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To determine a possible correlation between SARS-CoV-2 infection during pregnancy and altered fetal behavior.Kurjak’s antenatal neurodevelopmental test (KANET) was applied from 28 to 40 weeks in 38 gestations (group A) diagnosed with COVID-19 infection during the first week and 43 non-COVID pregnant women (group B).No statistically significant differences considering maternal age (33±3.9 years for group A vs. 31±4.1 years for group B) and gestational age (33±1.6 weeks for group A compared to 33±2.1 weeks for group B) were observed. KANET scores were not different between the two groups.Fetal behavior differences are not altered in women diagnosed with SARS-CoV-2 infection during the third trimester of pregnancy. [ABSTRACT FROM AUTHOR]

Three-dimensional (3D) ultrasound offers the possibility of studying the fetal face in a more global way than conventional twodimensional (2D) ultrasound. In normal cases, the images obtained help to transmit a feeling of calmness to the parents and reinforce the affective bonds with their child. In pathological cases, 3D ultrasound can help parents and other doctors involved to take a more realistic view of the problem. It is expected that the use of this technology will provide parents with the knowledge to have a better judgment while taking decisions. [ABSTRACT FROM AUTHOR]

Preoperative diagnosis of endometrial pathology is essential for the outcome of treatment. It is important to preoperatively detect the malignant potential of changes and choose an adequate therapeutic approach. This is especially important for women who have not completed their reproduction in terms of choosing minimally invasive operative methods and preserving their fertile potential. It is very important to optimize the preoperative ultrasound examination of endometrial tumors concerning the differential diagnosis of an endometrial benign and malignant lesion, as well as the type of tumor, and to assess the degree of myometrial invasion of malignant lesions. The performance of the use of three-dimensional/four-dimensional (3D/4D) ultrasound in diagnostics, especially in the analysis of certain endometrial pathologies, has already been established and provides very useful information. However, the morphological and vascular characteristics might correlate with tumor stage, grade, and size, and that information could be of benefit in the assessment of the preoperative tumor and perhaps be used in risk evaluation in the future. Exploratory curettage and pathohistological findings of endometrial pathology are the gold standard, but in some cases, even these methods, which depend on several variables, do not provide a definitive, accurate diagnosis. This is why, in combination with new ultrasound techniques, the effectiveness of preoperative diagnosis of pathological changes in the endometrium increases. [ABSTRACT FROM AUTHOR]

Hydrops fetalis is defined as the accumulation of fluid with or without edema involving at least two fetal components. About 10% of cases are due to maternal hemolytic antibodies, that is, immune hydrops, while 90% of cases are nonimmune. Nonimmune hydrops fetalis (NIHF) is a heterogeneous condition that may be secondary to over 100 conditions, the cardiovascular causes are the most common. A significant percentage of cases will still not have an identifiable cause even after postnatal evaluation. Sonographic features include increased amniotic fluid volume, increased nuchal translucency, placentomegaly, fetal pleural or pericardial effusion, generalized fetal body swelling, and umbilical venous dilatation. Once the diagnosis of NIHF has been established, scans should be performed every 2-3 weeks to monitor the evolution of hydrops, and every effort should be made to identify the underlying cause. The treatment of nonimmune hydrops is determined by the gestational age (GA) at which the diagnosis is made, as well as the ability to identify the cause of the NIHF. Delivery should be done at a tertiary care hospital for appropriate neonatal interventions. Timing and method of delivery depend on the cause of hydrops. Preterm delivery is recommended only for obstetric indications including the development of "mirror syndrome." The prognosis is dependent on the underlying cause and onset of NIHF. Progressive unexplained hydrops is often lethal before or soon after birth with an overall mortality of 50-90%. NIHF secondary to treatable causes such as fetal arrhythmia, chylothorax, or infection with parvovirus B19 has a better survival rate. [ABSTRACT FROM AUTHOR]

Endometrial cancer (EC) is the fourth most commonly diagnosed malignancy in the world. The first symptom of endometrial carcinoma usually is postmenopausal bleeding, but only about 10-15% of women presenting with postmenopausal bleeding will actually have EC, and a definitive diagnosis needs histological proof. Ultrasonography is a useful tool for detecting endometrial pathology in everyday practice. To optimize the sonographic assessment of endometrial tumors, a better understanding of the association between sonographic features and tumor stage, grade, and histological type is needed. Three-dimensional (3D) ultrasonography is a new imaging technique that has become currently available in gynecologic practice, specifically in gynecologic oncology. In addition, 3D/four-dimensional (4D) power Doppler ultrasonography allows a 3D reconstruction of the vascular network and also calculates vascular indices based on the total and relative amount of power Doppler information within the volume of interest. Accurate clinical staging of EC not only reduces complications caused by inadequate or overtreatment but is also a guarantee for the retention of fertility in young patients. [ABSTRACT FROM AUTHOR]

Ian Donald Inter-University School of Ultrasound is a living tribute to Ian Donald, the visionary physician who pioneered ultrasound in obstetrics and gynecology. The School is dedicated to the improvement of all aspects of perinatal and gynecologic care. The discovery of ultrasound has enabled us to see and care for the fetus as a patient as well as visualize pelvic organs noninvasively--and has therefore brought obstetric and gynecologic diagnosis out of the dark ages. The School has evolved to almost 140 international Chapters or Branches which permits the spread of knowledge throughout the world. With the rapid development of information and communication technologies, industrial nations are transforming into societies in which knowledge, although intangible, is the most valuable commodity. The traditional choreography of learning, with its long, rigidly defined school, job, and university educational periods, is already obsolete. The most important factors which have influenced the changes occurring in education have been the installation and development of the Internet, electronic multimedia techniques and artificial intelligence. Donald Schools have to reinvent themselves in order to remain relevant to the current generation. The distance learning campaign (which extensively developed in the last three years of the COVID-19 pandemic) aims to establish a distinct visual identity for Ian Donald School and to unify all its various branches and entities into a single voice. [ABSTRACT FROM AUTHOR]

Prenatal cardiology is a part of preventive cardiology based on fetal echocardiography and fetal interventional cardiology, which facilitates treatment of congenital heart defects (CHD) in pediatric patients and consequently in adults. Timely prenatal detection of CHD plays a pivotal role in facilitating the appropriate referral of pregnant women to facilities equipped to provide thorough perinatal care within the framework of a well-structured healthcare system. The aim of this paper is to highlight the role of left atrial strain (LAS) in prenatal evaluation of fetal heart and prediction of structural and functional disorders. We conducted a comprehensive literature review searching PubMed for articles published from inception up until August 2023, including the search terms "left atrial strain", "fetal echocardiography", and "prenatal cardiology" combined through Boolean operators. In addition, references lists of identified articles were further reviewed for inclusion. Our review underscores the significance of LAS parameters in fetal echocardiography as a screening tool during specific gestational windows (starting from 11 to 14 weeks of gestation, followed by better visualization between 18 and 22 weeks of gestation). The left atrial strain technique and its parameters serve as valuable indicators, not only for identifying cardiac complications but also for predicting and guiding therapeutic interventions in cases of both cardiac and noncardiac pregnancy complications in fetuses. Evidence suggests establishment of second-trimester reference strain and strain rate values by speckle-tracking echocardiography in the healthy fetal cohort is essential for the evaluation of myocardial pathologies during pregnancy. Finding of LAS of fetal heart is feasible and probably can have potential for clinical and prognostic implications. [ABSTRACT FROM AUTHOR]

The 3D ultrasound technique with different visualization and manipulation capabilities of stored volume, provides a unique opportunity for a detailed view of normal and abnormal fetal development. If facial anomaly is suspected, this technique will help in the evaluation and gained images will give some answers to question about severity and extent of anomalies. Particularly handy tool may be when communicating the neonatologist, pediatrician, plastic and reconstructive head and neck surgeon and especially when consulting with the parents of the child. However, as in any imaging technique (ultrasound, MSCT, MRI), you need to know the dome and limitations of 3D / 4D rendering and to be aware of possible artifacts and traps. From the first trimester to the next, as soon as it becomes possible to detect congenital anomaly by prenatal ultrasound, the question ariseswhat can and should be done. Many ethical dilemmas present at the time.2, 4 Contemporary medicine faces some major problems when it has the ability to prolong life of severely sick baby with potentially lethal congenital syndromes. Taking specific ultrasonic diagnostics into account, the idea is to find the balance between the advantages and limitations of sonographic assessment. At the same time, it should be possible to optimize recommendations with the expectations of parents of potentially seriously ill baby. Given the complexity of prenatal diagnosis of syndrome, everything involved in the process is also complex. This includes conformation of prenatal diagnosis postnatally and determination of the short and long term prognosis if possible to assist parents who are facing a baby with syndrome. 2, 4 It is essential to point out the necessity of complex, lifelong and costly multidisciplinary care for severely ill baby. All the aforementioned, 3D / 4D US techniques promise to improve the accuracy of clinicians in detection of fetal abnormalities and detecting fetal syndromes as early as possible. There are many advantages in prenatal detection of fetal syndromes already described, but there is also a great room for improvement. Since new 3D / 4D ultrasound technology becomes more available in everyday clinical practice, the clinician should remain well-informed, well trained and monitor new diagnostic capabilities. Continuous education is necessary. In this way, the number of fetal abnormalities and syndromes detected prenatally will probably increase over time.4 Auxiliary tools such as network databases ("online databases") that integrate all the necessary information should be included and used for better diagnostic precision.

During the past 20 years, significant advances have been made in better understanding of the complex problem of cerebral palsy (CP). The most significant contribution has been made by the introduction of our Kurjak antenatal neurodevelopmental test (KANET), which in many multicentric studies proved to be successful in separating healthy fetuses from those with CP and other neurological problems. In this review article, we tried to review present knowledge on CP. [ABSTRACT FROM AUTHOR]

Congenital pulmonary airway malformation (CPAM) is a hamartoma-like lesion characterized by a polycystic mass of lung tissue with abnormal bronchial proliferation. It is the most frequent congenital thoracic malformation, accounting for 30-47% of fetal thoracic lung lesions. The exact pathogenesis is still unknown. Comorbidities associated with CPAM include pulmonary sequestration, lung malignancy, polyhydramnios, fetal hydrops, agenesis of the corpus callosum, congenital nephrotic syndrome, cleft lip and cleft palate, renal agenesis, esophageal atresia, diaphragmatic hernia, cardiovascular, and skeletal defects. Histopathological classification consists of five types of lesions; however, the most common clinical practice is to describe the CPAM lesion as microcystic (<5 mm) or macrocystic (>5 mm) and state its size. Microcystic lesions are associated with fetal hydrops and have a poor prognosis, whereas macrocystic lesions are usually not associated with hydrops and have a favorable prognosis. Ultrasound (US) scans every 2 weeks are recommended to monitor growth, lung lesions, and amniotic fluid volume for possible complications. Around 40% of CPAMs increase with the gestational age and stabilize around 26 weeks of gestation; however, in some cases, these lesions may continue to grow late into the third trimester. Fetal hydrops occur in about 5% and are associated with a close to 100% mortality rate. In cases of fetal hydrops, prenatal interventions may allow survival to birth. In the absence of contraindications, term delivery is recommended at a tertiary care center. In cases of poor growth, fetal hypoxia, or hydrops, earlier delivery is recommended for immediate postpartum treatment. About 70% of the children are asymptomatic at birth. For symptomatic infants, surgical resection is the management of choice. [ABSTRACT FROM AUTHOR]

Background: Fetal neurological impairment disorders, encompassing conditions like cerebral palsy, epilepsy, and autism spectrum disorder, can result from various factors affecting fetal nervous system development. Timely diagnosis of these disorders is challenging but crucial for early intervention. Recent advancements in deep learning and ultrasound technology present an opportunity to develop a tool for early detection. Objective: This study aims to leverage convolutional neural networks (CNNs) to analyze fetal neurobehavioral movements in ultrasound images, with the goal of aiding in the early detection of neurological impairment disorders. Materials and methods: The study utilized a dataset of 3D ultrasound images extracted from 4D recordings of fetuses undergoing the Kurjak Antenatal Neurodevelopmental Test (KANET) during the third trimester. The methodology relies on the application of deep learning, more specifically convolutional neural networks (CNN) for the purpose of recognizing characteristic fetal movements. Results: The custom CNN architecture achieved an overall accuracy of 93.83%. The system was visualized by means of designing a graphical user interface that includes the developed model that works in the background every time a frame of a recorded 4D ultrasound video is deemed to be parsed through the system. Notably, distinguishing between facial and hand-to-face movements proved challenging. This pilot study lays the foundation for AI-based fetal neurological risk assessment, providing a promising tool for the early detection of fetal neurological impairment disorders. Conclusion: While acknowledging limitations such as class imbalance and the absence of differentiation between specific facial expressions, the study demonstrates the potential of AI in enhancing prenatal care. Future work will involve expanding the dataset, conducting real-time clinical validations, and further refining the model. The research holds implications for improving outcomes for affected children and making advanced diagnostic capabilities accessible in diverse healthcare settings. [ABSTRACT FROM AUTHOR]

Ovarian cancer is the most common cause of death compared to other cancers. The development of ultrasonography has brought great progress in terms of detecting ovarian pathology. This is very important not only in order to detect malignant potential as early as possible but also to choose an adequate approach to treatment in women who have not completed their reproduction. The devastating fact is that around 65% of women with ovarian cancer have advanced disease (stage III/IV) at diagnosis and certainly a much lower survival rate in comparison with patients who have detected stage IA ovarian cancer, whose 5-year survival is over 90% of cases. Due to this fact, for decades, there has been a strong effort to improve the ultrasound findings in order to detect changes in the ovary and to establish markers that enable the recognition of the malignant potential of tumoral changes in the ovary. Three-dimensional/four-dimensional (3D/4D) ultrasound and color Doppler techniques should bring a new quality to the recognition of pathological changes in the ovaries. These new techniques should bring the most accurate preoperative diagnosis of ovarian tumor changes and definitely the intention to detect ovarian cancer at the earliest stage of the disease, which is central to decisions regarding clinical management and surgical planning. [ABSTRACT FROM AUTHOR]

Rapid improvements in the field of prenatal medicine have been achieved due to the technological advancement of ultrasonography that has allowed recognition of various ultrasonographic findings and their combination with biochemical results and demographic characteristics in order to estimate a final individual risk for a chromosomal anomaly of the fetus and analysis of short fragments of fetal DNA released into the mother's bloodstream through a natural process of cell death. Invasive testing still remains the main clinically available diagnostic modality for the definite diagnosis of both chromosomal anomalies and many single-gene disorders. Amniocentesis is performed between 15 and 20 weeks of pregnancy to obtain fetal cells for genetic testing. This method is performed almost in the middle of pregnancy, and waiting for the results of the analysis may indicate termination of pregnancy in the second trimester. Chorionic villus sampling (CVS), usually performed between 11+0 and 13+6 weeks of gestation, is one of the invasive diagnostic methods used to diagnose chromosomal, genetic, and metabolic diseases in the embryonic period. Invasive procedures such as CVS and amniocentesis still remain the only definitive diagnostic tests for aneuploidy in pregnancy. CVS, as an invasive procedure carried out with experienced physicians in specialist centers, is not associated with a significant increase in fetal loss rate, with a risk rate below 0.5%, and the possible background risk for miscarriage is significantly higher in the presence of fetal anomaly and abnormal karyotype. Ultrasound-guided transabdominal (TA) CVS is a useful outdoor procedure and is considered the method of choice for fetal sampling and accurate early prenatal diagnosis. [ABSTRACT FROM AUTHOR]