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Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):227. · 3.01 Impact Factor
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Ultrasound in Obstetrics and Gynecology 07/2009; 33(6):731-3. · 3.01 Impact Factor
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ABSTRACT: Cervical chondrocutaneous vestiges or remnants originate from anomalous development of the branchial arches in the fourth week of gestation. Owing to their relative rarity, published data of cervical chondrocutaneous vestiges remain scarce. We report on the diagnosis and associated anomalies of cervical chondrocutaneous vestiges in three fetuses. The association of cervical chondrocutaneous vestige with other anomalies emphasizes the importance of performing meticulous examination and biochemical marker analysis in affected cases.
Ultrasound in Obstetrics and Gynecology 01/2008; 30(7):1010-2. · 3.01 Impact Factor
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Ultrasound in Obstetrics and Gynecology 07/2005; 25(6):625-7. · 3.01 Impact Factor
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ABSTRACT: To investigate whether uterine contractions at the time of a Cesarean section have an impact on future presence and location of a cervical Cesarean scar.
A targeted transvaginal ultrasound examination of the fetus, uterus and cervix was done in 2973 consecutive women at 14-16 weeks' gestation. The sonographer was blinded to the women's previous obstetric histories. The presence and location of a sonographic cervical hypoechogenic line, which probably represented a Cesarean scar, was recorded.
There were 180 women with a previous Cesarean section performed before the start of uterine contractions and 173 with a Cesarean section performed during contractions in labor. The cervical hypoechogenic line was more common in sections performed during contractions (75.7% vs. 52.7%; P < 0.001) and was more distally located from the internal os (17.9 +/- 9.4 vs. 14.6 +/- 9.1 mm; P = 0.01). A hypoechogenic line was observed in 21/2620 women without a previous Cesarean section, representing a false-positive rate of 0.8%.
Cesarean sections, especially those done during uterine contractions, are actually performed through cervical tissue. This finding is in agreement with the physiological process of cervical effacement during contractions.
Ultrasound in Obstetrics and Gynecology 06/2004; 23(6):594-8. · 3.01 Impact Factor
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Ultrasound in Obstetrics and Gynecology 08/2003; 22(S1):157 - 157. · 3.01 Impact Factor
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Ultrasound in Obstetrics and Gynecology 08/2003; 22(S1):81 - 81. · 3.01 Impact Factor
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ABSTRACT: To describe a novel, sonographic approach for in-utero evaluation of normal and abnormal aortic arch.
Aortic arch was evaluated by imaging of the axial view of the upper fetal mediastinum. The normal left aortic arch was defined by the V-shaped appearance of the junction between the ductus arteriosus and aortic arch, with the trachea situated posteriorly. Right and double aortic arches were diagnosed when the great vessels appeared U-shaped, with intermediate location of the trachea.
Between 1997 and 1999, 18 347 women were scanned in three prenatal centers, and pathological findings were prospectively recorded. In a retrospective analysis of the records, we identified 19 fetuses (0.1%) with atypical, U-shaped appearance, and no other structural abnormalities present. With the exception of one fetus with a ventricular septal defect, no congenital cardiac defects were present. Right aortic arch was found in 18 cases, while color Doppler made it possible to diagnose one case with double aortic arch, and one fetus was demonstrated as having Kommerell's diverticulum. In all 18 cases, a left descending aorta and left ductus arteriosus were present, the latter coursing to the left of the trachea, forming a loose partial vascular ring. All were asymptomatic at birth and early infancy. The fetus with double aortic arch that had a true vascular ring underwent early infantile correction.
It is possible to diagnose right and double fetal aortic arch using prenatal ultrasound. The use of color Doppler facilitated in-utero evaluation of possible complications, such as true vascular ring.
Ultrasound in Obstetrics and Gynecology 01/2003; 20(6):553-7. · 3.01 Impact Factor
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ABSTRACT: Transvaginal sonography enables imaging of the fetal heart in various planes and directions in early pregnancy. This study summarizes our experience in early detection of fetal cardiac anomalies.
Transvaginal sonographic examination was performed in 36 323 consecutive fetuses in both high- and low-risk pregnancies. More than 99% of cases were evaluated at 14-16 weeks' gestation. Examination of the cardiovascular system did not rely on still images of the classic views but instead was performed in a dynamic mode visualizing the heart and great vessels from different directions and in various scanning planes.
Cardiac anomalies were detected in 173 fetuses, giving an overall incidence of 1 in 210 pregnancies. In 44% of these, the cardiac anomaly was isolated. An abnormal karyotype was detected in 27 of the 72 cases that underwent chromosomal analysis. An abnormal nuchal translucency finding was observed in 59 fetuses. The sonographic diagnosis was confirmed after delivery or at postmortem in 90 cases. Ten fetuses had a cardiac anomaly which differed from the anomaly suggested by sonography. In the remaining cases, a postmortem examination was not possible because termination of pregnancy was performed by dilatation and curettage. In four cases we did not detect the cardiac anomaly in early pregnancy. Two of them were detected at rescanning in mid-pregnancy.
Early detection of fetal cardiac anomalies is now possible. Most anomalies occur in low-risk pregnancies. We suggest performing a detailed early multidirectional dynamic continuous sweep ultrasound examination of the fetal cardiovascular system in all pregnancies.
Ultrasound in Obstetrics and Gynecology 05/2002; 19(4):360-5. · 3.01 Impact Factor
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ABSTRACT: To describe the sonographic features and outcome of fetuses with isolated hyperechogenic foci in the thalamic region.
A detailed sonographic survey was performed in 46,244 consecutive pregnancies. Both low- and high-risk pregnancies were included. Transvaginal examinations were performed at 14-16 weeks' gestation, while transabdominal examinations were performed after 18 weeks' gestation.
Isolated hyperechogenic foci in the thalamic region were observed in seven fetuses. All cases were diagnosed at 14-16 weeks' gestation. Six fetuses had one hyperechogenic focus, and one fetus had two foci. The size of these foci ranged from 2-4 mm. A serologic work-up was negative in all these fetuses and their karyotype was normal. The hyperechogenic foci disappeared in mid-pregnancy in all cases, and fetuses were normal at delivery and on follow up to the age of 9 years.
Isolated hyperechogenic foci in the thalamic region in early pregnancy are probably benign in nature.
Ultrasound in Obstetrics and Gynecology 05/2001; 17(4):333-4. · 3.01 Impact Factor
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JAMA The Journal of the American Medical Association 03/2001; 285(6):737-8. · 30.03 Impact Factor
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ABSTRACT: This study was undertaken to assess the incidence of fetal polydactyly observed by ultrasonography and to evaluate the outcome of these fetuses.
Detailed ultrasonographic examinations were performed in 17,760 consecutive pregnant women. Both low- and high-risk pregnancies were included in the study. Most examinations were carried out at 14 to 16 weeks' gestation.
Twenty-six fetuses with polydactyly were observed. Ten fetuses had either associated anomalies or polydactyly of the feet, or both, and those pregnancies were terminated. The other 16 fetuses had isolated polydactyly and a normal karyotype. Fourteen of them had postaxial polydactyly type B. The outcomes of fetuses with isolated polydactyly were usually favorable. There was 1 intrauterine death and there were 2 terminations of pregnancy. Four infants were born with polydactyly. In utero autoamputation of extra digits occurred in 2 cases, whereas in the remaining infants only a small residual bump was noted.
Isolated fetal postaxial polydactyly type B is associated with a favorable outcome.
American Journal of Obstetrics and Gynecology 10/2000; 183(3):755-8. · 3.47 Impact Factor
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ABSTRACT: Background
The purpose of this study is to describe the monographic features and outcome of fetuses with isolated hyperechogenic foci in the thalamic region.MethodA detailed monographic survey was performed in 46244 consecutive pregnancies. Both low and high-risk pregnancies were included. Transvaginal examinations were performed at 14–16 weeks' gestation, while transabdominal examinations were performed after 18 weeks' gestation.ResultsIsolated hyperechogenic foci in the thalamic region were observed in 7 fetuses. All cases were diagnosed at 14–16 weeks' gestation. Six fetuses had one hyperechogenic focus, and one fetus had two foci. The size of these foci ranged from 2 to 4 mm. A serologic work-up was negative in all these fetuses and their karyotype was normal. The hyperechogenic foci disappeared in mid-pregnancy in all cases, and fetuses were normal at delivery and on follow-up up to the age of 9 years.Conclusion
Isolated hyperechogenic foci in the thalamic region in the early pregnancy have probably a benign nature.
Ultrasound in Obstetrics and Gynecology 09/2000; 16:68 - 68. · 3.01 Impact Factor
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Ultrasound in Obstetrics and Gynecology 08/2000; 16(1):98-9. · 3.01 Impact Factor
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ABSTRACT: To evaluate outcomes of fetuses with antepartum sonographic diagnoses of persistent intrahepatic right umbilical veins.
A detailed fetal sonographic examination was done in 30,240 consecutive pregnancies at 14-26 weeks' gestation. High- and low-risk pregnancies were included and persistent right umbilical veins specifically were recorded.
Sixty-nine fetuses had persistent intrahepatic right umbilical veins, of which 60 had no additional sonographic abnormalities, four had transient nuchal findings, and four had minor anomalies or anatomic variants. Only one of the 69 fetuses had a major anomaly (diaphragmatic hernia), and died after surgery. The remaining 68 fetuses were normal and healthy after birth.
Persistent intrahepatic right umbilical vein is a fetal anatomic variant that is not rare and usually associated with a favorable outcome.
Obstetrics and Gynecology 04/2000; 95(3):433-6. · 4.73 Impact Factor
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Ultrasound in Obstetrics and Gynecology 02/2000; 15(1):85. · 3.01 Impact Factor
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Ultrasound in Obstetrics and Gynecology 11/1999; 14(4):290-1. · 3.01 Impact Factor
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ABSTRACT: The propagation speed of ultrasound beams changes in different media. The aim of the study was to assess the possible measurement error of fetal biometry performed in cases of a myomatous uterus.
Three iron phantoms of 30 mm, 50 mm and 70 mm were measured by ultrasound. Each phantom was measured by three different transducers of 3.5 MHz, 6.5 MHz and 7.5 MHz. Measurements were performed in a water bath and the intraobserver variability was assessed. Thereafter phantoms were measured with one of their edges covered by a specimen of a myomatous uterus while their other edge was covered with water.
Artifactual lengthening of the phantoms' size was observed in measurements performed with the uterine myoma. The measurement errors were inversely related to the length of the phantoms and became statistically significant in the phantoms of 30 mm (13.15 +/- 3.16% without the myoma vs. 17.38 +/- 4.39% with the myoma; p < 0.0001). Measurement errors were independent of the transducer type (p = 0.001, p = 0.01 and p = 0.014 for the 3.5-MHz, 6.5-MHz and 7.5-MHz transducers, respectively).
Ultrasound measurement errors are expected while examining small fetal organs which are partially overshadowed by a myoma.
Ultrasound in Obstetrics and Gynecology 07/1999; 14(1):47-51. · 3.01 Impact Factor
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The Cleft Palate-Craniofacial Journal 04/1999; 36(2):105-7. · 0.82 Impact Factor
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ABSTRACT: Twenty-one fetuses with an enlarged fourth ventricle were detected by ultrasound at 14-16 weeks' gestation. No other central nervous system anomalies were observed and a normal size fourth ventricle was noted in all cases on follow-up scans at 22-23 weeks' gestation. Five fetuses had associated structural anomalies: a single umbilical artery in two cases, non-septated cystic hygroma in two cases and ventricular septal defect in one fetus. All fetuses had a normal brain sonogram after delivery. Nineteen newborns who were followed up to the age of one year had no developmental problems. It is concluded that an isolated enlarged fourth ventricle might be a physiological variant in early fetal life.
Prenatal Diagnosis 11/1998; 18(10):997-1000. · 2.11 Impact Factor
