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Objectives: The aim of the present study was two‐fold. Firstly, we aimed to develop and describe a technique for measurement of the transverse diameter (TD) of the levator ani muscle (LAM) hiatus in the coronal view using two‐dimensional (2D) transperineal ultrasound (TPUS) in nulliparous women with a term pregnancy. Secondly, we aimed to evaluate the feasibility and reproducibility of 2D‐TPUS assessment of LAM hiatal TD and assess intermethod agreement between 2D‐TPUS and three‐dimensional (3D) TPUS measurement of TD in the axial plane, which is considered the gold standard in nulliparous women with term pregnancy. Methods: We recruited a group of nulliparous women with term pregnancy before the onset of labor. The study was conducted in two phases: Phase 1 involved developing and describing the 2D‐TPUS technique for measuring LAM hiatal TD, and Phase 2 focused on assessing the technique's feasibility, reproducibility and intermethod agreement with 3D‐TPUS measurement of LAM hiatal TD. In Phase 1, we enrolled 30 women. Each woman underwent acquisition of a 3D‐TPUS volume, which was analyzed using multiplanar mode to identify and determine the appearance of the lateral borders of the LAM in the coronal plane, at the level of the plane of minimal hiatal dimensions. These borders were used as landmarks for TD measurement. Additionally, we measured the distance between the plane used for TD measurement and the center of the urethra in the axial view. In Phase 2, we recruited 100 women. Each woman underwent acquisition of three 2D‐TPUS videoclips in the coronal plane, each encompassing a sweep of the entire LAM hiatus, and a 3D volume, all obtained during rest. On the 2D videoclips, TD was measured twice by one operator and once by another operator. In the 3D volume, TD was measured once, by one operator, in the axial plane; this measurement was considered the gold standard. Each operator was blinded to all other measurements during their assessments. We analyzed intraobserver and interobserver reproducibility and performed an intermethod (2D vs 3D) comparison. Bland–Altman analysis was conducted, and Levene's W0 test and Student's t‐test were performed to explore clinical factors that might contribute to systematic differences. Results: In Phase 1, we identified successfully the landmarks denoting the lateral borders of the LAM hiatal TD in the coronal view. These appeared as two symmetrical hypoechogenic indentations located at the inner border of the hyperechogenic structure of the LAM, at the point of maximum distance between the two sides of the LAM. The distance between the urethra and the plane where TD should be measured using 3D‐TPUS in the axial plane had a median of 4 mm and varied from 0 to 9 mm. This enabled us to describe a method for assessing LAM hiatal TD in the coronal plane using 2D‐TPUS. In Phase 2, LAM hiatal TD was measured successfully in all 2D and 3D acquisitions from the entire group of 100 women. The analyses for intraobserver and interobserver reproducibility and the intermethod comparison (2D vs 3D) revealed almost perfect agreement in TD measurements using 2D‐TPUS, with intraclass correlation coefficients of 0.95 (95% CI, 0.92–0.96), 0.87 (95% CI, 0.78–0.92) and 0.85 (95% CI, 0.78–0.90), respectively. The average differences between measurements were 0.1 mm for intraobserver, 1.0 mm for interobserver and 0.2 mm for intermethod repeatability. No systematic differences were observed in any of the measurement sets, except in the interobserver analysis, although this difference was clinically not significant (38.2 vs 37.2 mm, P = 0.01). None of the examined clinical factors (maternal body mass index and maternal age) exhibited a statistically significant impact on intraobserver, interobserver or intermethod reliability. Conclusions: Utilizing our technique, described herein, to measure the LAM hiatal TD in the coronal view using 2D‐TPUS is not only feasible but also highly reproducible and accurate in nulliparous women with term pregnancy. Moreover, it yields measurements that are comparable to those obtained in the reconstructed axial plane generated by 3D‐TPUS. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This article discusses a study that aimed to evaluate the reproducibility of measurements of breech progression angle (BPA) using transperineal ultrasound (US). The study involved providing 3D ultrasound volumes to eight operators from four maternity units in Spain and Italy. The operators measured the BPA using 3D US volume processing software, and the interobserver reproducibility was assessed. After an online review and the development of an image-based score for BPA measurement, the reproducibility improved. The study concludes that the measurement of BPA is feasible and reproducible when using a standardized image-based score. [Extracted from the article]

This article, titled "Perinatal outcomes of early Twin–twin transfusion syndrome treated with laser: an international multicentre study," presents the results of a study on the perinatal outcomes of monochorionic diamniotic (MCDA) twin pregnancies with early Twin–twin transfusion syndrome (TTTS) that were treated with laser surgery. The study included 542 pregnancies diagnosed with early TTTS, with 12.2% of the women diagnosed at or before 16 weeks. The majority of cases (85.4%) were at stage II or III at diagnosis, and 81.5% of the cases were treated with laser before 18 weeks. The study found that laser surgery, even when performed before 18 weeks, was associated with a good outcome, with at least one surviving fetus in 67.4% of pregnancies and two surviving fetuses in 43.6% of pregnancies. [Extracted from the article]

This article, titled "EP19.03: Narrower subpubic arch angle is associated with breech presentation in nulliparous women at term," explores the correlation between the subpubic arch angle (SPA) and fetal breech presentation in nulliparous women at term. The study involved 124 nulliparous women at term with singleton pregnancies, and a three-dimensional transperineal ultrasound volume was acquired for each woman. The results showed that women with a fetus in breech presentation had significantly narrower SPA values compared to women with a cephalic fetus. Additionally, women with a fetus in breech presentation had a lower body mass index (BMI) compared to women with a fetus in cephalic presentation. The study concludes that breech presentation is associated with a narrower subpubic arch angle in nulliparous women at term. [Extracted from the article]

This article, published in the journal Ultrasound in Obstetrics & Gynecology, examines the correlation between levator ani muscle coactivation and breech presentation in nulliparous women at term. The study found that women with fetuses in breech presentation had smaller anteroposterior diameter (APD) of the levator ani muscle (LAM) under pushing, a higher prevalence of LAM coactivation, and a smaller change in APD from rest to maximum pushing compared to women with fetuses in cephalic presentation. The results suggest that proper pelvic floor relaxation may favor fetal cephalic presentation, while levator ani muscle coactivation and smaller increase in APD at maternal pushing are associated with an increased risk of breech presentation. [Extracted from the article]

This article discusses a case study of a 37-year-old woman who was referred to a medical center during her third trimester of pregnancy. An ultrasound scan revealed the presence of an intra-abdominal mass near the abdominal wall and umbilical cord insertion. The mass was diagnosed as an isolated fetal intra-abdominal umbilical vein varix (FIUVV) using color Doppler ultrasound. Three-dimensional reconstruction of the varix was performed, confirming its continuity with the umbilical vein and ruling out complications such as thrombosis. The woman gave birth to a healthy baby without any complications, who is now 9 months old and asymptomatic. [Extracted from the article]

This article examines the agreement between measurements of the anteroposterior diameter (APD) of the levator ani muscle hiatus using 2D and automated 3D transperineal ultrasound techniques. The study recruited nulliparous women at term before labor and measured APD using both techniques. The results showed a high agreement between the two methods, with an intraclass correlation coefficient (ICC) of 0.91. Although there was a small systematic difference between the measurements, it was clinically irrelevant. The study concludes that both techniques can be used interchangeably in nulliparous women at term. [Extracted from the article]

This article discusses a study on early Twin-Twin Transfusion Syndrome (TTTS) and the factors that predict single and double survival after laser surgery for TTTS. The study analyzed data from 484 cases of early TTTS undergoing laser surgery and found that coexisting selective fetal growth restriction (sFGR) and postoperative preterm premature rupture of membranes (PPROM) were independent predictors of survival. However, factors such as placental location, Quintero stage, and technique of laser ablation did not significantly impact survival. This research provides valuable insights for the management and counseling of pregnancies with early TTTS. [Extracted from the article]