiveness at improving perinatal outcomes. An exception is the use of Doppler ultrasound in monitoring high-risk pregnancies thought to be at risk of placental insufficiency. Otherwise, obstetricians should proceed with caution and approach the initiation of a testing protocol by obtaining an informed consent. When confronted with an abnormal test, clinicians should evaluate with a second antenatal test and consider administering betamethasone, performing amniocentesis to assess lung maturity, and/or repeating testing to minimize the chance of iatrogenic prematurity in case of a healthy fetus...
September 2012: Clinical Obstetrics and Gynecology
A Ozgur Yeniel, A Mete Ergenoglu, Ismail Mete Itil, Niyazi Askar, Reci Meseri
AIM: To examine the association between placenta previa and adverse perinatal outcomes such as low birth weight, preterm delivery, stillbirth and fetal growth restriction (FGR). METHODS: This retrospective cohort study includes 12,034 delivered pregnant women who were recruited for the study between 2004 and 2010 in Ege University Hospital. Data were collected by browsing the clinic's archives. The association between placenta previa and adverse perinatal outcomes was determined via Chi-square tests and Student's t test...
August 2012: Archives of Gynecology and Obstetrics
Lucie Morin, Kenneth Lim
OBJECTIVE: To review the literature with respect to the use of diagnostic ultrasound in the management of twin pregnancies. To make recommendations for the best use of ultrasound in twin pregnancies. OUTCOMES: Reduction in perinatal mortality and morbidity and short- and long-term neonatal morbidity in twin pregnancies. Optimization of ultrasound use in twin pregnancies. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in 2008 and 2009 using appropriate controlled vocabulary (e...
June 2011: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Khalil N Abi-Nader, Anna L David
Gene delivery to the fetal muscles is a potential strategy for the early treatment of muscular dystrophies. In utero muscle gene therapy can also be used to treat other genetic disorders such as hemophilia, where the missing clotting proteins may be secreted from the treated muscle. In the past few years, studies in small animal models have raised the hopes that a phenotypic cure can be obtained after fetal application of gene therapy. Studies of efficacy and safety in large animals are, however, essential before clinical application can be considered in the human fetus...
2011: Methods in Molecular Biology
Syed Amir Gilani, Amber Javaid, Alsafi Abdella Bala
OBJECTIVE: To evaluate the ductus venosus hemodynamic parameters in 31-40 weeks gestation normal fetus in the Pakistani population using Doppler ultrasonography. MATERIAL AND METHODS: In a standardized protocol 106 pregnant women (31 to 40 gestation weeks) were scanned. The peak systolic velocity (maximum velocity during S wave) (PSV), peak velocity index (peak velocity S wave minus peak velocity A wave/peak velocity D wave) (PVI), and S/A ratio (peak velocity S wave/peak velocity A wave) were measured...
June 2010: Medical Ultrasonography
S Yagel, S M Cohen, D Rosenak, B Messing, M Lipschuetz, O Shen, D V Valsky
OBJECTIVE: Many published studies have shown that application of three-dimensional (3D) and real-time 3D (4D) ultrasound modalities can improve certain aspects of fetal echocardiography, but have left open the question of whether these modalities improved the accuracy of prenatal detection of anatomical fetal cardiovascular malformations. We aimed to determine whether 3D/4D ultrasound improved diagnostic ability in cases of congenital heart disease (CHD). METHODS: Women who attended for early- or midtrimester targeted organ scans had complete fetal echocardiography according to our five-planes protocol, as well as examination of the ductus venosus and longitudinal aortic arch planes, performed with 2D ultrasound combined with 2D color Doppler, spatiotemporal image correlation (STIC), STIC with color Doppler, and STIC with B-flow...
April 2011: Ultrasound in Obstetrics & Gynecology
Corina Grigoriu, Cristina Cezar, Mirela Grigoras, Irina Horhoianu, Corina Parau, Petrache Vîrtej, Adina Lungu, V Horhoianu, Catalina Poiana
UNLABELLED: Maternal hypertiroidism is a relative rare disorder, which can seriously complicate pregnancy in each of its periods. There are several maternal and fetal complications during pregnancy, delivery and postpartum period. Correct management includes an accurate diagnosis, rigorous individualized treatment and minutious follow-up. We are presenting a retrospective study of 38 pregnant women who delivered in the Obstetric Unit of the University Emergency Bucharest Hospital in the past five years...
October 2008: Journal of Medicine and Life
Kate Morse, Amanda Williams, Jason Gardosi
Fundal height assessment is an inexpensive method for screening for fetal growth restriction. It has had mixed results in the literature, which is likely to be because of a wide variety of methods used. A standardised protocol of measurement by tape and plotting on customised charts is presented, which in routine practice has shown to be able to significantly increase detection rates, while reducing unnecessary referral for further investigation. Fundal height measurement needs to be part of a comprehensive protocol and care pathway, which includes serial assessment, referral for ultrasound biometry and additional investigation by Doppler as required...
December 2009: Best Practice & Research. Clinical Obstetrics & Gynaecology
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