Talk:Ultrasound: Difference between revisions

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==2010==
===13-14-week fetal anatomy scan: a 5-year prospective study===
Ultrasound Obstet Gynecol. 2010 Mar;35(3):292-6.
Ebrashy A, El Kateb A, Momtaz M, El Sheikhah A, Aboulghar MM, Ibrahim M, Saad M.
Source
Fetal Medicine Unit, Cairo University, Cairo, Egypt.
Abstract
OBJECTIVES:
To assess the potential value of an early (first-trimester) ultrasound examination in depicting fetal anomalies by transabdominal (TAS) and transvaginal (TVS) sonography, to compare it with the traditional mid-trimester anomaly ultrasound examination and to evaluate the degree of patient acceptance of early sonography by the transvaginal route.
METHODS:
In this prospective study over a 5-year period (January 2002 to January 2007) 2876 pregnant women underwent a 13-14-week ultrasound examination. The scan was performed by TAS at first and then, if a full fetal anatomical survey was not achieved, by TVS. A mid-trimester fetal anatomy scan was then performed in patients who had not dropped out, miscarried or undergone pregnancy termination (n = 2834).
RESULTS:
In the early scan, analyzable data for 2876 TAS and 1357 TVS examinations showed that TVS was significantly better in visualizing the cranium, spine, stomach, kidneys, bladder and upper and lower limbs (P < 0.001). Complete fetal anatomical surveys were achieved by TAS in 64% of cases versus 82% of the cases in which it was attempted by TVS (P < 0.001). Patient body mass index significantly affected the ability of the sonographer to achieve a complete anatomical survey by both TAS and TVS (P < 0.001 and P = 0.004, respectively). The duration of the scan was significantly longer using TVS. The heart and kidneys were not properly visualized in 42% and 27% of cases, respectively, at the 13-week scan compared with 1.6% and 0% at the mid-trimester scan. The total number of cases in which anomalies were detected was 31. At the first-trimester scan, anomalies were detected in 21 fetuses and in 14 of these cases the parents chose pregnancy termination. At the second-trimester scan, anomalies were detected in 17 fetuses: 10 new anomalous cases along with seven cases already detected in the first-trimester scan.
CONCLUSION:
Besides its importance in screening for chromosomal abnormalities, the early scan has great potential in visualizing with precision fetal anatomy. TVS can be used to compliment difficult TAS examinations; however, patients do not always agree to undergo TVS. The mid-trimester scan remains crucial for detailed fetal anatomical survey.
(c) 2010 ISUOG. Published by John Wiley & Sons, Ltd.
PMID: 20205205
http://www.ncbi.nlm.nih.gov/pubmed/20205205


==2009==
==2009==

Revision as of 18:02, 3 May 2011

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Cite this page: Hill, M.A. (2024, March 28) Embryology Ultrasound. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Ultrasound

2010

13-14-week fetal anatomy scan: a 5-year prospective study

Ultrasound Obstet Gynecol. 2010 Mar;35(3):292-6.

Ebrashy A, El Kateb A, Momtaz M, El Sheikhah A, Aboulghar MM, Ibrahim M, Saad M. Source Fetal Medicine Unit, Cairo University, Cairo, Egypt.

Abstract OBJECTIVES: To assess the potential value of an early (first-trimester) ultrasound examination in depicting fetal anomalies by transabdominal (TAS) and transvaginal (TVS) sonography, to compare it with the traditional mid-trimester anomaly ultrasound examination and to evaluate the degree of patient acceptance of early sonography by the transvaginal route.

METHODS: In this prospective study over a 5-year period (January 2002 to January 2007) 2876 pregnant women underwent a 13-14-week ultrasound examination. The scan was performed by TAS at first and then, if a full fetal anatomical survey was not achieved, by TVS. A mid-trimester fetal anatomy scan was then performed in patients who had not dropped out, miscarried or undergone pregnancy termination (n = 2834).

RESULTS: In the early scan, analyzable data for 2876 TAS and 1357 TVS examinations showed that TVS was significantly better in visualizing the cranium, spine, stomach, kidneys, bladder and upper and lower limbs (P < 0.001). Complete fetal anatomical surveys were achieved by TAS in 64% of cases versus 82% of the cases in which it was attempted by TVS (P < 0.001). Patient body mass index significantly affected the ability of the sonographer to achieve a complete anatomical survey by both TAS and TVS (P < 0.001 and P = 0.004, respectively). The duration of the scan was significantly longer using TVS. The heart and kidneys were not properly visualized in 42% and 27% of cases, respectively, at the 13-week scan compared with 1.6% and 0% at the mid-trimester scan. The total number of cases in which anomalies were detected was 31. At the first-trimester scan, anomalies were detected in 21 fetuses and in 14 of these cases the parents chose pregnancy termination. At the second-trimester scan, anomalies were detected in 17 fetuses: 10 new anomalous cases along with seven cases already detected in the first-trimester scan.

CONCLUSION: Besides its importance in screening for chromosomal abnormalities, the early scan has great potential in visualizing with precision fetal anatomy. TVS can be used to compliment difficult TAS examinations; however, patients do not always agree to undergo TVS. The mid-trimester scan remains crucial for detailed fetal anatomical survey.

(c) 2010 ISUOG. Published by John Wiley & Sons, Ltd.

PMID: 20205205 http://www.ncbi.nlm.nih.gov/pubmed/20205205

2009

A fast automatic recognition and location algorithm for fetal genital organs in ultrasound images

J Zhejiang Univ Sci B. 2009 Sep;10(9):648-58.

Tang S, Chen SP.

Post-Doctoral Research Station, Shenzhen University, Shenzhen 518060, China. Abstract Severe sex ratio imbalance at birth is now becoming an important issue in several Asian countries. Its leading immediate cause is prenatal sex-selective abortion following illegal sex identification by ultrasound scanning. In this paper, a fast automatic recognition and location algorithm for fetal genital organs is proposed as an effective method to help prevent ultrasound technicians from unethically and illegally identifying the sex of the fetus. This automatic recognition algorithm can be divided into two stages. In the 'rough' stage, a few pixels in the image, which are likely to represent the genital organs, are automatically chosen as points of interest (POIs) according to certain salient characteristics of fetal genital organs. In the 'fine' stage, a specifically supervised learning framework, which fuses an effective feature data preprocessing mechanism into the multiple classifier architecture, is applied to every POI. The basic classifiers in the framework are selected from three widely used classifiers: radial basis function network, backpropagation network, and support vector machine. The classification results of all the POIs are then synthesized to determine whether the fetal genital organ is present in the image, and to locate the genital organ within the positive image. Experiments were designed and carried out based on an image dataset comprising 658 positive images (images with fetal genital organs) and 500 negative images (images without fetal genital organs). The experimental results showed true positive (TP) and true negative (TN) results from 80.5% (265 from 329) and 83.0% (415 from 500) of samples, respectively. The average computation time was 453 ms per image.

PMID: 19735097 http://www.ncbi.nlm.nih.gov/pubmed/19735097

Fetal volume and crown-rump length from 7 to 10 weeks of gestational age in singletons and twins

Martins WP, Nastri CO, Barra DA, Navarro PA, Mauad Filho F, Ferriani RA. Eur J Obstet Gynecol Reprod Biol. 2009 Jul;145(1):32-5. Epub 2009 Apr 21. PMID: 19386409

"Twins and singletons had similar fetal volume and crown-rump length between the 7th and 10th week of gestational age. Additionally, fetal volume assessed by VOCAL was better than crown-rump length to estimate the gestational age at the evaluated period. However, the improvement was small and probably without clinical significance. CONDENSATION: Fetal volume and crown-rump length were similar between singletons and twins. Fetal volume relative increase was higher and the predicted gestational age was better."

Fetal crown-rump length and estimation of gestational age in an ethnic Chinese population

Sahota DS, Leung TY, Leung TN, Chan OK, Lau TK. Ultrasound Obstet Gynecol. 2009 Feb;33(2):157-60. PMID: 19115262

"The best-fit equation for the sonographic estimate of gestational age (GA, in days) from CRL (in mm) was GA = 26.643 + 7.822 x CRL(1/2)(R(2) = 0.96). The mean difference between menstrual age and the predicted gestational age was 0.22 days (95% CI, - 0.14 to 0.56), which was lower than that of the three established CRL dating formulae. CONCLUSION: We have derived a formula suitable for the dating of naturally conceived pregnancies between 6 and 15 weeks of gestation that has no systematic prediction error (the 95% CI of mean difference between predicted and menstrual age included zero), comparing favorably with established CRL dating formulae."

2008

New charts for ultrasound dating of pregnancy and assessment of fetal growth: longitudinal data from a population-based cohort study

Ultrasound Obstet Gynecol. 2008 Apr;31(4):388-96.


Verburg BO, Steegers EA, De Ridder M, Snijders RJ, Smith E, Hofman A, Moll HA, Jaddoe VW, Witteman JC.

The Generation R Study Group, Erasmus Medical Center, Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Abstract

OBJECTIVES: Correct assessment of gestational age and fetal growth is essential for optimal obstetric management. The objectives of this study were, first, to develop charts for ultrasound dating of pregnancy based on crown-rump length and biparietal diameter and, second, to derive reference curves for normal fetal growth based on biparietal diameter, head circumference, transverse cerebellar diameter, abdominal circumference and femur length from 10 weeks of gestational age onwards.

METHODS: A total of 8313 pregnant women were included for analysis in this population-based prospective cohort study. All women had repeated ultrasound assessments to examine fetal growth.

RESULTS: Charts for ultrasound dating of pregnancy, based on crown-rump length and biparietal diameter, were derived. Internal validation with the actual date of delivery showed that ultrasound imaging provided reliable gestational age estimates. Up to 92% of deliveries took place within 37-42 weeks of gestation if gestational age was derived from ultrasound data, compared with 87% based on a reliable last menstrual period. The earlier the ultrasound assessment the more accurate the prediction of date of delivery. After 24 weeks of gestation a reliable last menstrual period provided better estimates of gestational age. Reference curves for normal fetal growth from 10 weeks of gestational age onwards were derived.

CONCLUSIONS: Charts for ultrasound dating of pregnancy and reference curves for fetal biometry are presented. The results indicate that, up to 24 weeks of pregnancy, dating by ultrasound examination provides a better prediction of the date of delivery than does last menstrual period. The earlier the ultrasound assessment in pregnancy, preferably between 10 and 12 weeks, the better the estimate of gestational age.

Copyright (c) 2008 ISUOG. Published by John Wiley & Sons, Ltd.

PMID: 18348183 http://www.ncbi.nlm.nih.gov/pubmed/18348183

Fetal age assessment based on 2nd trimester ultrasound in Africa and the effect of ethnicity

BMC Pregnancy Childbirth. 2008 Oct 30;8:48.

Salpou D, Kiserud T, Rasmussen S, Johnsen SL.

Centre for International Health, University of Bergen, Norway. danielsalpou@yahoo.fr Abstract BACKGROUND: The African population is composed of a variety of ethnic groups, which differ considerably from each other. Some studies suggest that ethnic variation may influence dating. The aim of the present study was to establish reference values for fetal age assessment in Cameroon using two different ethnic groups (Fulani and Kirdi).

METHODS: This was a prospective cross sectional study of 200 healthy pregnant women from Cameroon. The participants had regular menstrual periods and singleton uncomplicated pregnancies, and were recruited after informed consent. The head circumference (HC), outer-outer biparietal diameter (BPDoo), outer-inner biparietal diameter and femur length (FL), also called femur diaphysis length, were measured using ultrasound at 12-22 weeks of gestation. Differences in demographic factors and fetal biometry between ethnic groups were assessed by t- and Chi-square tests.

RESULTS: Compared with Fulani women (N = 96), the Kirdi (N = 104) were 2 years older (p = 0.005), 3 cm taller (p = 0.001), 6 kg heavier (p < 0.0001), had a higher body mass index (BMI) (p = 0.001), but were not different with regard to parity. Ethnicity had no effect on BPDoo (p = 0.82), HC (p = 0.89) or FL (p = 00.24). Weight, height, maternal age and BMI had no effect on HC, BPDoo and FL (p = 0.2-0.58, 0.1-0.83, and 0.17-0.6, respectively). When comparing with relevant European charts based on similar design and statistics, we found overlapping 95% CI for BPD (Norway & UK) and a 0-4 day difference for FL and HC.

CONCLUSION: Significant ethnic differences between mothers were not reflected in fetal biometry at second trimester. The results support the recommendation that ultrasound in practical health care can be used to assess gestational age in various populations with little risk of error due to ethnic variation.

PMID: 18973673 http://www.ncbi.nlm.nih.gov/pubmed/18973673

http://www.biomedcentral.com/1471-2393/8/48

Fetal size in the second trimester is associated with the duration of pregnancy, small fetuses having longer pregnancies

Johnsen SL, Wilsgaard T, Rasmussen S, Hanson MA, Godfrey KM, Kiserud T. BMC Pregnancy Childbirth. 2008 Jul 16;8:25. PMID: 18627638 | BMC

Functional linear discriminant analysis: a new longitudinal approach to the assessment of embryonic growth

Bottomley C, Daemen A, Mukri F, Papageorghiou AT, Kirk E, Pexsters A, De Moor B, Timmerman D, Bourne T. Hum Reprod. 2009 Feb;24(2):278-83. Epub 2008 Oct 31. PMID: 18978027 | Hum Reprod.

Fetal age assessment based on 2nd trimester ultrasound in Africa and the effect of ethnicity

Salpou D, Kiserud T, Rasmussen S, Johnsen SL. BMC Pregnancy Childbirth. 2008 Oct 30;8:48. PMID: 18973673

  • Ultrasonic evaluation of fetal limb growth. Jeanty P, Kirkpatrick C, Dramaix-Wilmet M, Struyven J. Radiology. 1981 Jul;140(1):165-8. PMID: 7244221

Nontraditional sonographic pearls in estimating gestational age

Gottlieb AG, Galan HL. Semin Perinatol. 2008 Jun;32(3):154-60. Review. PMID: 18482614

"This chapter focuses on nontraditional fetal ultrasound measurements, including the transverse cerebellar diameter, fetal foot length, ratios of biometric and nonbiometric measurements, epiphyseal ossification centers, amniotic fluid volume, placental grading, and other miscellaneous markers in the context of evaluating a fetus with possible intrauterine growth restriction."

Terms

  • Crown-Rump Length (CRL)
  • Functional linear discriminant analysis (FLDA) - new growth assessment technique using serial measurements to discriminate between normal and abnormal fetal growth.
  • Gestational sac (GS) size
  • Linear discriminant analysis (LDA) to longitudinal data (James and Hastie, 2001)
  • Mean gestation sac diameter (MSD)
  • Mean yolk sac diameter (MYD)
  • Transvaginal scan (TVS)
  • Termination of pregnancy (TOP)