Ultrasound in Obstetrics & Gynecology最新文献

{"title":"Is two-dimensional oblique parasagittal ultrasound imaging valid for levator ani muscle assessment?","authors":"K L Shek, H P Dietz","doi":"10.1002/uog.29236","DOIUrl":"10.1002/uog.29236","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the validity of two-dimensional (2D) oblique parasagittal ultrasound imaging to assess levator ani muscle avulsion.</p><p><strong>Methods: </strong>This was a cross-sectional prospective study of women attending a tertiary urogynecological service between February 2021 and August 2022. All women underwent a standardized interview, pelvic organ prolapse quantification (POP-Q) assessment and four-dimensional transperineal ultrasound. 2D oblique parasagittal ultrasound imaging was performed by rotating the transducer 10-20° from the midline to line up the main transducer axis with the fiber direction of the puborectalis muscle, followed by a full parasagittal sweep of the hiatus at rest. Postprocessing of archived ultrasound volume data was performed at a later date, blinded to all other data. Findings were compared with levator ani assessment results obtained previously using three-dimensional tomographic ultrasound imaging (TUI). Diagnosis of levator ani avulsion on TUI and oblique parasagittal imaging was analyzed for associations with pelvic organ prolapse (POP).</p><p><strong>Results: </strong>The datasets of 484 women were analyzed. Mean age was 58 (range, 16-94) years, mean body mass index was 30 (range, 17-65) kg/m² and mean parity was 2.6 (range, 0-8). POP symptoms were reported by 278 (57%) women. Clinically and sonographically significant POP was found in 385 (80%) and 350 (72%) women, respectively. Levator ani avulsion was diagnosed in 77 (16%) women on TUI and in 90 (18.6%) women on oblique parasagittal ultrasound imaging, with fair agreement between the two methods (Cohen's kappa of 0.365). There were significant associations between levator ani avulsion on 2D ultrasound imaging and POP diagnosis on clinical examination (odds ratio (OR), 2.88 (95% CI, 1.34-6.18); P = 0.005) and on ultrasound (OR, 2.92 (95% CI, 1.53-5.55); P = 0.001), but these associations were much stronger for TUI (P < 0.001 for both).</p><p><strong>Conclusion: </strong>There was limited agreement between tomographic and oblique parasagittal ultrasound diagnosis of levator ani muscle avulsion. The latter technique has some validity for levator ani assessment but is clearly less valid than TUI. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"96-100"},"PeriodicalIF":6.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single fetal demise in twin anemia-polycythemia sequence: perinatal outcome of surviving cotwin.","authors":"M J A van de Sande, E Lopriore, M Lanna, Y Ville, L Lewi, A S Weingertner, G Ryan, L Otaño, P Klaritsch, A M B Blanco, E Bevilacqua, F Slaghekke, L S A Tollenaar","doi":"10.1002/uog.29242","DOIUrl":"10.1002/uog.29242","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the perinatal outcome after spontaneous single intrauterine fetal demise (IUFD) in monochorionic twin pregnancies with twin anemia-polycythemia sequence (TAPS).</p><p><strong>Methods: </strong>This was a retrospective study of all monochorionic twin pregnancies with TAPS that underwent spontaneous single IUFD and were registered in the international TAPS Registry between 2014 and 2023. The primary outcomes were mortality and severe neonatal cerebral injury in the surviving cotwin.</p><p><strong>Results: </strong>A total of 39 twin pregnancies with TAPS that underwent spontaneous single IUFD were included, of which 77% (30/39) developed TAPS after laser surgery for twin-twin transfusion syndrome and 23% (9/39) developed TAPS spontaneously. Single IUFD occurred mostly in the donor twin (35/39 (90%)). The median gestational age at single IUFD was 23.0 (interquartile range (IQR), 20.7-27.9) weeks. The median gestational age at birth of the surviving cotwin was 34.3 (IQR, 32.2-36.0) weeks. Cotwin death occurred in one (3%) case and was due to extreme prematurity and intrauterine fetal infection. None of the surviving cotwins had severe neonatal cerebral injury, nor did any require rescue intrauterine transfusion.</p><p><strong>Conclusions: </strong>In twin pregnancy with TAPS, the risk of mortality and severe neonatal cerebral injury in the surviving cotwin after spontaneous single IUFD appears to be low, which is probably owing to reduced perimortem transfusion through minuscule placental anastomoses. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"51-55"},"PeriodicalIF":6.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Additional value of uterine artery Doppler pulsatility index for ultrasound diagnosis of placental site trophoblastic tumor: prospective cohort study.","authors":"R Cioffi, P I Cavoretto, G Sabetta, A Bergamini, E Rabaiotti, M Candiani, G Mangili","doi":"10.1002/uog.29235","DOIUrl":"10.1002/uog.29235","url":null,"abstract":"<p><strong>Objectives: </strong>The ultrasound diagnosis of placental site trophoblastic tumor (PSTT) is challenging owing to a lack of pathognomonic features. Differential diagnosis from other forms of gestational trophoblastic neoplasia (GTN) is critical owing to major differences in prognosis and treatment. Doppler measurement of uterine artery (UtA) pulsatility index (PI) has been proposed for the diagnosis and management of GTN. The aim of this study was to evaluate the added value of UtA-PI Doppler measurement during the standard transvaginal ultrasound (TVS) assessment, in patients with PSTT as compared to those with other GTN.</p><p><strong>Methods: </strong>This was a single-center prospective cohort study involving ultrasound assessment of all GTN cases referred to and treated at the trophoblast unit of San Raffaele Hospital, Milan, Italy, between 2011 and 2023. TVS assessment included: grayscale analysis for the detection of myometrial or endometrial abnormalities, color and power Doppler assessment of lesions with scoring of vascularization, and spectral pulsed-wave Doppler for measurement of mean UtA-PI from the left and right UtAs. Sonographic findings were compared between patients with PSTT and those with other forms of GTN (postmolar, invasive mole or choriocarcinoma), using non-parametric two-tailed statistical analysis.</p><p><strong>Results: </strong>A total of 73 GTN cases were recruited, comprising nine (12.3%) with PSTT and 64 (87.7%) with other GTN. A significant difference was detected between other-GTN and PSTT cases when comparing rates of substantial endometrial vascularity on Doppler (50% vs 0%; P = 0.013) and mean UtA-PI measurements (median, 1.5 (interquartile range (IQR), 1.0-2.4) vs 2.2 (IQR, 1.5-2.7); P = 0.014; area under the receiver-operating-characteristics curve, 0.768 (95% CI, 0.610-0.888)).</p><p><strong>Conclusions: </strong>This study describes UtA-PI as a novel and effective marker allowing for the ultrasound differentiation of PSTT from other forms of GTN. The significantly higher mean UtA-PI and lower endometrial vascularity observed in PSTT as compared with other GTN suggests a unique vascularization pattern, with a potential role in differential diagnosis and management. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"73-80"},"PeriodicalIF":6.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal diagnosis of Blake's pouch cyst: from natural history to management.","authors":"L Pomar, J Sichitiu, S Lebon, D Paladini","doi":"10.1002/uog.29239","DOIUrl":"10.1002/uog.29239","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"5-10"},"PeriodicalIF":6.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarifying the role of vesicoamniotic shunt in fetal medicine: three key lessons from the past and call for international registry.","authors":"F Fontanella, E C Weber, L A M Brinkman, P Adama van Scheltema, S Kohl, R Stein, E J T Verweij, C Berg, C M Bilardo","doi":"10.1002/uog.29228","DOIUrl":"10.1002/uog.29228","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"11-13"},"PeriodicalIF":6.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal progesterone for the prevention of preterm birth and adverse perinatal outcomes in women with a twin gestation and a short cervix (≤ 25 mm): an updated individual patient data meta-analysis.","authors":"R Romero, A Conde-Agudelo, A Rehal, E Da Fonseca, M L Brizot, L Rode, V Serra, A Syngelaki, A Tabor, A Perales, S S Hassan, K H Nicolaides","doi":"10.1002/uog.29243","DOIUrl":"10.1002/uog.29243","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"104-107"},"PeriodicalIF":6.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal diagnosis of duplicated gallbladder: two-dimensional and three-dimensional ultrasound imaging and reconstruction.","authors":"G H A S Pacheco, P T Castro, G Tonni, H Werner, E Araujo Júnior","doi":"10.1002/uog.29173","DOIUrl":"10.1002/uog.29173","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"116-119"},"PeriodicalIF":6.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to check correct position of fiducial markers on vaginal cuff for radiotherapy using transvaginal ultrasound.","authors":"S Restaino, S Zermano, G Pellecchia, A Biasioli, F Titone, M Arcieri, L Driul, G Vizzielli","doi":"10.1002/uog.29246","DOIUrl":"10.1002/uog.29246","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"799-800"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation and comparison of Fetal Medicine Foundation competing-risks model for small-for-gestational-age neonate in the first trimester: multicenter cohort study.","authors":"P Chaveeva, I Papastefanou, T Dagklis, N Valiño, R Revello, B Adiego, J L Delgado, V Kalev, I Tsakiridis, C Triano, M Pertegal, A Siargkas, B Santacruz, C de Paco Matallana, M M Gil","doi":"10.1002/uog.29219","DOIUrl":"10.1002/uog.29219","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the predictive performance of the Fetal Medicine Foundation (FMF) competing-risks model for the first-trimester prediction of a small-for-gestational-age (SGA) neonate in a large, independent, unselected European cohort and to compare the competing-risks algorithm with previously published logistic-regression models.</p><p><strong>Methods: </strong>This was a retrospective, non-interventional, multicenter cohort study including 35 170 women with a singleton pregnancy who underwent a first-trimester ultrasound assessment between 11 + 0 and 13 + 6 weeks' gestation. We used the default FMF competing-risks model for the prediction of SGA combining maternal factors, uterine artery pulsatility index (UtA-PI), pregnancy-associated plasma protein-A (PAPP-A) and placental growth factor (PlGF) to obtain risks for different cut-offs of birth-weight percentile and gestational age at delivery. We examined the predictive performance in terms of discrimination and calibration and compared it with the published data on the model's development population and with published logistic-regression equations.</p><p><strong>Results: </strong>At a 10% false-positive rate, maternal factors and UtA-PI predicted 42.2% and 51.5% of SGA < 10^th percentile delivered < 37 weeks and < 32 weeks, respectively. The respective values for SGA < 3^rd percentile were 44.7% and 51.7%. Also at a 10% false-positive rate, maternal factors, UtA-PI and PAPP-A predicted 42.2% and 51.5% of SGA < 10^th percentile delivered < 37 weeks and < 32 weeks, respectively. The respective values for SGA < 3^rd percentile were 46.2% and 51.7%. At a 10% false-positive rate, maternal factors, UtA-PI, PAPP-A and PlGF predicted 47.6% and 66.7% of SGA < 10^th percentile delivered < 37 weeks and < 32 weeks, respectively. The respective values for SGA < 3^rd percentile were 50.0% and 69.0%. These data were similar to those reported in the original model's development study and substantially better than those calculated using pre-existing logistic-regression models (McNemar's test, P < 0.001). The FMF competing-risks model was well calibrated.</p><p><strong>Conclusions: </strong>The FMF competing-risks model for the first-trimester prediction of SGA is reproducible in an independent, unselected low-risk cohort and superior to logistic-regression approaches. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"729-737"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of risk for pre-eclampsia at mid-gestation to define subsequent care.","authors":"S Adjahou, V Logdanidis, A Wright, A Syngelaki, R Akolekar, K H Nicolaides","doi":"10.1002/uog.29222","DOIUrl":"10.1002/uog.29222","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To stratify pregnancy care based on the estimated risk of pre-eclampsia (PE) from screening at 19-24 weeks' gestation by combinations of maternal risk factors, estimated fetal weight (EFW), mean arterial pressure (MAP) and uterine artery pulsatility index (UtA-PI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The data for this study were derived from a prospective non-interventional study in 134 443 women with a singleton pregnancy attending for a routine ultrasound scan at 19 + 0 to 23 + 6 weeks' gestation in two UK maternity hospitals. The visit included recording of maternal demographic characteristics and medical history, sonographic EFW and measurement of MAP and UtA-PI. The competing-risks model was used to estimate the individual patient-specific risk of delivery with PE at &lt; 28, &lt; 32 and &lt; 36 weeks' gestation. Receiver-operating-characteristics curves were constructed for screen-positive rates (SPRs) at different detection rates of delivery with PE at &lt; 28, &lt; 32 and &lt; 36 weeks' gestation for the combinations of maternal risk factors, EFW and MAP, and of maternal risk factors, EFW, MAP and UtA-PI. Different risk cut-offs were used with the intention of detecting about 80%, 85% and 90% of cases of delivery with PE at &lt; 28, &lt; 32 and &lt; 36 weeks' gestation. Calibration for risk of delivery with PE at &lt; 28, &lt; 32 and &lt; 36 weeks' gestation was assessed by plotting the observed incidence of PE against the predicted incidence of PE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study population contained 4335 (3.2%) women that subsequently developed PE, including 64 (0.05%) that delivered with PE at &lt; 28 weeks' gestation, 209 (0.2%) that delivered with PE at &lt; 32 weeks and 655 (0.5%) that delivered with PE at &lt; 36 weeks. If the objective of screening was to identify about 90% of cases of delivery with PE at &lt; 28, &lt; 32 and &lt; 36 weeks and the method of screening was a combination of maternal risk factors, EFW and MAP, the respective SPRs would be 11.0%, 18.3% and 38.8%. If the method of screening also included UtA-PI, the respective SPRs would be 2.6%, 3.8% and 23.6%. If the objective of screening was to identify about 80% of cases of delivery with PE at &lt; 28, &lt; 32 and &lt; 36 weeks and the method of screening was a combination of maternal risk factors, EFW and MAP, the respective SPRs would be 5.9%, 9.7% and 21.9%. If the method of screening also included UtA-PI, the respective SPRs would be 1.0%, 2.1% and 11.7%. The calibration plots demonstrated good agreement between the estimated risk and observed incidence of PE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;All women should be offered assessment of risk for PE at 11-13 weeks, to help identify those requiring aspirin prophylaxis to reduce the rate of preterm PE, and at 35-37 weeks, to determine the optimal timing of birth to reduce the rate of term PE. Assessment of risk for PE at mid-gestation can be used to identify the subgroups that require additional monitoring at 24-35, 28-35 and 32-35 weeks' ","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"694-702"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}