{"title":"Correction to 'Role of artificial-intelligence-assisted automated cardiac biometrics in prenatal screening for coarctation of aorta'.","authors":"","doi":"10.1002/uog.29156","DOIUrl":"10.1002/uog.29156","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"512"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932827","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}
P Dicker, S Daly, R M Conroy, F M McAuliffe, M P Geary, J J Morrison, S S Carroll, F D Malone, F M Breathnach
{"title":"Fetal biometry reference ranges derived from prospective twin population and evaluation of adverse perinatal outcome.","authors":"P Dicker, S Daly, R M Conroy, F M McAuliffe, M P Geary, J J Morrison, S S Carroll, F D Malone, F M Breathnach","doi":"10.1002/uog.29190","DOIUrl":"10.1002/uog.29190","url":null,"abstract":"<p><strong>Objectives: </strong>Ultrasound-derived estimates of fetal size play an integral role in the prenatal management of twin pregnancy. These biometric measurements are conventionally plotted against singleton standards. We sought to establish fetal growth references for abdominal circumference, head circumference, biparietal diameter, femur diaphysis length and estimated fetal weight (EFW) in twin pregnancy. We also aimed to determine whether the performance of a twin fetal growth reference was superior to a singleton reference in the prediction of adverse perinatal outcome in twin pregnancies.</p><p><strong>Methods: </strong>This was a retrospective analysis of data collected prospectively in the Evaluation of Sonographic Predictors of Restricted growth in Twins (ESPRiT) study, which was conducted at eight academic perinatal centers in Ireland, all with tertiary neonatal intensive care facilities. Only diamniotic twin pregnancies with two live fetuses were eligible for inclusion. Exclusion criteria were monoamnionicity, congenital abnormality, twin-to-twin transfusion syndrome or previable fetal demise (< 24 weeks' gestation). Using serial ultrasound observations, we applied fractional polynomial multilevel models to derive an equation for fetal centile determination. We compared these centiles with published singleton and twin fetal references, with particular focus on the Fetal Medicine Foundation (FMF) references. Using the last ultrasound examinations before delivery, we determined associations between biometric measures and a composite measure of adverse perinatal outcome (intraventricular hemorrhage, periventricular leukomalacia, hypoxic ischemic encephalopathy, necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis or perinatal death), neonatal intensive care unit admission, preterm delivery (< 34 weeks) and birth-weight discordance ≥ 25%, based on the varied prevalence of these outcomes. We compared our results with the singleton and twin FMF reference ranges and the twin reference of the Southwest Thames Obstetric Research Collaborative (STORK) study.</p><p><strong>Results: </strong>Among the 948 twin pairs that met the inclusion criteria, 776 (81.9%) dichorionic and 172 (18.1%) monochorionic twin pairs completed the prospective 2-weekly ultrasound surveillance program. Fetal biometric measurements were obtained in 15 274 ultrasound assessments (12 279 in dichorionic and 2995 in monochorionic twin pairs) from serial ultrasound assessments. The median number of ultrasound assessments per pregnancy was 8 (interquartile range, 7-9). Growth trajectories in this cohort were consistent with the FMF and STORK published twin cohorts and notably less consistent with the FMF singleton standard. Compared with the FMF singleton standards, the 50<sup>th</sup> centiles for twins were greater early in pregnancy and lower later in pregnancy for all biometric measures, in both dichorionic and monochorionic twin pregnancies. This crossover","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"436-446"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524252","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}
D A Lasry, D V Valsky, N Cohen, A Nahum, S M Cohen, S Yagel
{"title":"High success rate in demonstration of soft palate in early and late mid-trimester ultrasound scans.","authors":"D A Lasry, D V Valsky, N Cohen, A Nahum, S M Cohen, S Yagel","doi":"10.1002/uog.29164","DOIUrl":"10.1002/uog.29164","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"388-389"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068279","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":"Will radiomics or visual assessment prevail?","authors":"A C Testa","doi":"10.1002/uog.29168","DOIUrl":"10.1002/uog.29168","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"385-386"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012371","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}
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
{"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":"Vertebroplacental ratio for prediction of perinatal outcome and operative delivery for suspected fetal compromise: prospective observational cohort study.","authors":"B Packet, R Van Severen, J Richter","doi":"10.1002/uog.29189","DOIUrl":"10.1002/uog.29189","url":null,"abstract":"<p><strong>Objective: </strong>To investigate differences in fetal vertebroplacental ratio (VPR) depending on the occurrence of operative delivery for suspected fetal compromise (ODFC) and composite perinatal outcome (CPO) at delivery.</p><p><strong>Methods: </strong>This was a prospective observational cohort study conducted in the Department of Obstetrics and Gynecology at the University Hospitals of Leuven, Leuven, Belgium, between December 2022 and April 2024. Women with a term (37-42 gestational weeks) singleton pregnancy with an appropriate-for-gestational-age (AGA) fetus were recruited, before cervical dilatation reached 5 cm, for sonographic fetal weight estimation (EFW) and Doppler sonography of the umbilical artery (UA), umbilical vein (UV), middle cerebral artery (MCA) and vertebral artery (VA). The primary outcomes were differences in VPR multiples of the median (MoM) depending on the occurrence of ODFC and CPO at delivery (based on UA cord blood pH and base excess, 1-min and 5-min Apgar score, and neonatal intensive care unit admission). We explored the technical feasibility of fetal Doppler sonography in this setting and differences in Doppler findings from individual fetal vessels (UA, UV blood flow (UVF), MCA, VA) and related parameters (UVF/EFW and cerebroplacental ratio (CPR)). We also investigated whether adding individual sonographic variables to baseline clinical prediction models could improve discriminatory power (using the area under the receiver-operating-characteristics curve (AUC)) and predictive accuracy (using the Brier score) for both outcomes.</p><p><strong>Results: </strong>A total of 161 women were recruited. The mean ± SD maternal age was 32.2 ± 3.8 years and approximately half (53.4%) of the women were nulliparous. Most (88.2%) women had labor induced. The mean ± SD gestational age at delivery was 39.3 ± 1.0 weeks and the mean ± SD ultrasound-to-delivery interval was 10.4 ± 2.75 h. An adverse CPO occurred in 13.3% of cases and ODFC occurred in 17.4%. No difference in mean VPR MoM was observed between cases with normal vs adverse CPO (1.04 ± 0.26 vs 1.17 ± 0.25; P = 0.09), or between cases which underwent ODFC vs those which did not (1.06 ± 0.29 vs 1.06 ± 0.26; P = 0.97). Likewise, no differences in other Doppler variables (UA pulsatility index (PI) MoM, MCA-PI MoM, VA-PI MoM, CPR MoM) were observed for both outcomes, except for significantly higher UVF rates in the adverse CPO group (both absolute (P = 0.02) and corrected for EFW (P = 0.048)). For both outcomes, adding VPR MoM or any other sonographic variable to baseline prediction models, which consisted solely of clinical variables, did not improve predictive accuracy or discriminatory power. The baseline model AUC and Brier score values were 0.68 (95% CI, 0.57-0.79) and 0.14 for adverse CPO, and 0.72 (95% CI, 0.61-0.83) and 0.13 for ODFC, respectively.</p><p><strong>Conclusions: </strong>Although technically feasible to measure in most women with an AGA fetu","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"334-343"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504292","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}