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Obstetrics ultrasound

Jeffrey P Wilkinson, Angela M Bengtson, Ennet Chipungu, Rachel J Pope, Bonus Makanani, Margaret Moyo, Mwawi Mwale, Jennifer H Tang
Objective: Obstetric fistula (OF) is a morbid condition caused by prolonged obstructed labor. Women with OF experience profound injury and have high rates of infertility and poor obstetric outcomes. We examined endovaginal ultrasound parameters in women with and without OF. Design/Setting/Sample/Methods: This cross-sectional study enrolled women evaluated at the Fistula Care Centre in Lilongwe, Malawi. Eligibility criteria included age 18-45, prior pregnancy, and a uterus on ultrasound...
2018: Obstetrics and Gynecology International
Mitko Kocarev, Fouzia Khalid, Fatima Khatoon, Roshan Fernando
PURPOSE OF REVIEW: Neuraxial labor analgesia remains the most effective and one of the most commonly utilized methods for pain relief during labor. This narrative review article is a summary of the literature published in 2017 on neuraxial analgesia for labor. RECENT FINDINGS: From a total of 41 identified articles, 13 were included in the review. The topics have been structured into three categories: initiation of neuraxial analgesia, maintenance of neuraxial analgesia, and neuraxial analgesia and obstetric outcomes...
March 14, 2018: Current Opinion in Anaesthesiology
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
Ronit Koren, Yifat Wiener, Karen Or, Carlos A Benbassat, Shlomit Koren
OBJECTIVES: To study the current practices in the management of subclinical hypothyroidism (SCH) and thyroid nodules during pregnancy of obstetricians/gynecologists (OB/GYNs) and endocrinologists in Israel. METHODS: An electronic questionnaire was sent by email to all members of the Israeli Endocrine Society and the Israel Society of Obstetrics and Gynecology. Questionnaires included demographic data and clinical scenarios with questions regarding the screening and management of pregnant women with SCH, hypothyroxinemia, and a palpable thyroid nodule...
March 2018: Israel Medical Association Journal: IMAJ
S Ibrahimi, A A Mroué, E Francois, R Jagodzinski
A 34-year-old woman in the 22nd week of gestation presented with generalized pruritis and weight loss since the first trimester of pregnancy. Physical examination revealed cutaneous scratch lesions, jaundice, and hepatomegaly. Blood tests revealed cholestasis with elevated direct bilirubinemia. Auto-antibody and viral hepatitis tests were negative. Liver ultrasound was normal. The initial diagnosis was cholestasis of pregnancy. However despite treatment with ursodeoxycholic acid, the patient did not improve...
July 2017: Acta Gastro-enterologica Belgica
A Drobníková, Z Vocásek, M Kacerovský
OBJECTIVE: A case report of the pregnancy complicated by the presence of vein of Galen aneurysmal malformation in fetus. DESIGN: The case report. SETTING: Department of Obstetrics and Gynaecology, Masaryks Hospital, Jilemnice; Obstetrics and Gynecology Clinic, University Hospital in Hradec Králové. CASE REPORT: The description of the pregnancy complicated by the presence of vein of Galen aneurysmal malformation in a fetus 32 weeks gestation which led to a progressive heart failure and the development of the hydrocephalus...
2018: Ceská Gynekologie
Cristina Mitric, Vincent Ponette
BACKGROUND: In twin pregnancies, elective cerclage placement based on obstetrical history or ultrasound findings has been shown to be ineffective and even harmful. There are currently no guidelines for the use of rescue cervical cerclage in twin pregnancies. CASE: The current report presents the case of a 33-year-old patient with monochorionic diamniotic twins (MCDA) found to have dilated cervix at 3.5cm with exposed membranes upon physical examination at 19 weeks and 3 days...
March 1, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Ashraf Talaat Youssef
INTRODUCTION: Many uncommon obstetric and gynecologic problems associated with pregnancy and the early postpartum period can lead to severe abdominal pain and be life-threatening. The patient will be in urgent need of a quick and accurate decision. The means of management will depend on the ability to differentiate between these problems to achieve an optimal diagnosis. MATERIALS AND METHODS: 30 pregnant females attended a private obstetric ultrasound clinic with clinical picture of acute abdomen with pregnancy...
March 3, 2018: Journal of Ultrasound
Piotr Szkodziak, Filip Szkodziak, Kamila Trzeciak, Piotr Czuczwar
Uterine fibroids are benign uterine tumors. In women during the reproductive period, uterine fibroids occur in about 25%, whereas after this time, they are observed in more than 40% of women. In the majority of women (about 20-50%), such tumors do not cause discomfort and do not require treatment. Asymptomatic uterine fibroids usually undergo only regular medical control, whereas symptomatic fibroids are an indication for treatment. Current treatment methods include surgical, pharmacological and minimally invasive treatment...
December 2017: Przeglad Menopauzalny, Menopause Review
Bronius Žaliūnas, Daiva Bartkevičienė, Gražina Drąsutienė, Algirdas Utkus, Juozas Kurmanavičius
Ultrasound imaging in obstetrics and gynecology dates back to 1958 when The Lancet published the first article about the use of ultrasonography for fetal and gynecological assessments. It is now almost inconceivable, 60 years later, to think of effective performance in obstetrics and gynecology without the variety of ultrasound, for example, real time imaging, power and color Doppler, 3D/4D ultrasonography, etc. Such examinations facilitate the assessment of intrauterine fetal growth and development during pregnancy, provide alerts about the risk of pre-eclampsia and preterm birth, help identify anatomic reasons for infertility, diagnose ectopic pregnancies, uterine, ovary and tubal pathology...
February 9, 2018: Medicina
Rosemary Townsend, Asma Khalil
In the decades since the introduction of ultrasound into routine obstetric practice, the advantages of ultrasound have moved beyond the simple ability to identify multiple pregnancies antenatally to the possibility of screening them for fetal anomalies, pre-eclampsia, preterm birth, and the complications specific to monochorionic pregnancies. Screening studies have often excluded twins because physiological differences impact on the validity and sensitivity of the screening tests in routine use in singletons, and therefore, the evidence of screening performance in multiple pregnancy lags behind the evidence from singleton pregnancies...
February 18, 2018: Seminars in Fetal & Neonatal Medicine
Layan Alrahmani, Elisabeth Codsi, Kristi S Borowski
OBJECTIVES: We evaluated the current state of ultrasound training in obstetrics and gynecology (OB-GYN) residency programs across the United States. METHODS: An electronic survey was sent to OB-GYN residency program directors and OB-GYN residents. Responses were obtained in September 2016. Program directors and residents were asked to reflect on their current ultrasound curriculum. RESULTS: A total of 93 program directors and 437 residents responded...
February 21, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Jessie V Madden, Christopher J Flatley, Sailesh Kumar
BACKGROUND: Small-for-gestational age (SGA) infants (birthweight <10th centile) are at increased risk of perinatal complications but are frequently not identified antenatally, particularly in low risk women delivering at term (>37 weeks gestation). This is compounded by the fact that late pregnancy ultrasound is not the norm in many jurisdictions for this cohort of women. We thus investigated the relationship between birthweight <10th centile and serious neonatal outcomes in low risk women at term...
February 17, 2018: American Journal of Obstetrics and Gynecology
Timothy J Lee, Daniel L Rolnik, Melody A Menezes, Andrew C McLennan, Fabricio da Silva Costa
STUDY QUESTION: Are fetal fraction, test failure rate and positive predictive value (PPV) of cell-free fetal DNA (cffDNA) testing different in singleton IVF conceptions compared to spontaneous conceptions? SUMMARY ANSWER: Fetal fraction is significantly lower; test failure rate is higher and PPV of cffDNA testing is lower in singleton pregnancies conceived by IVF than those conceived spontaneously. WHAT IS ALREADY KNOWN: cffDNA testing, which analyses circulating cffDNA in maternal blood, has very high accuracy for detection of trisomy 21 in the general obstetric population...
February 15, 2018: Human Reproduction
Roy Lauterbach, Cara Ferrer Sokolovski, Jenia Rozenberg, Amir Weissman
STUDY OBJECTIVES: The aims of the present study were to evaluate acupuncture as an alternative treatment to an indwelling catheter for women with postpartum urinary retention, and to evaluate the accuracy of sonographic estimation of bladder volume by portable bedside equipment in women postpartum. STUDY BACKGROUND: Post-partum urinary retention is a common obstetric complication. The accepted method for diagnosing post void residual bladder volume is by ultrasound or catheterization...
January 31, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
William Shyy, Roneesha S Knight, Nathan A Teismann
BACKGROUND: Abdominal pain is one of the most common chief complaints of patients presenting to emergency departments, and emergency physicians (EPs) often evaluate patients with right lower quadrant abdominal pain. Ovarian torsion is a rare cause of abdominal pain, but early diagnosis is essential for salvage of the affected ovary. The diagnostic study of choice for ovarian torsion is a pelvic ultrasound with color Doppler, but it is important for EPs and radiologists to be aware of findings of ovarian torsion that might appear on computed tomography (CT)...
February 17, 2018: Journal of Emergency Medicine
Gillian Coleman, Heather Venables
Vasa praevia is an obstetric complication currently not screened for within the United Kingdom, which if undetected prenatally can lead to fetal death when the membranes rupture. Internationally, guidelines are available providing guidance on the best screening policy and management pathways. However, the UK National Screening Committee and Royal College of Obstetricians and Gynaecologists do not support screening due to a lack of evidence. Recent studies explore the ability of ultrasound to detect vasa praevia prenatally in both the general and high-risk populations...
February 2018: Ultrasound: Journal of the British Medical Ultrasound Society
Nathalie Jeanne Bravo-Valenzuela, Alberto Borges Peixoto, Edward Araujo Júnior
This article reviews important features to improve the diagnosis of congenital heart disease (CHD) by applying ultrasound in prenatal cardiac screening. As low and high-risk pregnancies for CHD are subject to routine obstetric ultrasound, the diagnosis of structural heart defects represents a challenge that involves a team of specialists and subspecialists on fetal ultrasonography. In this review, the images highlight normal anatomy of the heart as well as pathologic cases consistent with cardiac malposition and isomerism, septal defects, pulmonary stenosis/atresia, aortic malformations, hypoplastic left ventricle, conotruncal anomalies, tricuspid dysplasia, and Ebstein's anomaly, and univentricular heart, among other congenital cardiovascular defects...
January 2018: Indian Heart Journal
Christopher Flatley, Sailesh Kumar
OBJECTIVE: In high-risk pregnancies combining the cerebro-placental ratio (CPR) with the estimated fetal weight (EFW) improves the identification of vulnerable fetuses. The purpose of this study was to assess the CPR and EFW's ability to predict adverse obstetric and perinatal outcomes in a low-risk pregnancy, when measured late in gestation. METHODS: This was a retrospective study of women who birthed at Mater Mothers Hospitals, Brisbane, Australia between 2010 and 2015...
February 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
M Rial-Crestelo, R J Martinez-Portilla, A Cancemi, J Caradeux, L Fernandez, A Peguero, E Gratacos, Francesc Figueras
OBJECTIVES: To determine the added value of cerebroplacental ratio (CPR) and uterine Doppler velocimetry at third trimester scan in an unselected obstetric population to predict smallness and growth restriction. METHODS: We constructed a prospective cohort study of women with singleton pregnancies attended for routine third trimester screening (32 +0 -34 +6 weeks). Fetal biometry and fetal-maternal Doppler ultrasound examinations were performed by certified sonographers...
February 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
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