Ultrasound in Obstetrics & Gynecology最新文献

{"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":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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<sup>th</sup> 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.</p><p><strong>Results: </strong>Median maternal perceived stress (PSS, 23 (interquartile range (IQR), 17-28) vs 20 (IQR, 15-26); P < 0.001) and median anxiety state (STAI-state, 19.0 (IQR, 14.0-29.0) vs 16.0 (IQR, 11.0-24.0); P < 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 < 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 < 0.001).</p><p><strong>Conclusions: </strong>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}

{"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":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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 < 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 < 15 CDH cases/year managed prenatally.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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":"Untreated ovarian endometrioma: not just a matter of dimensional change over time.","authors":"P Vercellini, P Viganò, E Somigliana","doi":"10.1002/uog.29187","DOIUrl":"10.1002/uog.29187","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"659"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658862","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":"Repurposing Advanix pancreatic stent for failed treatment of lower urinary tract obstruction.","authors":"S Backley, R Papanna, S Pandiri, L Cisek, A Salazar, L K Mann","doi":"10.1002/uog.29215","DOIUrl":"10.1002/uog.29215","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"655-657"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804013","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":"Prediction of hypertension and diabetes in twin pregnancy using machine learning model based on characteristics at first prenatal visit: national registry study.","authors":"H J Mustafa, E Kalafat, S Prasad, M-H Heydari, R N Nunge, A Khalil","doi":"10.1002/uog.27710","DOIUrl":"10.1002/uog.27710","url":null,"abstract":"<p><strong>Objective: </strong>To develop a prediction model for hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) in twin pregnancy using characteristics obtained at the first prenatal visit.</p><p><strong>Methods: </strong>This was a cross-sectional study using national live-birth data in the USA between 2016 and 2021. The association of all prenatal candidate variables with HDP and GDM was tested on univariable and multivariable logistic regression analyses. Prediction models were built with generalized linear models using the logit link function and classification and regression tree (XGboost) machine learning algorithm. Performance was assessed with repeated 2-fold cross-validation and the area under the receiver-operating-characteristics curve (AUC) was calculated. A P value < 0.001 was considered statistically significant.</p><p><strong>Results: </strong>A total of 707 198 twin pregnancies were included in the HDP analysis and 723 882 twin pregnancies were included in the GDM analysis. The incidence of HDP and GDM increased significantly from 12.6% and 8.1%, respectively, in 2016 to 16.0% and 10.7%, respectively, in 2021. Factors associated with increased odds of HDP in twin pregnancy were maternal age < 20 years or ≥ 35 years, infertility treatment, prepregnancy diabetes mellitus, non-Hispanic Black race, overweight prepregnancy BMI, prepregnancy obesity and Medicaid as the payment source for delivery (P < 0.001 for all). Obesity Class II and III more than doubled the odds of HDP. Factors associated with increased odds of GDM in twin pregnancy were maternal age ≤ 24 years or ≥ 30 years, infertility treatment, prepregnancy hypertension, non-Hispanic Asian race, maternal birthplace outside the USA and prepregnancy obesity (P < 0.001 for all). Maternal age ≥ 30 years, non-Hispanic Asian race and obesity Class I, II and III more than doubled the odds of GDM. For both HDP and GDM, the performances of the machine learning model and logistic regression model were mostly similar, with negligible differences in the performance domains tested. The mean ± SD AUCs of the final machine learning models for HDP and GDM were 0.620 ± 0.001 and 0.671 ± 0.001, respectively.</p><p><strong>Conclusions: </strong>The incidence of HDP and GDM in twin pregnancies in the USA is increasing. The predictive accuracy of the machine learning models for HDP and GDM in twin pregnancies was similar to that of the logistic regression models. The models for HDP and GDM had modest predictive performance, were well calibrated and did not have poor fit. © 2024 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":"613-623"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162644","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":"The cerebroplacental ratio: a useful marker but should it be a screening test?","authors":"S Yagel, S M Cohen, D V Valsky","doi":"10.1002/uog.29154","DOIUrl":"10.1002/uog.29154","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"541-545"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932831","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":"J Knez, D Jurkovic","doi":"10.1002/uog.29217","DOIUrl":"10.1002/uog.29217","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"660-661"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658859","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":"Congenital heart defects during COVID-19 pandemic.","authors":"A Khalil, I Painter, V Souter","doi":"10.1002/uog.29126","DOIUrl":"10.1002/uog.29126","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"546-551"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629452","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":"Transvaginal SlowflowHD for embryonic and fetal hearts: human cardiac development in first trimester of pregnancy.","authors":"T Hata, R Takayoshi, M Sugihara, A Koyanagi, T Miyake","doi":"10.1002/uog.29095","DOIUrl":"10.1002/uog.29095","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"662-666"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890234","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":"Biparietal diameter for first-trimester pregnancy dating: multicenter cohort study.","authors":"C de Paco Matallana, V Rolle, A M Fidalgo, J Sánchez-Romero, J C Jani, P Chaveeva, J L Delgado, B Santacruz, K H Nicolaides, M M Gil","doi":"10.1002/uog.29216","DOIUrl":"10.1002/uog.29216","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the accuracy of fetal biparietal diameter (BPD) measurement in comparison with crown-rump length (CRL) measurement for pregnancy dating at 11-13 weeks' gestation.</p><p><strong>Methods: </strong>This was a retrospective multicenter cohort study performed in five maternity units in Spain, the UK, Belgium and Bulgaria between January 2011 and December 2019. We included all women who attended a routine ultrasound examination at 11 + 0 to 13 + 6 weeks who had a singleton pregnancy with a viable non-malformed fetus/neonate and ultrasound-derived measurements for both CRL and BPD, along with a comprehensive record of pregnancy outcomes. We developed a formula for pregnancy dating based on BPD using data from pregnancies conceived via in-vitro fertilization (IVF) by applying a simple linear regression. We validated this formula both internally and externally and compared it with the most commonly used formulae (Robinson's CRL-based and Kustermann's BPD-based formulae) through utilization of the Euclidean distance, relative absolute error and mean squared error. We also examined the rate of induction of labor for post-term pregnancy based on dating using each of the formulae.</p><p><strong>Results: </strong>A total of 49 492 women were included in the study, comprising 47 223 (95.4%) who conceived spontaneously and 2269 (4.6%) who conceived via IVF. In the internal validation performed using data from IVF pregnancies, our newly developed formula showed no significant difference when compared with the true gestational age calculated using conception date, with a mean difference of 0.0006 (95% CI, -0.09 to 0.09) days. In contrast, the mean difference of Kustermann's BPD-based formula was -0.31 (95% CI, -0.46 to -0.17) days and the mean difference of Robinson's CRL-based formula was -1.78 (95% CI, -1.88 to -1.68) days. In the external validation using data from spontaneously conceived pregnancies, with dating using Robinson's formula as the reference for 'true' gestational age, both our formula and Kustermann's formula resulted in underestimation of gestational age, with significant mean differences of -1.25 (95% CI, -1.28 to -1.22) days and -0.96 (95% CI, -0.98 to -0.93) days, respectively. The largest differences compared with Robinson's formula-based dating results were observed between 11 + 0 and 12 + 0 weeks. Dating the pregnancy using Robinson's formula led to 8.1% of pregnancies identified as requiring induction after 41 + 3 weeks, compared with 6.8% (P < 0.001) and 7.0% (P < 0.001) when applying our formula and Kustermann's formula, respectively.</p><p><strong>Conclusion: </strong>Pregnancy dating based on ultrasound measurement of fetal BPD between 11 + 0 and 13 + 6 weeks' gestation is a reliable alternative to dating based on fetal CRL. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"560-566"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781342","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}