Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology最新文献

{"title":"The 'gable roof' sign for early diagnosis of Cesarean scar ectopic pregnancy.","authors":"A D'Amico, G Cali, A Khalil, A Lucidi, G Grisolia, I Timor-Tritsch, F D'Antonio","doi":"10.1002/uog.70312","DOIUrl":"10.1002/uog.70312","url":null,"abstract":"","PeriodicalId":520822,"journal":{"name":"Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology","volume":" ","pages":"583-586"},"PeriodicalIF":6.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sagittal aortic-arch assessment for prenatal diagnosis of coarctation of the aorta: comparative evaluation of 10 published methods and a new predictive model.","authors":"U Chonnak, F Tongprasert, S Anuwutnavin, T Tongsong","doi":"10.1002/uog.70321","DOIUrl":"10.1002/uog.70321","url":null,"abstract":"<p><strong>Objectives: </strong>To externally validate the diagnostic performance of 10 previously published fetal echocardiographic sagittal aortic-arch parameters and to develop an optimal predictive model based on these parameters for the prenatal identification of neonatal coarctation of the aorta (CoA).</p><p><strong>Methods: </strong>This was a retrospective, multicenter diagnostic cohort study, including pregnancies with suspected fetal CoA and postnatal diagnostic confirmation. Sagittal aortic-arch videoclips obtained from patients at two tertiary referral centers in Thailand between January 2014 and January 2025 were reviewed offline by a single investigator blinded to the final diagnosis to assess 10 predefined echocardiographic parameters of the aortic arch, including vascular diameters, interarterial distances, vessel angles and the presence of a shelf sign. The discriminatory performance of the 10 published predictors for neonatal CoA was evaluated using univariate binary logistic regression and receiver-operating-characteristics (ROC)-curve analysis. A final predictive model was developed by entering the 10 sagittal aortic-arch parameters into a multivariable logistic regression model and applying backward elimination to derive the model with the fewest parameters without compromising discriminatory performance.</p><p><strong>Results: </strong>Of the 154 fetuses included in the study, 82 (53.2%) were subsequently diagnosed with neonatal CoA. Fetuses subsequently diagnosed with neonatal CoA had a significantly longer left common carotid artery-left subclavian artery (LCCA-LSCA) distance (median, 3.12 mm vs 2.14 mm; P = 0.001) and a higher prevalence of the shelf sign (74.4% vs 50.0%; P = 0.002). Among individual parameters, the carotid-subclavian artery index showed the highest diagnostic accuracy for predicting neonatal CoA (area under the ROC curve (AUC), 0.684 (95% CI, 0.600-0.767)). The final multivariable model, incorporating LCCA-LSCA distance, LSCA diameter, descending aortic diameter and the presence of the shelf sign, demonstrated moderate performance (AUC, 0.749 (95% CI, 0.672-0.826)). At a predicted probability cut-off of 0.45, the sensitivity and specificity of the combined model for the prenatal identification of neonatal CoA were 84.1% (95% CI, 74.4-91.3%) and 54.2% (95% CI, 42.0-66.0%), respectively.</p><p><strong>Conclusions: </strong>In fetuses with suspected CoA, a multiparametric predictive model based on sagittal aortic-arch assessment improves prenatal diagnosis compared with previously published methods. A longer LCCA-LSCA distance, the presence of the shelf sign and an increased LSCA diameter are useful for distinguishing true-positive cases of CoA during fetal echocardiography. © 2026 International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":520822,"journal":{"name":"Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology","volume":" ","pages":"550-558"},"PeriodicalIF":6.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-intensity pulsed ultrasound to facilitate uterine involution: prospective multicenter study on clinical efficacy and mechanistic insights.","authors":"H-L Liu, L-M Xie, J Wang, H Zou, L-J Sun, J-C Xu, X-F Li, H Zhang, H-B Qi, X Luo","doi":"10.1002/uog.70330","DOIUrl":"10.1002/uog.70330","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess the clinical efficacy and safety of low-intensity pulsed ultrasound (LIPUS) in facilitating uterine involution after delivery and mitigating postpartum complications, and to explore its molecular mechanisms of action through both in-vitro and in-vivo experimental animal models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This multicenter, randomized, double-blind, controlled trial was conducted across three centers in China from January 2023 to December 2024. Participants were randomized to a LIPUS group or a control group. The LIPUS group received treatment at 0.8 MHz with a spatial peak-temporal average intensity of 2.0 W/cm&lt;sup&gt;2&lt;/sup&gt;, focal area of 0.09-0.12 cm&lt;sup&gt;2&lt;/sup&gt; and pulse duration of 4 ms, for 30 min daily over 10 consecutive days, starting 2 h after delivery. The control group received sham treatment with identical parameters but no acoustic output. The primary outcome, percentage reduction in uterine volume on post-treatment day 10, measured using transabdominal three-dimensional ultrasonography, was compared between the two groups. Secondary outcomes, including the incidence of postpartum complications (secondary postpartum hemorrhage and puerperal infection), duration of lochia and indices of uterine involution (fundal height descent index and uterine dimensions) were also compared. For in-vivo experiments, uterine tissues from postpartum Sprague-Dawley rats that had undergone LIPUS or sham treatment were evaluated using hematoxylin and eosin staining for morphology, and immunohistochemistry and Western blotting to assess distribution of endothelin-1 (ET-1) and oxytocin receptor (OTR) proteins and to quantify their expression. For in-vitro experiments, uterine tissue strips from untreated rats were exposed to LIPUS or sham treatment ex vivo for contractility measurement using a BL-420F biological signal acquisition system. Primary uterine smooth-muscle cells (USMCs) from untreated rats were exposed to LIPUS or sham irradiation in vitro and assessed for intracellular calcium ions (Ca&lt;sup&gt;2+&lt;/sup&gt;) by fluorescence imaging and flow cytometry, and for ET-1 and OTR expression by Western blotting. To assess calcium-channel involvement, nifedipine (an L-type calcium-channel antagonist) was included in the contractility and flow cytometry experiments, establishing four treatment groups: control, LIPUS alone, nifedipine alone and LIPUS + nifedipine. For in-vivo and in-vitro experiments, results were compared between the LIPUS-treated and control groups; for the contractility and flow cytometry assays, comparisons were made among all four groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 1106 participants were enrolled, with 553 assigned randomly to the control group and 553 to the LIPUS group. After exclusions, 528 women in the LIPUS group and 530 in the control group were included in the final analysis. Compared with controls, the LIPUS-treated participants showed a significantly greater percentage reducti","PeriodicalId":520822,"journal":{"name":"Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology","volume":" ","pages":"453-467"},"PeriodicalIF":6.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decidualized ovarian endometrioma mimicking malignancy in a non-pregnant woman.","authors":"S Alson, S Neringer, L Valentin","doi":"10.1002/uog.70273","DOIUrl":"10.1002/uog.70273","url":null,"abstract":"","PeriodicalId":520822,"journal":{"name":"Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology","volume":" ","pages":"580-581"},"PeriodicalIF":6.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum anthropometric and cardiovascular profile following hypertensive disorders of pregnancy: 12-month follow-up.","authors":"Y Chen, I S Wong, X Chen, J Lin, J Liu, F Liu, S L Lau, Q Zhang, X Xu, A P W Lee, L C Poon","doi":"10.1002/uog.70313","DOIUrl":"10.1002/uog.70313","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To compare anthropometric and cardiovascular parameters at 6-12 weeks postpartum among women classified at first-trimester screening as high risk for pre-eclampsia (PE) who subsequently developed hypertensive disorders of pregnancy (HDP), those classified as high risk who did not develop HDP and those classified as low risk for PE, and, among high-risk women, to evaluate the trajectory of these parameters from 6-12 weeks to 12 months postpartum according to the subsequent development of HDP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a prospective postpartum longitudinal study conducted at the Prince of Wales Hospital, Hong Kong Special Administrative Region, in which women underwent postpartum assessment between October 2022 and January 2025. Eligible participants were Chinese women in the postpartum period following a singleton pregnancy who had undergone first-trimester PE screening at 11 + 0 to 13 + 6 weeks' gestation. Women were classified into three groups based on their first-trimester screening result and subsequent pregnancy outcome: (1) women at high risk (≥ 1:100) for PE who subsequently developed HDP; (2) women at high risk for PE who did not develop HDP; and (3) low-risk controls with a normotensive pregnancy. Participants were enrolled between 6 and 12 weeks postpartum for anthropometric and cardiovascular assessments, and these findings were compared among the groups. Subsequently, women at high risk for PE were examined longitudinally at 6 months and 12 months postpartum to assess changes in anthropometric and cardiovascular parameters. High-risk women received lifestyle counseling at each visit. Linear mixed-effects analysis was performed to compare the longitudinal changes in anthropometric and cardiovascular parameters over the postpartum period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 201 women were included in the study, of whom 130 were at high risk for PE and did not develop HDP, 41 were at high risk for PE and developed HDP and 30 were low-risk controls. At 6-12 weeks postpartum, high-risk women with HDP exhibited a significantly higher mean arterial pressure, left ventricular (LV) mass index (MI), systemic vascular resistance, myocardial performance index and more impaired global longitudinal strain (GLS), along with lower mitral annular plane systolic excursion, compared with the low-risk and high-risk-without-HDP groups. Similar findings mostly persisted over the 12-month postpartum period, even after adjusting for risk factors (all P &lt; 0.05). From 6 to 12 weeks to 12 months postpartum, the high-risk-without-HDP group showed a statistically significant declining trend in weight, waist circumference and waist-to-hip ratio, along with reduced weight gain from the first trimester to 12 months postpartum, whereas the high-risk-with-HDP group showed no significant change during the same period. The high-risk-without-HDP group exhibited a decreasing trend in LV-MI and increasing trends in LV eje","PeriodicalId":520822,"journal":{"name":"Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology","volume":" ","pages":"527-539"},"PeriodicalIF":6.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic imaging of adnexal lesions in pregnancy: systematic review.","authors":"N Cooper, N Kotecha, A Novak, J Barcroft, J Yazbek, C Landolfo, M Al-Memar, D Timmerman, S Saso, T Bourne","doi":"10.1002/uog.70296","DOIUrl":"10.1002/uog.70296","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To describe the imaging features of adnexal lesions during pregnancy and assess the performance of current models for the risk assessment of such lesions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a PROSPERO-registered systematic review including studies published from inception to 1 August 2025 and was performed as per Preferred Reporting Systems for Systematic Reviews and Meta-Analysis guidance using Covidence software. Studies were included if they utilized an objective or standardized assessment of imaging features (based on the International Ovarian Tumor Analysis (IOTA) terms and definitions, or predefined categorical variables), expert description or quantitative data (such as lesion measurements and number of papillary projections) to assess the risk of adnexal lesions during pregnancy. Standardized extraction of imaging features was performed and classification of outcomes was based on histology, resolution or expert impression. Diagnostic model performance was also extracted. Meta-analysis of model performance was not performed owing to study heterogeneity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 3349 studies were screened, of which 40 underwent full-text review and 16 were included in the systematic review, comprising 1674 patients and 1660 adnexal lesions. Most included studies were retrospective and ultrasound-based. Excluding six studies that exclusively reported benign lesions, 93.1% (1284/1379) of patients had benign lesions, 3.4% (47/1379) had borderline ovarian tumors (BOTs) and 3.5% (48/1379) had malignant lesions. Excluding studies reporting exclusively on endometrioma, the most common benign adnexal lesions were simple cysts (39.0% (393/1007)), mature cystic teratomas (24.2% (244/1007)) and endometriomas (14.9% (150/1007)). Malignant lesions were most often epithelial ovarian cancer or metastases. Both BOTs and malignant lesions retained imaging characteristics comparable with those observed in non-pregnant women. Decidualization was present in 11.8-39.5% of reported endometriomas. While decidualized endometriomas (DEs) and BOTs typically share characteristics, experts noted distinguishing morphological features and behaviors. BOTs were larger (median, 88.0 mm vs 48.1 mm), and although both were predominantly unilocular-solid lesions, BOTs were relatively more often multilocular-solid (30.0% vs 22.4%) compared with DEs. Both showed high vascularity, with most cases having a color score of 3. Most DEs (83.9%) had one to three papillary projections, whereas most BOTs (66.7%) had more than three papillary projections. Diagnostic models, such as the IOTA two-step strategy and the Assessment of Different NEoplasias in the adneXa model alone, showed high specificity (70.0-90.2%) and negative predictive value (90.0-98.3%), but performance was limited by misclassification of DEs as malignant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Ultrasound can reliably assess adnexal lesions in pregnancy. DEs and BOTs ca","PeriodicalId":520822,"journal":{"name":"Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology","volume":" ","pages":"480-491"},"PeriodicalIF":6.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse outcome in Cesarean scar pregnancy continuing into mid-to-late gestation: systematic review and meta-analysis.","authors":"S Zeng, Y Tian, J Qu, H Shi, H Jiang, Y Chong, Y Wang, Y-Y Zhao, L Chen","doi":"10.1002/uog.70293","DOIUrl":"10.1002/uog.70293","url":null,"abstract":"<p><strong>Objective: </strong>To review systematically and assess quantitatively the incidence and risk of placenta accreta spectrum (PAS) disorders and hysterectomy in Cesarean scar pregnancy (CSP) continuing into mid-to-late gestation.</p><p><strong>Methods: </strong>A comprehensive literature search was performed in PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov, China National Knowledge Infrastructure (CNKI) and Yiigle databases from inception to 12 February 2025. Studies reporting the rates of PAS and/or hysterectomy in women with a singleton CSP that continued ≥ 14 weeks' gestation were eligible for inclusion. Data extracted included information on medical history, CSP classification and clinical manifestation, gestational age at delivery and pregnancy outcome. Data were synthesized as pooled incidences and odds ratios with 95% CIs, and random-effects models were used owing to high heterogeneity. Subgroup analyses were performed according to CSP subtype (Type I vs Type II vs Type III; and endogenous vs exogenous) and residual myometrial thickness (RMT) (≤ 3 mm vs > 3 mm).</p><p><strong>Results: </strong>Among 61 studies included in the systematic review, 20 studies (432 cases) were eligible for inclusion in the meta-analysis. Qualitative synthesis captured severe clinical phenotypes, including spontaneous uterine rupture and massive hemorrhage during Cesarean section. The pooled incidences of PAS and hysterectomy were 0.90 (95% CI, 0.81-0.96) and 0.39 (95% CI, 0.22-0.57), respectively. Marked heterogeneity was observed across CSP subtypes: Type-III and exogenous CSPs were associated with significantly higher odds of invasive PAS, hysterectomy and preterm delivery compared with Types-I/II and endogenous subtypes, respectively. Reduced RMT was associated significantly with increased odds of overall PAS and invasive PAS, and was predictive of hysterectomy on receiver-operating-characteristics-curve analysis. The pooled incidence of reaching ≥ 28 weeks' gestation was 0.85 (95% CI, 0.73-0.94), whereas the pooled incidence of reaching term (≥ 37 weeks) was 0.19 (95% CI, 0.10-0.30). Among studies that reported uterine rupture, the pooled incidence of this outcome was 0.05 (95% CI, 0.02-0.10).</p><p><strong>Conclusions: </strong>Type-III and exogenous CSPs that progress into mid-to-late gestation present substantial risks for PAS and hysterectomy, with a low likelihood of term delivery. Type-I, Type-II and endogenous CSPs are associated with a comparatively lower risk of adverse outcome. CSP subtype and RMT are key determinants for risk stratification and individualized counseling. © 2026 International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":520822,"journal":{"name":"Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology","volume":" ","pages":"468-479"},"PeriodicalIF":6.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective fetal growth restriction in twin pregnancies: appraisal of clinical practice guidelines.","authors":"S Sorrenti, E Deuster, A Khalil","doi":"10.1002/uog.70295","DOIUrl":"10.1002/uog.70295","url":null,"abstract":"","PeriodicalId":520822,"journal":{"name":"Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology","volume":" ","pages":"449-452"},"PeriodicalIF":6.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal aortic morphometry by echocardiography: reproducibility study using stringent criteria and standardized nomenclature.","authors":"P Vazirani, L Nogué, A Fernández, M Pérez, M Guilleumes, E Cabello, A Sepúlveda-Martínez, M C Escobar-Díaz, G Bernardino, B Bijnens, F Crispi, O Gómez","doi":"10.1002/uog.70329","DOIUrl":"10.1002/uog.70329","url":null,"abstract":"<p><strong>Objective: </strong>To establish and assess the reproducibility of standardized echocardiographic nomenclature and the protocol for comprehensive evaluation of fetal aortic morphology.</p><p><strong>Methods: </strong>This was a prospective cohort study of fetuses with a normal three-vessel branching pattern of the aortic arch, evaluated from 18-40 weeks' gestation at a single center between January 2024 and November 2024. Alongside standard two-dimensional views, four-dimensional spatiotemporal image correlation cardiac volumes were acquired to establish the correspondence between the longitudinal aortic-arch view and the three-vessel-and-trachea (3VT) view. A comprehensive nomenclature, based on clear anatomical landmarks, and stringent measurement protocol were defined for fetal aortic dimensions and angles measured in the left ventricular outflow tract (LVOT), the longitudinal aortic-arch and the 3VT echocardiographic views. Measurements were performed independently by two observers, with a repeat analysis by a single observer, to assess intra- and interobserver reproducibility, respectively, using intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>A total of 45 singleton fetuses with normal three-vessel branching were randomly selected to comprise the study population. Parameters measured in the LVOT view demonstrated good-to-excellent intra- and interobserver reproducibility (ICC > 0.8), with excellent reproducibility observed for the sinotubular junction and mid-ascending aorta diameters (except the interobserver reproducibility for mid-ascending aorta diameter (ICC, 0.883 (95% CI, 0.739-0.945)), which was good). Good-to-excellent intra- and interobserver reproducibility (ICC, 0.8-0.9) was also demonstrated for longitudinal aortic-arch diameters and distances between supra-aortic vessels, whereas the ascending-to-descending aorta angle showed moderate intra- and interobserver reproducibility (ICC, 0.652 (95% CI, 0.435-0.798) and 0.593 (95% CI, 0.199-0.776), respectively). In the 3VT view, the standardized aortic diameters and the 3VT angle had good-to-excellent intraobserver reproducibility (ICC, 0.75-0.9). There was also good agreement between the aortic isthmus diameter in the longitudinal aortic-arch view and the 3VT view (ICC, 0.870 (95% CI, 0.458-0.995); P < 0.001). No significant differences or systematic bias were found between observers.</p><p><strong>Conclusion: </strong>A standardized echocardiographic protocol with uniform nomenclature and anatomical landmarks would enable reliable and reproducible fetal aortic morphometry across multiple echocardiographic views, and would be a significant step towards harmonizing fetal aorta imaging, enabling meaningful comparisons across studies and promoting collaborative research. © 2026 International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":520822,"journal":{"name":"Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology","volume":" ","pages":"540-549"},"PeriodicalIF":6.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging in gynecological disease (32): clinical and ultrasound characteristics of early abdominal ectopic pregnancy.","authors":"L Berg, L V de Braud, E Bean, M Lomheim, L Savelli, D Jurkovic","doi":"10.1002/uog.70342","DOIUrl":"10.1002/uog.70342","url":null,"abstract":"<p><strong>Objectives: </strong>To compare clinical and sonographic characteristics of first-trimester abdominal ectopic pregnancy (AEP) with those of tubal ectopic pregnancy (TEP), and to define ultrasound-based diagnostic criteria for AEP.</p><p><strong>Methods: </strong>This was a retrospective case-control study comparing cases of AEP diagnosed at four centers with controls diagnosed with TEP, between May 2008 and May 2025. AEP was defined as a pregnancy implanted within the peritoneal cavity outside the uterus, ovaries and Fallopian tubes. We compared demographics, clinical and ultrasound findings and clinical outcomes between the groups. We identified the key ultrasound features of first-trimester AEP and used these to develop refined diagnostic criteria.</p><p><strong>Results: </strong>During the study period, 19 cases of AEP were identified and compared to 57 controls with TEP. The groups were matched for age, parity and gestational age at presentation. Compared with TEP, AEP was more likely to occur in pregnancies conceived via in-vitro fertilization (6/19 (32%) vs 5/57 (9%); odds ratio (OR) 4.80 (95% CI, 1.27-18.21); P = 0.02; adjusted OR (aOR), 5.02 (95% CI, 1.24-20.25); P = 0.02) and patients with AEP were less likely to present with vaginal bleeding (5/18 (28%) vs 40/57 (70%); OR, 0.16 (95% CI, 0.05-0.53); P = 0.003; aOR, 0.17 (95% CI, 0.05-0.64); P = 0.009). With respect to clinical outcomes, patients with AEP were more likely to have significant blood loss (≥ 500 ml) at surgery (4/16 (25%) vs 1/36 (3%); OR, 11.67 (95% CI, 1.18-114.90); P = 0.04) and require blood transfusion (4/19 (21%) vs 0/56 (0%); P = 0.003). Four diagnostic ultrasound criteria for AEP were identified: (1) the presence of a gestational sac or trophoblast separate from the uterus and ovaries; (2) the absence of a hypoechogenic tissue layer surrounding the pregnancy; (3) a negative 'sliding organs' sign; and (4) trophoblastic blood flow arising from the peritoneum detected on color Doppler examination.</p><p><strong>Conclusions: </strong>Assisted conception is a risk factor for a pregnancy implanting into the peritoneal cavity. Early ultrasound diagnosis of AEP is important to reduce the risk of major intra-abdominal bleeding, which is significantly higher in AEP compared with TEP. © 2026 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":520822,"journal":{"name":"Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology","volume":" ","pages":"571-579"},"PeriodicalIF":6.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}