Ultrasound in Obstetrics & Gynecology最新文献

{"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}

{"title":"Pseudocleft lip: is prenatal diagnosis possible?","authors":"B Melis, G Chambon, B Deloison, N Fries, L J Salomon, E Quarello","doi":"10.1002/uog.29249","DOIUrl":"10.1002/uog.29249","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"800-803"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014751","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":"Radiomics analysis of solid adnexal masses - a step towards automated ultrasound diagnosis.","authors":"Y-J Ye, P An","doi":"10.1002/uog.29252","DOIUrl":"10.1002/uog.29252","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"805-806"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129013","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":"Reply.","authors":"F Moro, M Vagni, H E Tran, L Boldrini, A Fagotti, A C Testa","doi":"10.1002/uog.29254","DOIUrl":"10.1002/uog.29254","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"806-807"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129014","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":"Photorealistic rendering of fetal faces from raw magnetic resonance imaging data.","authors":"T Blanc, C Godard, D Grevent, M El Beheiry, L J Salomon, B Hajj, J-B Masson","doi":"10.1002/uog.29165","DOIUrl":"10.1002/uog.29165","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"808-811"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012365","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":"What type of terminology should be applied to define levator ani muscle avulsion?","authors":"J A García-Mejido, J A Sainz-Bueno","doi":"10.1002/uog.29232","DOIUrl":"10.1002/uog.29232","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"803-804"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020845","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":"Variability in antenatal prognostication of congenital diaphragmatic hernia by magnetic resonance imaging across the North American Fetal Therapy Network (NAFTNet).","authors":"N Abbasi, D Kajal, A Johnson, G Ryan, M Sanz-Cortes, S Lee, P S Shah, E E Perrone","doi":"10.1002/uog.29233","DOIUrl":"10.1002/uog.29233","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the variability in magnetic resonance imaging (MRI)-based parameters used for fetal lung volume estimation in the prediction of pulmonary hypoplasia and the degree of liver herniation in cases of antenatally diagnosed left congenital diaphragmatic hernia (CDH) across North American Fetal Therapy Network (NAFTNet) centers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this study, 14 NAFTNet radiologists reviewed MRI exams of 15 cases of left CDH of variable severity, eight of which had liver herniation confirmed at surgery. Images were obtained at a median gestational age of 29.3 (range, 25.0-37.6) weeks, between 2020 and 2022. All participants were asked to rate image quality using a scale of 1-4 (where 1 represents excellent quality and 4 represents poor quality (unable to perform measurements)) and to determine the observed-to-expected total fetal lung volume (o/e-TFLV) using the formulae of Rypens et al. and Meyers et al., the percent predicted lung volume (PPLV), the presence or absence of liver herniation and the percentage of liver herniation (%LH). Fleiss' κ was used to assess inter-rater agreement for image-quality ratings. Concordance between participants was evaluated by determining a coefficient of variation (CV), with CV &lt; 30 defined as acceptable. Additionally, the variation of individual participant's assessment of a case from the group average was also assessed. Data were also evaluated by center case volume, for which high volume was indicated by ≥ 15 CDH cases/year and low volume was indicated by &lt; 15 CDH cases/year managed prenatally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, there was acceptable concordance for o/e-TFLV among reviewers using the formula of either Rypens et al. or Meyers et al. (median CV, 24 (interquartile range (IQR), 19-34)). Slightly lower but acceptable concordance was noted for PPLV (median CV, 26 (IQR, 18-42)). For the determination of liver herniation, most participants agreed with the final diagnosis at surgery in 14/15 cases; however, concordance was lowest among reviewers for the quantification of %LH (median CV, 46 (IQR, 44-53)). Among the three MRI exams rated as being of poor quality by the majority of participants, CV was higher for o/e-TFLV (median CV, 39) and PPLV (median CV, 43), indicating poor concordance among reviewers. No significant difference was noted in concordance among reviewers for the assessment of lung volume and liver herniation based on a center's CDH volume.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Noticeable variability with acceptable agreement was noted for o/e-TFLV, PPLV and determination of liver herniation between NAFTNet radiologists from 14 centers in cases of left CDH. However, significant heterogeneity was noted for %LH. Concordance among reviewers was similar, irrespective of center case volume, highlighting the need for standardization of imaging protocols and CDH prognostication by MRI. © 2025 The Author(s). Ultrasound in Obstetrics & Gynec","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"771-777"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036076","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":"Maternal stress and fetoplacental cortisol regulation in small-for-gestational-age newborns.","authors":"J Miranda, L Benitez, S Macías-Redondo, C Paules, A Gomez-Gomez, A Basso, F Crovetto, L Youssef, O J Pozo, J Schoorlemmer, F Crispi, E Gratacós","doi":"10.1002/uog.29238","DOIUrl":"10.1002/uog.29238","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Previous research has identified an association between maternal stress, fetal growth and the expression of glucocorticoid-related genes in the placenta, particularly 11-beta hydroxysteroid dehydrogenase-2 (HSD11β2). However, to date, no studies have simultaneously explored the relationships between maternal stress, placental expression and methylation of HSD11β2, and fetal cortisol metabolites according to fetal growth. The aim of the present study was to evaluate the association between perceived antenatal maternal stress, the expression and methylation of the placental HSD11β2 gene, fetal cortisol metabolites in amniotic fluid and birth weight.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This nested case-control study, which was part of a large prospective cohort study, was conducted at two maternofetal medicine units in Barcelona, Spain (BCNatal: Hospitals Clinic and Sant Joan de Déu). We enrolled singleton pregnancies and classified neonates as small-for-gestational age (SGA) if their birth weight was below the 10&lt;sup&gt;th&lt;/sup&gt; percentile (n = 343) or as appropriate-for-gestational-age (AGA) controls (n = 399). The Perceived Stress Scale (PSS) and the State-Trait Anxiety Inventory (STAI) scores were obtained to assess maternal stress and anxiety levels. We analyzed placental HSD11β2 RNA expression (n = 44 SGA and n = 28 AGA) and DNA methylation levels (n = 89 SGA and n = 34 AGA), and fetal cortisol metabolites and the activity of metabolizing enzymes in amniotic fluid (n = 135 SGA and n = 78 AGA) using liquid chromatography-tandem mass spectrometry.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Median maternal perceived stress (PSS, 23 (interquartile range (IQR), 17-28) vs 20 (IQR, 15-26); P &lt; 0.001) and median anxiety state (STAI-state, 19.0 (IQR, 14.0-29.0) vs 16.0 (IQR, 11.0-24.0); P &lt; 0.001) scores were significantly higher in the SGA group compared with the control group. SGA cases showed lower median placental HSD11β2 RNA expression (Δ Ct, 50.5 (IQR, 21.6-106.0) vs 92.7 (IQR, 62.3-118.0); P = 0.013) with similar DNA methylation levels (mean ± SD, 10.7 ± 3.0% vs 11.0 ± 2.8%; P = 0.648) compared with AGA controls. Analysis of amniotic fluid revealed altered cortisol metabolism in SGA fetuses, with increased median 5α-tetrahydrocortisol concentration (SGA, 0.09% (IQR, 0.06-0.15%) vs controls, 0.07% (IQR, 0.05-0.11%); P = 0.020) and activity of its related enzyme (5α-reductase activity in SGA, 0.19% (IQR, 0.14-0.31%) vs controls, 0.17% (IQR, 0.12-0.22%); P = 0.007), together with a decrease in median 6-hydroxycortisol concentration (SGA, 0.09% (IQR, 0.06-0.11%) vs controls, 0.11% (IQR, 0.08-0.12%); P &lt; 0.001) and activity of its related enzyme (CYP3A7 activity in SGA, 0.19% (IQR, 0.11-0.25%) vs controls, 0.24% (IQR, 0.17-0.33%); P &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;SGA pregnancy is associated with high perceived maternal stress and dysregulated fetoplacental cortisol metabolism. These results deepen our understanding of the ","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"738-748"},"PeriodicalIF":6.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055207","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}