Ultrasound in Obstetrics & Gynecology最新文献

{"title":"ISUOG Practice Guidelines (updated): role of ultrasound in twin pregnancy.","authors":"A Khalil, A Sotiriadis, A Baschat, A Bhide, E Gratacós, K Hecher, L Lewi, L J Salomon, B Thilaganathan, Y Ville","doi":"10.1002/uog.29166","DOIUrl":"10.1002/uog.29166","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"253-276"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012364","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":"Performance evaluation of computerized antepartum fetal heart rate monitoring: Dawes-Redman algorithm at term.","authors":"G Davis Jones, B Albert, W Cooke, M Vatish","doi":"10.1002/uog.29167","DOIUrl":"10.1002/uog.29167","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effectiveness of the Dawes-Redman algorithm in identifying fetal wellbeing at term by analyzing 30 years of retrospective clinical data, comparing normal and adverse pregnancy outcomes, evaluating key metrics and testing its performance when used 0-48 h before delivery.</p><p><strong>Methods: </strong>Antepartum fetal heart rate (FHR) traces from term singleton pregnancies at 37 + 0 to 41 + 6 weeks' gestation obtained between 1991 and 2024 were extracted from the Oxford University Hospitals database. Traces with > 30% of their signal information missing or with incomplete Dawes-Redman analyses were excluded. Only traces performed within 48 h prior to delivery were considered. A cohort of pregnancies with subsequent normal pregnancy outcome (NPO) was established using rigorous inclusion and exclusion criteria. Another cohort of pregnancies with adverse pregnancy outcome (APO) was developed if the neonate experienced at least one of seven APOs after delivery. Propensity score matching (PSM) facilitated a balanced comparison between NPO and APO cohorts using six factors: gestational age at FHR monitoring, fetal sex, maternal body mass index at presentation, maternal age at delivery, parity and time interval between FHR trace and delivery. FHR traces were categorized as either 'criteria met' (indicating fetal wellbeing) or 'criteria not met' (indicating a need for further evaluation) according to the Dawes-Redman algorithm, which informed the evaluation of predictive performance metrics. Performance was assessed using accuracy, sensitivity, specificity, positive predictive value, and negative predictive value (NPV) adjusted for various population risk prevalences of APO.</p><p><strong>Results: </strong>A balanced dataset of 3316 antepartum FHR traces was developed with PSM (standardized mean difference < 0.10). The Dawes-Redman algorithm showed a high specificity of 90.7% (95% CI, 89.2-92.0%) for ruling out APO. Sensitivity was 18.2% (95% CI, 16.3-20.0%). The NPV varied with the population prevalence of APO and was high in very-low-risk settings (NPV, 99.1% (95% CI, 98.9-99.3%) at 1% APO prevalence) and decreased with increasing risk of APO (NPV, 72.1% (95% CI, 67.7-76.1%) at 30% APO prevalence). Temporal proximity of FHR assessment to delivery indicated robust specificity, which was similar for assessments performed at 0-24 h and 24-48 h prior to delivery (specificity at 0-24 h, 90.8% (95% CI, 88.8-92.7%); specificity at 24-48 h, 90.3% (95% CI, 88.2-92.3%); P = 0.898). Across the different adverse outcomes comprising the APO cohort, the performance of the Dawes-Redman algorithm remained consistent, with high specificity (ranging from 87.7% to 94.7%) and NPVs (ranging from 95.4% to 96.0%), confirming its utility in identifying fetal wellbeing.</p><p><strong>Conclusion: </strong>These findings indicate that the Dawes-Redman algorithm is effective for its intended purpose: identifying a state of fetal wellb","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":"65 2","pages":"191-197"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081178","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":"Diagnostic accuracy of cell-free fetal DNA in maternal blood in detecting chromosomal anomalies in twin pregnancy: systematic review and meta-analysis.","authors":"L Della Valle, M Piergianni, A Khalil, A Novelli, G Rizzo, I Mappa, S Prasad, B Matarrelli, V Gatta, L Stuppia, G Pagani, M E Flacco, F D'Antonio","doi":"10.1002/uog.27698","DOIUrl":"10.1002/uog.27698","url":null,"abstract":"<p><strong>Objective: </strong>To report the diagnostic accuracy of cell-free fetal DNA (cfDNA) in maternal blood in detecting fetal chromosomal anomalies in twin pregnancy.</p><p><strong>Methods: </strong>PubMed, MEDLINE, EMBASE and Cochrane databases were searched from inception to November 2023. The inclusion criteria were twin pregnancy undergoing cfDNA screening for trisomies 21, 18 and 13, monosomy X and/or other sex-chromosome aneuploidies (SCA). The index test was cfDNA screening. The reference standard was pre- or postnatal karyotyping (in the case of a positive cfDNA result) or neonatal phenotypic assessment (in case of a negative cfDNA result). The quality of included studies was assessed using the revised quality assessment of diagnostic accuracy studies (QUADAS-2) tool. Summary estimates of diagnostic accuracy were computed using a bivariate random-effects model.</p><p><strong>Results: </strong>Thirty-five studies were included in the systematic review and meta-analysis. cfDNA had a high accuracy in detecting trisomy 21 in twin pregnancy, with a sensitivity of 98.8% (95% CI, 96.5-100%) and specificity of 100% (95% CI, 99.9-100%). Sensitivity and specificity were 94.9% (95% CI, 75.9-99.1%) and 100% (95% CI, 99.9-100%), respectively, for trisomy 18 and 84.6% (95% CI, 54.6-98.1%) and 100% (95% CI, 99.9-100%), respectively, for trisomy 13. We could not compute the diagnostic accuracy of cfDNA in detecting monosomy X, owing to an absence of positive cases, while cfDNA had a sensitivity of 100% (95% CI, 71.5-100%) and specificity of 99.8% (95% CI, 99.7-99.9%) for other SCA. The accuracy of cfDNA in detecting the common trisomies was similar in dichorionic and monochorionic twin pregnancies.</p><p><strong>Conclusions: </strong>cfDNA has high diagnostic accuracy in detecting trisomies 21 and 18 in twin pregnancy, irrespective of chorionicity. Estimation of diagnostic accuracy for trisomy 13 and other SCA was limited by the small number of affected cases and the difficulty associated with detecting false-negative cases of other SCA, and thus requires confirmation in larger studies. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"147-153"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076865","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":"Perinatal diagnosis of renal agenesis in female fetus: implication for investigation of OHVIRA syndrome in adolescence.","authors":"A Ludwin, L Zaborowska","doi":"10.1002/uog.27714","DOIUrl":"10.1002/uog.27714","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"249-252"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761229","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":"Correlation between prenatal ultrasound prognostic criteria and pulmonary hypoplasia on pathological examination of fetuses with congenital diaphragmatic hernia.","authors":"C Maillet, J Martinovic, J Jani, P Delorme, A Benachi, A-G Cordier","doi":"10.1002/uog.27700","DOIUrl":"10.1002/uog.27700","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"238-239"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065778","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":"Standardized approach to ultrasound-guided balloon puncture for reversal of tracheal occlusion in congenital diaphragmatic hernia.","authors":"A A Baschat, A D Forrest, S M Millard, M L Laurie, D Wolfson, M Rosner, J L Miller","doi":"10.1002/uog.27711","DOIUrl":"10.1002/uog.27711","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"235-238"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158372","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":"Society of Radiologists in Ultrasound response to 'Proposed simplified protocol for initial assessment of endometriosis with transvaginal ultrasound'.","authors":"S W Young, P Jha, W VanBuren, S Rodgers, R Kho, Y Groszmann, T Burnett, M Feldman, Z Khan, L Chamie, M Horrow, S L Young","doi":"10.1002/uog.29147","DOIUrl":"10.1002/uog.29147","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"243-245"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732950","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":"Why create a new protocol or a new consensus in the ultrasound diagnosis of endometriosis?","authors":"S Guerriero, J L Alcázar, H Oyarce, D Timmerman, G Hudelist, G Condous","doi":"10.1002/uog.29159","DOIUrl":"10.1002/uog.29159","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"246-247"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839784","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":"Relationship of maternal ophthalmic artery Doppler with uterine artery Doppler, hemodynamic indices and gestational age: prospective MATERA study.","authors":"S Ali, D C Mukasa, D Lukakamwa, A Nakayenga, P Namagero, J Biira, J Byamugisha, A T Papageorghiou","doi":"10.1002/uog.29162","DOIUrl":"10.1002/uog.29162","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To examine the relationship of ophthalmic artery (OA) Doppler indices with uterine artery (UtA) Doppler indices, selected maternal hemodynamic parameters and gestational age, and to evaluate the intraobserver reproducibility of OA Doppler indices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a prospective cohort study of women recruited between 11 + 0 and 23 + 6 weeks' gestation using a stratified and random sampling approach to ensure adequate distribution across the gestational-age range. OA pulsatility index (PI), first peak systolic velocity (PSV1), second peak systolic velocity (PSV2) and peak systolic velocity ratio (PSV ratio), calculated as PSV2/PSV1, were measured twice in each eye by the same observer. UtA-PI was also measured twice on each side by the same observer. Maternal hemodynamic assessment was undertaken using an ultrasonic cardiac output monitor (USCOM 1A). Pearson's and Spearman's rank correlation coefficients were used to assess the correlations between variables, and Bland-Altman plots were used to evaluate the intraobserver reproducibility of OA Doppler indices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 194 women invited to participate in the study, 169 were eligible for inclusion, of whom 16 were excluded following an obstetric ultrasound scan and a further three owing to inadequate or incomplete OA or UtA Doppler assessment, leaving 150 women in the final analysis. Log UtA-PI had a weak correlation with both OA-PI (r = -0.19 (95% CI, -0.34 to -0.03), P = 0.021) and OA-PSV ratio (r = 0.31 (95% CI, 0.15-0.45), P &lt; 0.001). The correlation between gestational age and OA-PI was non-significant (r = 0.14 (95% CI, -0.03 to 0.29), P = 0.097), and that between gestational age and OA-PSV ratio was weak (r = -0.23 (95% CI, -0.38 to -0.07), P = 0.004), as opposed to the strong correlation between gestational age and UtA-PI (r = -0.68 (95% CI, -0.76 to -0.58), P &lt; 0.001). No strong correlations were observed between OA-PI or OA-PSV ratio and maternal hemodynamic indices. The correlations were unaltered by adjustment for maternal age and body mass index. The intraobserver reproducibility of OA-PI and OA-PSV ratio in the same eye was high. The correlation between the right and left eyes was moderate for OA-PI (r = 0.63 (95% CI, 0.53-0.72), P &lt; 0.001) and strong for OA-PSV ratio (r = 0.81 (95% CI, 0.75-0.86), P &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;OA-PI and OA-PSV ratio had a weak or no correlation with UtA-PI and maternal hemodynamic parameters, meaning that they can be used as independent predictors for pre-eclampsia. Gestational age had no clinically relevant effect on OA-PI and OA-PSV ratio, suggesting that these indices could be measured without adjustment at any time between 11 and 23 weeks' gestation. OA Doppler indices had high intraobserver reproducibility and were strongly correlated between the right and left eyes. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wile","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"163-172"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012369","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 ultrasonography in pediatric and adolescent gynecology: retrospective review of 1313 ultrasound examinations.","authors":"N Cooper, H Meehan, K Linton-Reid, J Barcroft, J Danin, M Seah, S Sadigh, N Bharwani, S Sur, C Fotopoulou, C Landolfo, J Yazbek, S Saso, D Timmerman, T Bourne, M Al-Memar","doi":"10.1002/uog.29155","DOIUrl":"10.1002/uog.29155","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Ultrasound is the first-line imaging modality of the pelvis in the pediatric and adolescent gynecology (PAG) population. Ultrasound findings in pre- and postpubertal PAG patients differ from those in adults. Diagnostic models for adnexal pathology have not been validated in this cohort. The primary aim of this study was to evaluate normative findings and the incidence of pathology in this cohort. The secondary aim was to assess the performance of expert opinion alone, as well as using retrospective application of the International Ovarian Tumor Analysis (IOTA) simple rules (SRs) and benign descriptors (BDs) in those found to have an adnexal mass.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a retrospective review of pelvic ultrasound examinations performed in patients &lt; 18 years of age from January 2017 to July 2021 in one expert center in the UK. Analysis was performed on three age groups: neonatal (aged &lt; 1 year), premenarchal (aged ≥ 1 year) and postmenarchal. The study was locally approved as an audit (GRM_082). Expert review of images of ovarian masses was performed using retrospective application of the IOTA-SRs and IOTA-BDs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, data on 1429 pelvic ultrasound examinations were retrieved, of which 116 were excluded, resulting in the inclusion of 1313 ultrasound images (1145 patients). The median age at the first ultrasound scan was 2 days after birth in the neonatal group (n = 20), 8.8 years in the premenarchal group (n = 124) and 16.1 years in the postmenarchal group (n = 961). The status of menarche was unknown in a further 40 patients. Normative ultrasound findings were in keeping with those in the existing literature. Uterine anomalies were seen in 14 (1.2%) patients. Endometrial pathology was rare, with five cases of gestational trophoblastic disease. The most frequent indication for ultrasound scan for each group were a known medical condition in neonates (n = 11 (55.0%)), suspected precocious puberty in premenarchal girls (n = 38 (30.6%)) and abnormal vaginal bleeding in postmenarchal girls (n = 504 (52.4%)). Polycystic ovarian appearances were described in 150 (15.6%) postmenarchal girls. Adnexal pathology was identified in 102 (8.9%) participants on initial ultrasound: four neonates, three premenarchal and 95 postmenarchal patients. Benign cystadenomas and hemorrhagic cysts were the most common adnexal mass type in all groups. Final outcomes were available for 79/95 masses in the postmenarchal group, none of which were malignant. The IOTA-SRs, IOTA-BDs, expert opinion and standard ultrasound reporting could characterize as benign 96.2%, 87.3%, 98.7% and 77.2% of the masses, respectively, all with a specificity of 100%. Eleven patients underwent 12 surgeries overall (three oophorectomies, six cystectomies and three cyst aspirations), with 11 out of 12 masses classified as benign based on retrospective expert assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Ultrasound i","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":"65 2","pages":"226-234"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081177","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}