Ultrasound in Obstetrics & Gynecology最新文献

{"title":"Transvaginal cervical cerclage: double monofilament modified Wurm vs single braided McDonald technique.","authors":"V Donadono, P Koutikwar, A Banerjee, M Ivan, C S Colley, M Sciacca, D Casagrandi, A Tetteh, N Greenwold, L M Kindinger, K Maksym, A L David, R Napolitano","doi":"10.1002/uog.29184","DOIUrl":"10.1002/uog.29184","url":null,"abstract":"<p><strong>Objective: </strong>To compare pregnancy outcome in women at high risk of preterm birth undergoing the modified Wurm (two monofilament sutures) vs those undergoing the McDonald (single braided suture) transvaginal cervical cerclage technique.</p><p><strong>Methods: </strong>This was a single-center prospective observational study of all women with a singleton pregnancy attending a prematurity surveillance clinic because of an increased risk of preterm birth, and undergoing history- or ultrasound-indicated transvaginal cervical cerclage. Two cerclage techniques were evaluated and the choice of cerclage was at the physician's discretion. In the modified Wurm technique using monofilament material, two circumferential sutures are placed with two insertions each (four in total). Outcomes were compared vs those of women undergoing the McDonald technique (single braided suture using a diamond-type insertion method with four insertions in total). Primary outcome was the rate of preterm birth at < 32 weeks' gestation, with planned subanalyses according to cervical cerclage indication (history- or ultrasound-indicated), preterm birth rate at any gestational age (< 37, < 34, < 28 and < 24 weeks), and sonographic cervical length (CL) of ≤ 25 mm and ≤ 15 mm. Secondary outcome measures included maternal and neonatal adverse events and outcomes, including the pre- and postsurgical characteristics. In addition, a reproducibility analysis using Bland-Altman plots was performed to evaluate the intra- and interobserver reproducibility in assessment of CL on ultrasound examination before and after cerclage.</p><p><strong>Results: </strong>In total, 147 patients were included in the final analysis: 55 (37%) received modified Wurm cerclage and 92 (63%) received McDonald cerclage. Other than race, demographic characteristics were comparable between the two groups. Of these, 22 (40%) women in the modified Wurm group had history-indicated cerclage, vs 50 (54%) women in the McDonald group; the remaining cerclages were ultrasound-indicated. In women with a short CL (≤ 25 mm), there was a significantly lower rate of preterm birth at < 32 weeks' gestation after modified Wurm compared with the McDonald technique (3 (9%) vs 14 (29%); adjusted odds ratio (aOR), 0.25 (95% CI, 0.06-0.95); P = 0.042). However, the study was underpowered to provide definitive conclusions. In the overall population, there was no significant difference in preterm birth rate for < 32 weeks' gestation between the two techniques (7 (13%) vs 22 (24%); aOR, 0.51 (95% CI, 0.20-1.33); P = 0.169). There was no difference in overall surgical complications between the two techniques. The pregnancy loss rate and composite neonatal morbidity/mortality rate were comparable between the two groups (2 (4%) vs 7 (8%); odds ratio (OR), 0.47 (95% CI, 0.09-2.33); P = 0.485; and 5 (9%) vs 11 (13%); OR, 0.68; (95% CI, 0.22-2.09); P = 0.593, respectively).</p><p><strong>Conclusions: </strong>In high-risk women w","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"344-352"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493817","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":"Re: Role of artificial-intelligence-assisted automated cardiac biometrics in prenatal screening for coarctation of aorta.","authors":"G R DeVore","doi":"10.1002/uog.29158","DOIUrl":"10.1002/uog.29158","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"390-392"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830078","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":"Application of artificial intelligence to ultrasound imaging for benign gynecological disorders: systematic review.","authors":"F Moro, M T Giudice, M Ciancia, D Zace, G Baldassari, M Vagni, H E Tran, G Scambia, A C Testa","doi":"10.1002/uog.29171","DOIUrl":"10.1002/uog.29171","url":null,"abstract":"<p><strong>Objective: </strong>Although artificial intelligence (AI) is increasingly being applied to ultrasound imaging in gynecology, efforts to synthesize the available evidence have been inadequate. The aim of this systematic review was to summarize and evaluate the literature on the role of AI applied to ultrasound imaging in benign gynecological disorders.</p><p><strong>Methods: </strong>Web of Science, PubMed and Scopus databases were searched from inception until August 2024. Inclusion criteria were studies applying AI to ultrasound imaging in the diagnosis and management of benign gynecological disorders. Studies retrieved from the literature search were imported into Rayyan software and quality assessment was performed using the Quality Assessment Tool for Artificial Intelligence-Centered Diagnostic Test Accuracy Studies (QUADAS-AI).</p><p><strong>Results: </strong>Of the 59 studies included, 12 were on polycystic ovary syndrome (PCOS), 11 were on infertility and assisted reproductive technology, 11 were on benign ovarian pathology (i.e. ovarian cysts, ovarian torsion, premature ovarian failure), 10 were on endometrial or myometrial pathology, nine were on pelvic floor disorder and six were on endometriosis. China was the most highly represented country (22/59 (37.3%)). According to QUADAS-AI, most studies were at high risk of bias for the subject selection domain (because the sample size, source or scanner model was not specified, data were not derived from open-source datasets and/or imaging preprocessing was not performed) and the index test domain (AI models were not validated externally), and at low risk of bias for the reference standard domain (the reference standard classified the target condition correctly) and the workflow domain (the time between the index test and the reference standard was reasonable). Most studies (40/59) developed and internally validated AI classification models for distinguishing between normal and pathological cases (i.e. presence vs absence of PCOS, pelvic endometriosis, urinary incontinence, ovarian cyst or ovarian torsion), whereas 19/59 studies aimed to automatically segment or measure ovarian follicles, ovarian volume, endometrial thickness, uterine fibroids or pelvic floor structures.</p><p><strong>Conclusion: </strong>The published literature on AI applied to ultrasound in benign gynecological disorders is focused mainly on creating classification models to distinguish between normal and pathological cases, and on developing models to automatically segment or measure ovarian volume or follicles. © 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":"295-302"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068199","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":"Clinical utility of prenatal exome sequencing for isolated short long bones and isolated small-for-gestational age.","authors":"B Jordan, S A Graham, S Allen, V Harrison","doi":"10.1002/uog.29188","DOIUrl":"10.1002/uog.29188","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"386-388"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400326","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":"Delivering unexpected news in pregnancy: a call for specialized training.","authors":"I Karapanos, S Iliodromiti, E Greco","doi":"10.1002/uog.27682","DOIUrl":"10.1002/uog.27682","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"384"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946057","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":"Artificial intelligence, radiomics and fetal ultrasound: review of literature and future perspectives.","authors":"A Bouachba, J De Jesus Neves, E Royer, R Bartin, L J Salomon, D Grevent, G Gorincour","doi":"10.1002/uog.29172","DOIUrl":"https://doi.org/10.1002/uog.29172","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":"65 3","pages":"281-291"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537826","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":"K Mikolaj, C A Taksøe-Vester, O B B Petersen, N G Vejlstrup, A N Christensen, A Feragen, M Nielsen, M B S Svendsen, M G Tolsgaard","doi":"10.1002/uog.29160","DOIUrl":"10.1002/uog.29160","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"392-393"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830084","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":"Thoughts on the contribution of artificial intelligence (AI) to assessment of the fetal heart: a true scientific odyssey.","authors":"E Quarello, E Corno","doi":"10.1002/uog.29185","DOIUrl":"10.1002/uog.29185","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"292-294"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493816","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":"Association of maternal body mass index with hemodynamic and vascular alterations at 35-37 weeks' gestation.","authors":"M Charakida, C Chatzakis, L A Magee, A Syngelaki, T Mansukhani, P von Dadelszen, K H Nicolaides","doi":"10.1002/uog.29170","DOIUrl":"10.1002/uog.29170","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Globally, one in four pregnant women is classified as overweight or obese, based on their prepregnancy body mass index (BMI). Obese pregnant women are at increased risk of adverse pregnancy outcomes and long-term cardiovascular disease that occurs earlier in life. This study aimed to assess maternal hemodynamic and vascular parameters at 35-37 weeks' gestation, to understand the alterations that may occur in association with increased maternal BMI and gestational weight gain, and to evaluate obesity-related pregnancy outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a prospective observational study of 11 731 women with a singleton pregnancy attending for a routine hospital visit at 35 + 0 to 36 + 6 weeks' gestation at King's College Hospital, London, UK, between December 2021 and June 2024. Women were categorized based on their BMI at 11-13 weeks' gestation, as normal weight (BMI, 18.5-24.9 kg/m&lt;sup&gt;2&lt;/sup&gt;), overweight (BMI, 25.0-29.9 kg/m&lt;sup&gt;2&lt;/sup&gt;) or obese (BMI, ≥ 30 kg/m&lt;sup&gt;2&lt;/sup&gt;). We recorded details regarding maternal demographic characteristics and medical history, used Doppler ultrasound to assess the uterine artery pulsatility index (UtA-PI) (as a marker for uteroplacental perfusion) and ophthalmic artery peak systolic velocity (PSV) ratio (as a marker for small vessel peripheral circulation), and measured carotid-to-femoral pulse-wave velocity, augmentation index (as direct and indirect markers of aortic stiffness, respectively), cardiac output, total peripheral resistance (TPR), and central systolic and diastolic blood pressure. Multivariable analysis was performed to examine the relationship of BMI and gestational weight gain with hemodynamic and vascular measures, adjusting for maternal demographics, medical history, pregnancy characteristics and pregnancy outcomes (including pre-eclampsia and gestational diabetes mellitus).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overweight and obese women were more often of black ethnicity, and had higher central systolic and diastolic blood pressure, cardiac output, aortic stiffness and UtA-PI, compared with normal-weight women. There was no significant difference between overweight or obese women and normal-weight women with regard to TPR and ophthalmic artery PSV ratio. On multivariable analysis, increasing BMI at 11-13 weeks and gestational weight gain between 11-13 weeks and 35-37 weeks were independently associated with increases in all cardiovascular indices (including ophthalmic artery PSV ratio), apart from TPR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Women with a high BMI in early pregnancy vs normal-weight women, and those with higher gestational weight gain, had worse maternal hemodynamic and vascular indices at 35-37 weeks' gestation, independent of baseline and pregnancy characteristics. Our findings support the notion that optimization of prepregnancy weight and gestational weight gain may improve maternal hemodynamics and vascular function during pregnancy","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"303-310"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012416","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":"Could maternal rest improve adverse outcome in fetuses defined by abnormal growth trajectory?","authors":"G R DeVore","doi":"10.1002/uog.29152","DOIUrl":"10.1002/uog.29152","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"393-394"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048064","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}