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ABSTRACT: Objectives- The primary aim of this study was to compare the accuracy of sonographic fetal weight estimation models. The secondary aim was to define the most accurate time (4-7 or 3 days before delivery) for evaluating fetal weight. Methods- In this retrospective cohort study, a total of 12,798 sonographic fetal weight estimations were analyzed, of which 9459 were performed within 3 days of delivery and 3339 within 4 to 7 days. The cohort included all singleton pregnancies recorded at a single medical center from January 2000 to December 2010, with 24 weeks' gestation minimum. Predicted birth weights were calculated according to 23 sonographic fetal weight estimation models; in total, 294,354 sonographic weight estimations were evaluated and compared to the actual birth weights. Results- The accuracy of the models in predicting birth weight differed considerably. The most accurate models used 3 or more fetal measurements followed by models using abdominal circumference only. The models developed by Sabbagha et al (Am J Obstet Gynecol 1989; 160:854-862) proved most accurate, with a mean percent error of -0.2% and greater than 92% of estimates within 15% of birth weight (P < .05). Nineteen sonographic fetal weight estimation models (82.6%) better predicted fetal weight at 4 to 7 days before delivery (P < .001). Twenty-two (95%) of the models were less accurate at the extreme ends of fetal weight. Conclusions- Different formulas for fetal weight estimation vary greatly; we recommend that each center should evaluate the most accurate formula according to its attending population. Estimation of fetal weight performed 4 to 7 days before delivery using most models was more accurate than estimations performed 3 days before delivery.
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 05/2013; 32(5):815-23. · 1.25 Impact Factor
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ABSTRACT: To assess the differences in the sequence of events, leading to termination of pregnancy (TOP) due to diagnosis of Down syndrome (DS). The study compared women who were referred to institutional abortion committees (< 23 weeks) to those who were referred to supreme regional abortion committees (> 23 weeks).
Cases of singleton pregnancy ending in TOP due to DS in our institute during the period January 2000-December 2010 were retrospectively reviewed. The women were divided into two groups according to the gestational age at the time of the TOP. Group 1 included women who underwent TOP prior to 23 weeks of pregnancy; group 2 included women who had TOP at 23 weeks and onwards. The groups were compared regarding their demographic, sonographic and biochemical parameters during the affected pregnancy. Women in group 2 completed a telephone questionnaire about the circumstances leading to a late TOP after 23 weeks.
There were 303 cases of DS, which had TOP during this period of time. All cases were diagnosed by fetal karyotyping. A total of 282 cases (93%) had earlier TOP while 21 cases (7%) had late TOP. The mean gestational age in each group was 18 weeks (range 12-22 weeks] versus 24 weeks (18-34 weeks) respectively (p < 0.001). In group 2, there were significantly more abnormal cardiovascular findings (67% vs. 21% in group 1, p < 0.002). No other significant differences were found between the groups regarding the demographic parameters, biochemical screening results (triple test), nuchal translucency (NT) and early and/or late sonographic anomaly scans. In Group 2 a total of 9 (42.8%) out of 21 women agreed to answer the telephone questionnaire. In this group the triple test, was performed in the upper recommended time limit according to the Ministry of Health. This may have led to the delay in the TOP.
In our institutional experience we found that the circumstances leading to late TOPs because of DS were maternal dependent and not related to the screening findings. This stresses the efficiency of current screening programs, leading to early karyotyping and diagnosis of DS.
Harefuah 11/2012; 151(11):602-6, 656.
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ABSTRACT: To estimate the Down syndrome detection rate for nuchal translucency (NT) screening in twins when fetus-specific risk allows for between-fetus NT correlation.
The between-fetus correlation coefficient of log NT, in multiples of the median (MoM), was estimated from a series of 977 unaffected twins scanned at a single centre. Results were expressed in multiples of the normal median using a curve derived from 515 unaffected singleton pregnancies at the same centre. A screening result was classified as positive if the risk for at least one fetus exceeded the cut-off. Detection rates were estimated for a fixed 1-5% false-positive rate, at different gestational weeks, separately for risk calculation using an algorithm which takes account of between-fetus NT correlation or not.
The correlation coefficient in unaffected pregnancies was 0.43 (P < 0.0001) and estimated to be 0.23 and 0.11 in discordant and concordant twins. At 12 weeks of gestation, the model predicted detection rate for a 3% false-positive rate was 68% when between-fetus correlation is not taken into account, increasing to 73% when it is applied. Similarly, for other false-positive rates and gestational weeks there was a predicted 4-6% increase in detection.
Using a fetus-specific Down syndrome risk algorithm leads to a worthwhile increase in detection.
Prenatal Diagnosis 03/2011; 31(5):426-9. · 2.11 Impact Factor
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ABSTRACT: To present four cases of twin tubal pregnancies and discuss possible etiologies. Twin tubal pregnancies are a rare event, with incidence rates estimated as 1 out of 725-1,580 of tubal pregnancies.
Case series.
Department of obstetrics and gynecology at a tertiary health care facility.
All women with twin tubal pregnancy diagnosed and treated in the department during the years 2007-2009, according to electronic files and histologic reports.
None.
Artificial reproductive technique preceding twin tubal pregnancies
We diagnosed four twin pregnancies of 163 tubal pregnancies, an incidence of 2.4%. Of the four cases, two conceived after gonadotropin stimulation and intrauterine insemination. The third conceived following in vitro fertilization and intracytoplasmic sperm injection. The fourth was a spontaneous conception diagnosed as monochorial monoamniotic twin tubal pregnancy.
Twin tubal pregnancies may not be as rare as previously thought. Three of the four cases identified during a 2-year period followed artificial reproductive technique. We hope that this report will promote the study of the epidemiology of this event, improve diagnosis, and encourage the development of treatment modalities.
Fertility and sterility 10/2010; 94(5):1910.e13-6. · 3.97 Impact Factor
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ABSTRACT: Maternal ovarian torsion is a very rare complication in pregnant women that may be misdiagnosed because signs and symptoms such as abdominal pain and nausea/vomiting are nonspecific and are present in a number of obstetric and surgical conditions. There is limited information in the medical literature on ovarian torsion in pregnancy. Most previous studies have been isolated case reports and small case series. This retrospective study investigated the incidence, risk factors, and sonographic findings of maternal ovarian torsion in pregnancy. The participants were 33 pregnant women with 38 episodes of surgically proven torsion who were examined and managed surgically at a tertiary referral center between the years 1993 and 2007. Ultrasound examination was performed upon admission in all cases. The primary outcome measures were clinical and sonographic findings of ovarian torsion in pregnancy.
Seventeen (51.5%) of the pregnancies were spontaneously conceived and 16 (48.5%) were conceived by ovulation induction or in vitro fertilization. The majority of cases of torsion (55.3%, n = 21) occurred in the first trimester; 34.2% (n = 13) occurred in the second trimester and 10.5% (n = 4) in the third trimester. At presentation, all patients had abdominal pain and 57.9% (n = 22) reported nausea/vomiting. The preoperative ultrasound findings were ovaries with unilocular cysts in 15 (39.5%) cases, multicystic ovaries in 14 (36.8%) cases, and normally appearing ovaries without cystic components in 9 (23.7%) cases. Compared to the cystic and normal appearing ovaries, the multicystic ovary occurred more frequently in the first trimester than in second and third trimester torsion (47.6% vs. 23.5%), whereas the normal appearing ovary components occurred more frequently in second and third trimester torsion (35.3% vs. 14.3%). The median duration from admission to surgery, 6 hours (range: 1 hour to 3.7 days), was significantly shorter in the first trimester compared with the second and third trimester.
The investigators recommend that patients with relevant clinical presentation and on ovarian mass or enlarged ovary should be followed throughout pregnancy to rule out the possibility of ovarian torsion. The correct diagnosis of maternal ovarian torsion may be delayed in the second half of pregnancy.
Obstetrical and Gynecological Survey 04/2010; 65(5):291-292. · 2.51 Impact Factor
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ABSTRACT: OBJECTIVE: To assess long-term outcomes of children who had ovarian cysts diagnosed prenatally. METHODS: We reviewed prenatal records of fetuses diagnosed with ovarian cysts in our ultrasound unit between January 1997 and December 2008. During January-April 2009, those children were invited to our institute for transabdominal pelvic sonographic re-examination. Demonstration of the uterus and adnexa was required. RESULTS: Twenty-one children were diagnosed prenatally with either simple (n = 11) or complex (n = 12) ovarian cysts and treated by either conservative management (n = 13) or surgical intervention (n = 10) postnatally. The ipsilateral ovary was not detected in 8 of 11 children in whom a complex cyst had been detected on the first postnatal scan. Significantly higher rate of ovarian loss was diagnosed when the sonographic appearance of the ovarian cyst was simple on the prenatal scan and complex on the postnatal scan (six of seven) compared with when the ovarian cyst was simple on both scans (one of four, P = 0.04). CONCLUSION: Prenatal detection of complex ovarian cyst might indicate close monitoring in order to alert the need for early intervention for preventing impending ovarian loss. Further researches are needed to empower this study. Copyright (c) 2010 John Wiley & Sons, Ltd.
Prenatal Diagnosis 02/2010; 30(4):342-7. · 2.11 Impact Factor
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ABSTRACT: The purpose of this study was to determine the accuracy and reproducibility of intrapartum translabial 3-dimensional (3D) ultrasonographic measurements of cervical dilatation during labor.
A prospective observational study was conducted. Three-dimensional ultrasonographic volume data sets from 52 patients were collected during labor and stored. Later, all volumes were randomly reviewed twice offline by 2 examiners blinded to previous clinical and ultrasonographic measurements. The correlation with delivery room personnel digital vaginal examinations and interobserver and intraobserver agreement were determined.
Twenty-four patients were examined during the latent phase (0- to 4-cm cervical dilatation), and 28 patients were examined during the active phase (5- to 10-cm cervical dilatation). Translabial 3D ultrasonographic measurements of the cervical mean and maximal diameters and inner cervical area showed a positive correlation with digital vaginal examinations (r(2) = 0.609, 0.587, and 0.469, respectively; all P < .001). The interobserver mean differences +/- SD between paired measurements for the mean and maximal cervical dilatation and inner cervical area were 0.11 +/- 0.49 cm, 0.12 +/- 0.48 cm, and -0.22 +/- 5.69 cm(2), and the intraclass correlation coefficients (ICCs) were 0.82, 0.85, and 0.87. The intraobserver mean differences between paired measurements of the mean and maximal cervical dilatation and inner cervical area were 0.002 +/- 1.15 cm, 0.02 +/- 1.4 cm, and -0.41 +/- 1.15 cm(2), and the ICCs were 0.85, 0.79, and 0.75.
Assessment of cervical dilatation using 3D ultrasonography during labor is feasible and reproducible.
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 10/2009; 28(10):1289-96. · 1.25 Impact Factor
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ABSTRACT: To assess the indications for late termination (> or =23 weeks' gestation) of pregnancy (LTOP), and to evaluate the rate of cases potentially diagnosable earlier.
Cases of singleton pregnancy ending in LTOP due to fetal abnormalities in our institute between 1/1998 and 12/2005 were retrospectively reviewed. The women were divided into two groups according to the sequence of events that led to LTOP: Group 1 - the first test indicating an abnormal finding was performed < or =23 weeks' gestation, but LTOP was performed >23 weeks; Group 2 - the first test indicating an abnormal finding was performed > or =23 weeks of gestation, or the fetal prognosis was not certain at the time of diagnosis and there was a medical recommendation to continue investigation.
There were 144 cases of LTOP (average gestational age 26.2 +/- 3.4 weeks). More than 70% of the cases were aborted because of chromosomal/genetic indication in Group 1; many of them could have been detected earlier in pregnancy, while about 80% of the cases were aborted because of structural abnormalities in Group 2 (p < 0.001). The structural anomaly could have been diagnosed earlier in 56 cases ( approximately 74%) if the pregnant woman had undergone an earlier anomaly scan. In another 13 cases (9%), fetal prognosis was not certain and continuing prenatal investigation was required.
The most common indications for LTOP were structural abnormalities (91 cases, 70%) which included the central nervous system (26 cases, 29%), cardiac abnormalities (24 cases, 26%), and multiple malformations (18 cases, 20%). The diagnosis of fetal anomaly could have been made earlier in more than half of the pregnant women undergoing LTOP.
Fetal Diagnosis and Therapy 08/2009; 25(2):291-6. · 1.05 Impact Factor
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ABSTRACT: To assess fetal abnormalities and events leading to third-trimester abortion.
The study population included all parturient women with singleton pregnancy that underwent termination of pregnancy (TOP) in the third trimester in our institute because of fetal indications between 1998 and 2006.
There were 777 cases of TOP due to fetal anomalies in our center during the study period, and 52 terminations were carried out in the third trimester. All cases of third-trimester abortions were due to severe malformations with high probability of perinatal death or severe handicap: 65.3% anomalies were structural, and 58.9% of them involved the central nervous system (CNS). Genetic indications included mostly genetic diseases, unlike aneupluidities in earlier terminations. Routine prenatal care raised suspicion of abnormalities in 22 (42.3%) cases, and diagnosis was established by additional tests. Abnormal findings were either missed in 4 (7.7%) cases or developed later in 11 (21.1%) cases. No routine prenatal screening was performed in the remaining 15 (28.8%) cases.
Third-trimester abortion may be obviated by timely screening and scanning in some cases. The possibility of late TOP should be considered in malformations occurring late in pregnancy and in cases that require meticulous evaluation and follow-up from earlier stages of gestation.
Prenatal Diagnosis 01/2009; 29(3):223-8. · 2.11 Impact Factor
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ABSTRACT: To investigate the incidence, risk factors, and sonographic findings of maternal ovarian torsion in pregnancy.
Retrospective study.
Department of Obstetrics/Gynecology of a tertiary referral center.
Thirty-three pregnant women with 38 episodes of surgically proven torsion between the years 1993 to 2007.
Surgical confirmation and treatment of torsion.
Clinical and sonographic findings of ovarian torsion in pregnancy.
Sixteen (48.5%) pregnancies were conceived by ovulation induction or in vitro fertilization. Twenty-one torsion events occurred in the first trimester (55.3%) versus 13 (34.2%) and 4 (10.5%) in the second and third trimester, respectively. All patients were admitted with abdominal pain, whereas 22 (57.9%) reported nausea/vomiting. The preoperative ultrasound examination showed unilocular ovarian cysts in 15 (39.5%) cases, multicystic ovaries in 14 (36.8%), and normally appearing ovaries in 9 (23.7%) cases. The multicystic ovary was more common in the first trimester torsion, whereas the "normal" appearing ovary was more common in the second and third trimester torsion (47.6% vs. 23.5% and 14.3% vs. 35.3%, respectively). The median duration from admission to surgery was 6 hours (range, 1 hour to 3.7 days), being significantly shorter in the first trimester.
Ovarian torsion in pregnancy is more common in the first trimester, and induction of ovulation is a major risk factor.
Fertility and sterility 12/2008; 92(6):1983-7. · 3.97 Impact Factor
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ABSTRACT: Medical treatment of viable unruptured ectopic pregnancies by systemic methotrexate (MTX) is controversial due to elevated failure rates. This study describes a combined local and systemic MTX administration and compares the outcomes between viable ectopics in different locations.
This retrospective study evaluated 31 patients treated with combined local (sonographically guided) and systemic MTX for viable, unruptured ectopic pregnancies. Success was defined by pregnancy resolution without surgical intervention. Details on subsequent pregnancies were obtained via telephone questionnaires.
The ectopic pregnancies were located in the fallopian tube (n = 23), cesarean section scar (n = 5), and intramural portion of the tube (interstitial pregnancy) (n = 3). beta-Human chorionic gonadotropin levels and gestational weeks were similar. The combined treatment was successful in 73.9%, 100%, and 66.7% of cases, respectively (p > 0.05). Details regarding reproductive outcomes were available for 28 women (90.3%). Eighteen of the 24 women attempting to conceive became pregnant, and 15 of these had at least one live birth. There were three subsequent tubal pregnancies, all in patients with previous tubal pregnancies.
Combined MTX administration is effective and safe for treating viable cesarean scar pregnancies but is less successful for viable tubal or interstitial pregnancies. Reproductive outcomes following the combined MTX treatment are comparable to other treatment modalities for ectopic pregnancy.
Journal of Clinical Ultrasound 07/2008; 36(9):545-50. · 0.81 Impact Factor
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ABSTRACT: To present prenatal findings and maternal and neonatal outcomes following second- and early third-trimester spontaneous antepartum uterine rupture events in our institute.
Charts of patients with full-thickness second- or early third-trimester symptomatic uterine ruptures locally treated between 1984 and 2007 were evaluated.
There were seven events involving six women, all requiring emergency laparotomy, and cesarean section (CS). During the study period in our institute, there were 120 636 singleton deliveries (> or =22 weeks' gestation), including 5 of our cases, while in 2 cases, the rupture occurred earlier (<22 weeks' gestation). The rupture occurred after > or = 1 previous CSs in five cases. Six events were associated with abnormal placentation: placenta previa (n = 3), placenta percreta (n = 1), or both (n = 2). Other associated events included short, interpregnancy (IP) interval (n = 3) and past uterine rupture (n = 2). Pregnant women at gestational age > or = 22 weeks, who had the combination of placenta previa, and previous CS (n = 3), had a higher chance for spontaneous symptomatic antepartum uterine rupture when compared to women with placenta previa without a previous CS (OR 29.3, 95% CI 1.5-569.3, p = 0.007). There were no maternal deaths. Three of the five viable neonates survived.
Spontaneous symptomatic second- or early third-trimester uterine rupture in nonlaboring women is a very rare, obstetric emergency, which is hard to diagnose. Maternal and neonatal outcomes can be optimized by awareness of risk factors, recognition of clinical signs and symptoms, and availability of ultrasound to assist in establishing diagnosis, and enabling prompt surgical intervention.
Prenatal Diagnosis 06/2008; 28(6):478-84. · 2.11 Impact Factor
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ABSTRACT: To supplement existing cases of cesarean scar pregnancy presenting as acute conditions. All of the study women had been treated by a conservative surgical approach.
Retrospective study.
Department of obstetrics/gynecology of a tertiary referral center.
We identified six pregnant women at 7-15 weeks' gestation who underwent emergency laparotomy and uterine-preserving surgery. Four of them were initially treated by uterine curettage because of misdiagnosed intrauterine pregnancies. The other two experienced failed methotrexate treatment.
All patients underwent a similar surgical technique while actively bleeding. This included laparotomy and ligation of bilateral uterine arteries, followed by wedge resection of the entire pregnancy in scar. The uterus was sutured in two layers.
All the reported women in our series had been cured and their uteruses have been preserved.
There was an inadvertent injury to the bladder in one case, which was immediately repaired, and blood transfusion was required in two other cases. The postoperative course was uneventful for all the patients. One of the patients has already spontaneously conceived and she had an ongoing normal pregnancy at the time of writing.
This small case series emphasizes that uterine-preserving surgery is an optional management for cesarean scar pregnancies presenting as acute conditions, cases resistant to medical treatment, or for women at advanced gestation.
Fertility and sterility 05/2008; 91(6):2623-7. · 3.97 Impact Factor
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ABSTRACT: Asymptomatic adnexal masses have become common findings due to the widespread use of the transvaginal ultrasound. Most asymptomatic adnexal masses are benign, but malignancy should still be excluded. The assessment of women with adnexal masses, intended to detect the ones suspicious for malignancy, includes the medical history, physical examination, ultrasound scan with Doppler flows, and, in some cases, the CA-125 levels. Once the patient has completed the primary assessment, the important decision is whether to follow her conservatively (if a benign condition is probable), or to proceed to surgery (if malignancy is suspected). This review discusses the evaluation, differential diagnosis, and general approach to adnexal masses, and proposes a management flow chart.
Harefuah 02/2008; 147(1):49-52, 94.
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ABSTRACT: To assess the indications for prenatal karyotyping of sex chromosomal abnormalities (SCAs) during pregnancy.
All singleton pregnancies interrupted in our institute because of SCAs (1998-2005) were categorized into subgroups of 45,XO (Turner syndrome), 47,XXY (Klinefelter syndrome), 47,XXX and 47,XYY. The indications for prenatal diagnostic testing were recorded.
There were 67 SCAs pregnancies: 33% Turner syndrome, 28% Klinefelter syndrome, 21% 47,XXX and 18% 47,XYY. Maternal age was similar among the 4 groups (34 +/- 5, range 25-42 years). The main indications for fetal karyotyping were abnormal Down's syndrome (DS) screening or ultrasound findings, advanced maternal age (> or =35 years), and parental request. About 2/3 of the Turner and 47,XYY cases had either abnormal DS screening tests or sonographic findings, such as: increased nuchal translucency, mainly cystic hygroma and fetal hydrops. However, fetal karyotyping in more than 2/3 of the 47,XXX and 47,XXY cases was mainly performed because of advanced maternal age, and the diagnosis of fetal SCAs was coincidental (p <0.03).
Our recent suggestion to expand the DS screening capacity to other chromosomal abnormalities including SCAs is further supported. Prenatal detection seems to be promising for Turner syndrome and possibly for 47,XYY syndrome, while other SCAs are less likely to be detected either by ultrasound or biochemical screening.
Fetal Diagnosis and Therapy 01/2008; 23(1):76-81. · 1.05 Impact Factor
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ABSTRACT: This manuscript discusses the clinical presentation, diagnosis, pathophysiology and possible etiologies of prenatal thrombosis of the inferior vena cava and renal veins.
Eleven cases were identified through a Medline search of the English literature. These cases were reviewed, together with a recent case that was treated in our medical center.
Fetal thrombosis in the aforementioned vessels, presented as hydrops fetalis (33%), acute fetal distress (42%), or as an incidental prenatal ultrasound finding (25%). Underlying maternal conditions were present in 58%, and included chronic conditions (hypertension and diabetes mellitus), acute conditions (pyelonephritis and preeclampsia) and thrombophilia. In 42% cases, the prenatal ultrasound scan revealed an enlarged and hyper-echogenic affected kidney.
Intrauterine fetal venous thrombosis is a rare phenomenon, probably attributed to a multifactorial process. These factors may include inherited thrombophilia as well as prothrombotic clinical conditions.
Prenatal Diagnosis 08/2007; 27(7):603-7. · 2.11 Impact Factor
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ABSTRACT: Acquired uterine arteriovenous malformation is a rare but potentially life threatening condition and, as such, must be considered in the differential diagnosis of cases of abrupt, profuse vaginal bleeding following uterine curettage. The condition can easily be confused with retained products of conception and gestational trophoblastic disease.
One case was managed surgically, while 2 others were treated with selective embolization.
A positive medical history, the clinical presentation and features for the the ultrasonic appearance are the main features for the correct differential diagnosis and treatment of traumatic arteriovenous malformation resulting from uterine curettage.
The Journal of reproductive medicine 06/2007; 52(5):445-9. · 0.87 Impact Factor
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Prenatal Diagnosis 04/2007; 27(4):387. · 2.11 Impact Factor
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ABSTRACT: To compare the incidence of recurrent torsion of normal adnexa to recurrent torsion of abnormal adnexa in postmenarchal women.
All cases of surgically confirmed adnexal torsion operated on in our department from January 2002 to April 2006 were retrospectively analyzed. Classification as torsion of pathologic adnexa versus torsion of normal adnexa was based on pre- and postoperative pelvic sonograms, operative findings, and pathologic diagnoses (when available). The torsion recurrence rates were evaluated by a telephone questionnaire, with 90.5% compliance.
Twelve women had twisted normal adnexa and 50 women had twisted abnormal adnexa. The women with twisted normal adnexa were younger (25.5+/-7.9 years versus 31.4+/-11.4 years, P=.10) and had a lower median parity (0 versus 1, P=.06). Both groups had similar clinical presentations and a similar mean time from admission to surgery. The torsion recurrence rates were 63.6% (95% confidence interval [CI] 0.3-0.9) in the twisted normal adnexa group and 8.7% (95% CI 0.02-0.2) in the twisted abnormal adnexa group (P<.001). The retorsion risk of the pathologic adnexa was especially low after cystectomy (5.3%, 95% CI 0.001-0.3) or salpingo-oophorectomy (0%). The Kaplan-Meier life table analysis also showed a higher retorsion risk for normal adnexa (P=.008).
The current adnexa-sparing laparoscopic management of adnexal torsion by simply untwisting may predispose to recurrent torsion of normal adnexa. The role of ovariopexy procedures in the prevention of recurrent torsion events remains uncertain.
III.
Obstetrics and Gynecology 02/2007; 109(2 Pt 1):355-9. · 4.73 Impact Factor
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ABSTRACT: This study aims to establish normal range of sonographically measured maternal spleen size throughout pregnancy. Currently, 288 healthy pregnant women between 6 and 42 weeks' gestation underwent ultrasonographic measurements of spleen length and width. The relationships between ultrasound measurements with prepregnancy body mass index (BMI) and gestational age were assessed using the Pearson correlation coefficient. A linear regression model was applied to construct the appropriate equation for measuring the spleen area relative to BMI and gestational age. A significant correlation (R) was found between gestational age and spleen dimensions length (R = 0.486; p < 0.001), width (R = 0.455; p < 0.001) and area (R = 0.522; p < 0.001)) as well as between prepregnancy BMI and spleen length [(R = 0.314; p < 0.001), width (R = 0.380; p < 0.001) and area (R = 0.413; p < 0.001)]. We divided the spleen area by the BMI, thus enabling to perform a linear regression analysis with gestational age (weeks) as an independent continuous variable. A high multiple correlation (R) between spleen area and this variable was found (R(2) = 0.47; p < 0.001). The equation [spleen area/BMI = 1.598 + 0.032 x gestational age in weeks] was performed for calculating the spleen area throughout pregnancy. A significant overall growth pattern of spleen area in pregnancy with increasing gestational age was found. Normograms from these data can be used to evaluate splenomegaly throughout pregnancy.
Ultrasound in Medicine & Biology 01/2007; 32(12):1827-31. · 2.29 Impact Factor
