Ultrasound in Obstetrics & Gynecology最新文献

{"title":"Indications for fetal echocardiography: consensus and controversies among evidence-based national and international guidelines.","authors":"V De Robertis, T Stampalija, A Z Abuhamad, M Bosco, R Chaoui, C Formigoni, A J Moon-Grady, D Paladini, G Pilu, I G Ramezzana, J Rychik, P Volpe","doi":"10.1002/uog.29224","DOIUrl":"10.1002/uog.29224","url":null,"abstract":"<p><strong>Objective: </strong>Fetal echocardiography (FE) is an indication-driven examination for pregnant women with a fetus at high risk for congenital heart disease (CHD). Several familial, maternal and fetal factors are reported to increase the risk of CHD. The aim of this study was to highlight the existing differences in recommended indications for FE among recently published guidelines and consensuses of experts.</p><p><strong>Methods: </strong>Guidelines and expert consensuses published from January 2008 to October 2023 were identified through a systematic literature search. FE guidelines and consensus statements were excluded if not written in the English language and if indications for FE were not reported. All familial, maternal and fetal risk factors for CHD reported in the consensuses and guidelines were listed and comparisons were made between documents. The agreement or disagreement for each risk factor between guidelines and consensuses was classified as: complete agreement (all analyzed documents reported the same indication); partial agreement (all documents considered a risk factor as an indication, but with inconsistency in its definition); or complete disagreement (inconsistency between documents for the considered risk factor as an indication).</p><p><strong>Results: </strong>Six guidelines and expert consensuses that met the inclusion criteria were identified. Overall, a total of 17 risk factors were identified as an indication for FE. Complete agreement was reached for 3/17 (17.6%) risk factors, all of which are fetal risk factors (suspected CHD at the anomaly scan, presence of major fetal extracardiac abnormality and non-immune hydrops fetalis). Partial agreement was recorded for 8/17 (47.1%) risk factors (family history of CHD, increased nuchal translucency, multiple gestation, maternal diabetes mellitus, maternal phenylketonuria, maternal infection, maternal autoimmune disease and autoantibody positivity, and teratogen exposure). Complete disagreement was recorded for 6/17 (35.3%) risk factors (inherited genetic disease associated with CHD, fetal genetic anomaly, suspected abnormality of heart rate or rhythm, first-trimester sonographic markers of CHD, abnormality of umbilical cord and venous system, and use of assisted reproductive technology).</p><p><strong>Conclusions: </strong>Areas of controversy regarding which CHD risk factors warrant FE were greater in quantity than were the areas of consensus. An internationally standardized agreement would be valuable for physicians and guideline developers. For many risk factors, further evidence is needed to justify their use as an indication for FE. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"682-693"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048343","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":"Racial and ethnic disparities in obstetric anal sphincter injury: cross-sectional study in the USA.","authors":"M Rajasingham, P Hossein-Pour, R D'Souza, R Geoffrion, C V Ananth, G M Muraca","doi":"10.1002/uog.29231","DOIUrl":"10.1002/uog.29231","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Racial disparities in obstetric anal sphincter injury (OASI) are poorly understood; their investigation by parity, obstetric history and mode of delivery may provide insight into which individuals are at the greatest risk for OASI. We aimed to quantify the association of race and ethnicity with OASI, stratified by parity, obstetric history and mode of delivery. Secondary aims were to explore variations in OASI rates among racial subgroups and by immigration status (foreign-born vs USA-born).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cross-sectional study of 12 501 183 vaginal births in the USA from January 2016 to December 2021 using birth-certificate data obtained from the National Vital Statistics System. Cox proportional hazard regression models were fitted, with gestational age as the timescale, to quantify the association of self-reported race and ethnicity with OASI, with adjustment for several confounders. The maternal race and ethnicity groups included: American Indian or Alaska Native (AIAN), Asian, Black, Hispanic, Native Hawaiian and other Pacific Islander, White and mixed race. Models were stratified by number of previous births and the occurrence of Cesarean delivery (CD) among prior births. This resulted in three groups: primiparous (i.e. only the index birth); multiparous without a previous CD; and multiparous with at least one previous CD. Within each stratum, we further grouped individuals by mode of delivery in the index birth, as spontaneous vaginal delivery (SVD), operative vaginal delivery (OVD) with forceps and OVD with vacuum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In primiparous individuals who had a vaginal birth, the overall OASI rate was 2.2%, but it varied widely by mode of delivery (SVD, 1.7%; OVD with forceps, 14.8%; OVD with vacuum, 6.6%). Asian primiparae had higher OASI hazards compared with White primiparae, irrespective of mode of delivery (SVD: adjusted hazard ratio (aHR), 1.69 (95% CI, 1.64-1.73); OVD with forceps: aHR, 1.48 (95% CI, 1.38-1.58); OVD with vacuum: aHR, 1.51 (95% CI, 1.44-1.58)), while AIAN and Black primiparae had inconsistent associations with OASI rate depending on mode of delivery, when compared with White primiparae. In multiparous individuals without a previous CD, the rates of OASI were lower than those seen in primiparae (SVD, 0.5%; OVD with forceps, 7.5%; OVD with vacuum, 3.2%) and the association of race and ethnicity with OASI varied by mode of delivery for all race groups except Asian, in whom it was consistently associated with a 1.5-2.1-times higher hazard of OASI. Among multiparous individuals with a previous CD, overall OASI rates were similar to those seen in primiparae (SVD, 1.3%; OVD with forceps, 11.8%; OVD with vacuum, 5.1%). In this group, the only associations of race and ethnicity with OASI were higher hazards among Asian vs White individuals who had a SVD (aHR, 2.16 (95% CI, 1.97-2.36)) and an OVD with vacuum (aHR, 1.65 (95% CI, 1.39-1.96)). ","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"778-789"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011724","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":"Transvaginal ultrasound assessment of corpus callosal length in the fetus: multicenter cross-sectional study.","authors":"D Paladini, S Parodi, H Xie, F Viñals, K Haratz, R Birnbaum, G Azumendi, L Pomar, E Montaguti, P Acharya, P Volpe, M Pérez-Cruz, K Karl, R Chaoui, R Pooh","doi":"10.1002/uog.29227","DOIUrl":"10.1002/uog.29227","url":null,"abstract":"<p><strong>Objective: </strong>To produce reference ranges and Z-scores for corpus callosal (CC) length in the fetus, based on transvaginal three-dimensional (3D) ultrasound imaging.</p><p><strong>Methods: </strong>This was a cross-sectional multicenter retrospective study based on 3D volume dataset acquisitions of the fetal CC between the 15^th and 37^th weeks of gestation. Only volume datasets acquired transvaginally through the anterior fontanelle were selected. After plane alignment on multiplanar imaging, the length of the CC was measured edge-to-edge on magnified images. Intra- and interobserver variability were assessed and the related intraclass correlation coefficients (ICC) calculated. Biometric charts to assess the reference values for fetal CC were obtained using the method proposed by Altman in 1993.</p><p><strong>Results: </strong>The 13 participating centers provided valid data for 2131 patients. Excellent agreement was observed for both intra- and interobserver analysis, with an ICC range of 0.98-1.00. A quadratic model was used for construction of the reference charts, modified with the insertion of cubic spline coefficients with a single knot at 18 gestational weeks, to recover an apparent lack of fit at lower gestational ages. Centile reference values and the corresponding Z-scores were produced for CC length between 15 and 37 gestational weeks.</p><p><strong>Conclusions: </strong>This multicenter study presents growth charts for the fetal CC, addressing the critical methodological weaknesses of several previous studies. An even distribution of cases across all gestational weeks, robust statistical methodology and a standardized, high-resolution transvaginal neurosonographic technique represent key factors supporting the reliability of the biometric curves presented here. © 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":"703-711"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038714","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":"Placental biomarker and fetoplacental Doppler abnormalities are strongly associated with placental pathology in pregnancies with small-for-gestational-age fetus: prospective study.","authors":"J Hong, K Crawford, E Cavanagh, V Clifton, F da Silva Costa, A V Perkins, S Kumar","doi":"10.1002/uog.29237","DOIUrl":"10.1002/uog.29237","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Placental dysfunction can result in small-for-gestational age (SGA) or fetal growth restriction (FGR). The aim of this prospective cohort study was to assess the association of the cerebroplacental ratio (CPR) and other more conventional fetoplacental Doppler indices, circulating placental growth factor (PlGF) levels and soluble fms-like tyrosine kinase-1 (sFlt-1)/PlGF ratio, with specific placental abnormalities in a large cohort of pregnancies with an SGA/FGR fetus.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a prospective cohort study of singleton pregnancies with a SGA/FGR fetus conducted at the Centre for Maternal and Fetal Medicine at the Mater Mother's Hospital, Queensland, Australia. Multivariable logistic regression with adjustment for pre-eclampsia was used to evaluate the effect of CPR &lt; 5&lt;sup&gt;th&lt;/sup&gt; centile, umbilical artery Doppler abnormality (defined as umbilical artery (UA) pulsatility index (PI) &gt; 95&lt;sup&gt;th&lt;/sup&gt; centile, or absent or reversed end-diastolic flow), mean uterine artery (UtA) PI &gt; 95&lt;sup&gt;th&lt;/sup&gt; centile and abnormal placental biomarkers (PlGF level &lt; 100 ng/L and sFlt-1/PlGF ratio &gt; 5.78 if gestational age &lt; 28 weeks or &gt; 38 if gestational age ≥ 28 weeks) on the following placental abnormalities, classified based on the Amsterdam Placental Workshop Group Consensus criteria: placental maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM), villitis of unknown etiology (VUE), chronic histiocytic intervillositis (CHI) and delayed villous maturation (DVM).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 367 women included in this study, MVM was present in 159 (43.3%) placentae, FVM in 20 (5.4%), VUE in 49 (13.4%), DVM in 19 (5.2%) and CHI in six (1.6%). Compared to SGA controls with normal fetoplacental Doppler and placental biomarkers, CPR &lt; 5&lt;sup&gt;th&lt;/sup&gt; centile (adjusted odds ratio (aOR), 3.17 (95% CI, 1.95-5.16); P &lt; 0.001), abnormal UA Doppler (aOR, 2.97 (95% CI, 1.80-4.90); P &lt; 0.001) and mean UtA-PI &gt; 95&lt;sup&gt;th&lt;/sup&gt; centile (aOR, 5.42 (95% CI 2.75-10.70); P &lt; 0.001) were associated with higher odds of placental abnormality. The odds of MVM specifically were significantly higher when CPR &lt; 5&lt;sup&gt;th&lt;/sup&gt; centile (aOR, 2.47 (95% CI, 1.64-4.33); P &lt; 0.001), abnormal UA Doppler (aOR, 3.13 (95% CI, 1.91-5.12); P &lt; 0.001) or mean UtA-PI &gt; 95&lt;sup&gt;th&lt;/sup&gt; centile (aOR, 4.01 (95% CI, 2.25-7.13); P &lt; 0.001) was present. The odds of placental abnormality were also significantly higher if PlGF levels were &lt; 100 ng/L (aOR, 3.66 (95% CI, 2.22-6.06); P &lt; 0.001) or the sFlt-1/PlGF ratio was elevated (aOR, 3.74 (95% CI, 2.17-6.43); P &lt; 0.001). The odds of MVM were also higher in women with PlGF &lt; 100 ng/L (aOR, 2.89 (95% CI, 1.72-4.85); P &lt; 0.001) and elevated sFlt-1/PlGF ratio (aOR, 3.15 (95% CI, 1.83-5.45); P &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In pregnancies with SGA/FGR fetus, mean UtA-PI &gt; 95&lt;sup&gt;th&lt;/sup&gt; centile, abnormal UA Doppler, CPR &lt; 5&lt;sup&gt;th&lt;/sup&gt; centile, PlGF &lt; ","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"749-760"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048345","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":"Small-for-gestational age according to INTERGROWTH-21^st fetal weight standard misses most pregnancies at risk of stillbirth identified by GROW.","authors":"O Hugh, E Butler, H Ellson, J Mytton, J Gardosi","doi":"10.1002/uog.29214","DOIUrl":"10.1002/uog.29214","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"798-799"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693558","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":"Feasibility and acceptability of randomized controlled trial of intervention vs expectant management for early-onset selective fetal growth restriction in monochorionic twin pregnancy.","authors":"A Khalil, S Prasad, J J Kirkham, R Jackson, K Woolfall","doi":"10.1002/uog.29175","DOIUrl":"10.1002/uog.29175","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"671-675"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041632","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":"Prediction of small-for-gestational age and fetal growth restriction at routine ultrasound examination at 35-37 weeks' gestation.","authors":"M Lopian, S Prasad, E Segal, A Dotan, C O Ulusoy, A Khalil","doi":"10.1002/uog.29223","DOIUrl":"10.1002/uog.29223","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the performance of sonographic fetal biometry and Doppler parameters assessed at routine third-trimester ultrasound examination for predicting small-for-gestational age (SGA) and fetal growth restriction (FGR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a retrospective cohort study of low-risk singleton pregnancies undergoing routine ultrasound examination between 35 + 0 and 37 + 6 weeks' gestation and delivered at St George's University Hospital, London, UK, between December 2019 and February 2024. The study outcomes were SGA (birth weight &lt; 5&lt;sup&gt;th&lt;/sup&gt; centile) and FGR (birth weight &lt; 3&lt;sup&gt;rd&lt;/sup&gt; centile or birth weight &lt; 10&lt;sup&gt;th&lt;/sup&gt; centile with composite adverse perinatal outcome). Composite adverse perinatal outcome comprised intrauterine death, neonatal death or admission to the neonatal intensive care unit. Demographic characteristics, estimated fetal weight (EFW) and abdominal circumference centiles, as well as Doppler indices, including pulsatility indices (PI) of the umbilical artery (UA), middle cerebral artery (MCA) and uterine artery (UtA) were evaluated. The cerebroplacental ratio (CPR) was calculated, and all indices were converted to multiples of the median (MoM). Multivariable logistic regression analysis was performed to identify and adjust for confounders. The area under the receiver-operating-characteristics curve (AUC) was used to evaluate the model's performance for predicting small neonates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 14 161 pregnancies were included in the study. The prevalence of SGA and FGR neonates was 3.1% and 1.5%, respectively. Independent predictors of SGA and FGR, respectively, were: EFW centile (adjusted odds ratio (aOR) 0.91 (95% CI, 0.90-0.92); P &lt; 0.001 and aOR 0.90 (95% CI, 0.89-0.91); P &lt; 0.001); AC centile (aOR 0.91 (95% CI, 0.90-0.92); P &lt; 0.001 and aOR 0.91 (95% CI, 0.90-0.92); P &lt;0.001); UA-PI MoM (aOR 4.60 (95% CI, 2.19-9.64); P &lt; 0.001 and aOR 2.53 (95% CI, 1.05-6.10); P = 0.038); MCA-PI MoM (aOR 0.37 (95% CI, 0.20-0.70); P = 0.002 and aOR 0.26 (95% CI, 0.12-0.59); P = 0.001); CPR MoM (aOR 0.23 (95% CI, 0.13-0.42); P &lt; 0.001 and aOR 0.25 (95% CI, 0.12-0.53); P &lt; 0.001); and UtA-PI MoM (aOR 2.54 (95% CI, 1.68-3.83); P &lt; 0.001 and aOR 2.16 (95% CI, 1.31-3.58); P = 0.003). The EFW centile alone was associated with an AUC of 0.917 (95% CI, 0.907-0.929) for the prediction of SGA and 0.925 (95% CI, 0.908-0.939) for the prediction of FGR. This was similar to AUCs of around 0.92 for the prediction of SGA and AUCs of around 0.93 for the prediction of FGR when the EFW centile was combined with any Doppler parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Sonographic fetal biometry evaluation in the late third trimester can predict delivery of a neonate affected by SGA or FGR, including those at risk for adverse perinatal outcomes. In an unselected population, fetal arterial Doppler parameters were independent predictors of SGA and FGR, but the addit","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"761-770"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025740","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":"Ultrasound-guided cyst aspiration for management of acute adnexal torsion.","authors":"L Berg, N Eagles, S Kastora, J Farren, J Naftalin, D Jurkovic","doi":"10.1002/uog.29225","DOIUrl":"10.1002/uog.29225","url":null,"abstract":"<p><strong>Objective: </strong>Ultrasound-guided cyst aspiration is a potential treatment for acute adnexal torsion that can be performed in the outpatient setting, offering an alternative to emergency laparoscopic surgery. The objective of this study was to describe our initial experience with aspiration of acutely torted adnexal cysts.</p><p><strong>Methods: </strong>This was a retrospective single-center study, in which we identified all patients who underwent ultrasound-guided cyst aspiration in our center between February 2008 and September 2023. Indications for the procedure were ultrasound diagnosis of adnexal torsion due to an ovarian cyst and clinical symptoms of acute adnexal torsion. Success was defined as the avoidance of emergency surgery for adnexal torsion related to the same cyst. We extracted clinical data, ultrasound scan findings, procedural details and clinical outcomes from our clinical database.</p><p><strong>Results: </strong>Overall, 46 patients underwent ultrasound-guided cyst aspiration for the management of adnexal torsion, 24 (52%) of whom were pregnant. At ultrasound examination, all 46 cysts had unilocular morphology, and in 96% (44/46) of cases, the cyst content was anechoic. Cyst aspiration was performed transabdominally in 30 (65%) patients and transvaginally in 16 (35%) patients. A total of 39 (85%) patients experienced complete resolution of symptoms immediately after ultrasound-guided cyst aspiration. One procedure was abandoned owing to patient discomfort and six (13%) patients reported non-resolution or short-term recurrence of symptoms, necessitating emergency laparoscopy in seven patients. No complications occurred as a result of ultrasound-guided cyst aspiration. Three patients had cyst aspiration more than once. Follow-up data were available for 29/39 (74%) patients who had successful ultrasound-guided cyst aspiration and received a subsequent ultrasound assessment in our clinic. In 8/29 (28%) patients, the cyst had completely resolved. In total, 4/21 (19%) patients with a persistent cyst opted for elective surgical intervention, while 17/21 (81%) continued conservative management at the last follow-up. Overall, 25/29 (86%) of those followed up after successful ultrasound-guided cyst aspiration, and at least 25/46 (54%) of all patients, avoided any form of surgical treatment.</p><p><strong>Conclusions: </strong>Ultrasound-guided cyst aspiration is an effective treatment for the management of acute adnexal torsion due to a cyst with unilocular morphology and anechoic or hypoechoic fluid content. With the use of this technique, emergency hospital admission and surgery were avoided in the majority of patients. © 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":"790-797"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062195","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":"Prevention of preterm birth in twin pregnancy: international Delphi consensus.","authors":"H J Mustafa, J Sheikh, V Berghella, W A Grobman, A A Shamshirsaz, S J Gordijn, W Ganzevoort, A Roman, A Khalil","doi":"10.1002/uog.29220","DOIUrl":"10.1002/uog.29220","url":null,"abstract":"<p><strong>Objective: </strong>To use the Delphi method to gain insight into approaches to prenatal diagnosis and management of preterm birth (PTB) in twin pregnancies, including complications such as twin-to-twin transfusion syndrome (TTTS) and a short and/or dilated cervix.</p><p><strong>Methods: </strong>A three-round Delphi process was conducted among an international panel of experts to assess their approach to prevention, monitoring and management strategies for PTB in twin pregnancies. Experts were selected based on their publication record or membership of related organizations. Response options were multiple-choice answers or a five-point Likert scale. A priori, a cut-off of ≥ 70% agreement was used to define consensus.</p><p><strong>Results: </strong>A total of 117 experts participated in the first round, of whom 94/117 (80.3%) completed all subsequent rounds. Representatives came from at least 22 countries (across five continents), most commonly the USA (50.4%) and the UK (12.0%). Over 70% of experts performed routine screening of cervical length (CL) using transvaginal ultrasound at 18-23 weeks' gestation, using CL ≤ 25 mm to diagnose short cervix in twin pregnancies, regardless of a history of PTB. In twin pregnancies with a short non-dilated cervix, most experts offered vaginal progesterone rather than pessary or cervical cerclage, regardless of a history of PTB. In twin pregnancies with asymptomatic dilated cervix, consensus was reached (88.3% agreement) for placement of cervical cerclage, performed up to 24 weeks' gestation (67.5% agreement; no consensus). Similarly, 96.1% of experts agreed that performing serial transvaginal ultrasound measurements of CL at 16-24 weeks' gestation was warranted in women with a current singleton pregnancy who had a previous twin pregnancy that required physical examination-indicated cerclage; these patients should be considered high risk for PTB (83.1% agreement). In twin pregnancies with TTTS, laser surgery is offered by most experts, regardless of preoperative CL. In patients with TTTS and short CL, most experts would recommend cervical cerclage (71.9%) or vaginal progesterone (65.6%) rather than pessary or expectant management. However, no consensus was reached on measures to prevent PTB in cases of TTTS with cervical dilation.</p><p><strong>Conclusions: </strong>This Delphi consensus study highlights practice variations among healthcare providers worldwide in the evaluation and management of PTB in twin pregnancies, which often differ from recommendations given by national and international societies. © 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":"712-722"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064878","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":"Intraoperative ultrasound in minimally invasive surgery for deep endometriosis: time for new approaches.","authors":"M P Nigdelis, G Hudelist, J Keckstein, E-F Solomayer, A Daniilidis, H Krentel, A-S Constantin","doi":"10.1002/uog.29212","DOIUrl":"10.1002/uog.29212","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"676-681"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693556","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}