Search

Objectives: To describe the sonographic features of the caudothalamic groove in the third trimester of pregnancy in a group of structurally normal fetuses and to report a small series of cases with abnormal appearance of the caudothalamic groove at antenatal cranial ultrasound. Methods: This was an observational study conducted at two fetal medicine referral units in Italy. A non‐consecutive cohort of pregnant women with a singleton non‐anomalous pregnancy were recruited prospectively and underwent three‐dimensional (3D) ultrasound assessment of the fetal brain at 28–32 weeks' gestation. At offline analysis, the ultrasound volumes were adjusted in the multiplanar mode, according to a standardized methodology, until the caudothalamic groove was visible in the parasagittal plane. To evaluate interobserver agreement, two operators were asked independently to indicate if the caudothalamic groove was visible unilaterally or bilaterally on each volume and Cohen's kappa (κ) coefficient was calculated. The digital archives of the two centers were also searched retrospectively to retrieve cases with abnormal findings at the level of the caudothalamic groove on antenatal cranial ultrasound that were confirmed postnatally. Results: A total of 180 non‐consecutive cases were included. At offline analysis of the 3D ultrasound volumes, the caudothalamic groove was identified in the parasagittal plane by both operators at least unilaterally in 176 (97.8%) cases and bilaterally in 174 (96.7%) cases. The κ‐coefficient for the agreement between the two independent operators in recognizing the caudothalamic groove was 0.89 and 0.83 for one and both hemispheres, respectively. The retrospective search of our archives yielded five cases with an abnormal appearance of the caudothalamic groove at antenatal cranial ultrasound, including two cases of hemorrhage and three cases of cyst. Conclusions: The caudothalamic groove is consistently seen in normal fetuses on multiplanar neurosonography in the third trimester, and abnormal findings in this region may be detected antenatally. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the relationship between the attitude of the fetal head quantified by means of the chin‐to‐chest angle (CCA) in fetuses in occiput posterior (OP) position at the beginning of the second stage of labor, and persistent OP position at birth. Methods: This was a single‐center, prospective observational study conducted at the University Hospital of Parma, Parma, Italy. We included singleton pregnancies at term with fetuses in the OP position at the beginning of the second stage of labor. The fetal head position, station by means of angle of progression and head‐to‐perineum distance, and attitude by means of CCA were assessed using transabdominal or transperineal ultrasound. The primary outcome was persistent OP position at birth. Results: Between January and July 2022, 76 women were included in the study. There were 48 (63.2%) spontaneous rotations of the fetal head and spontaneous vaginal delivery occurred in all. Among the 28 (36.8%) fetuses that did not rotate spontaneously into an occiput anterior position, eight (28.6%) had a spontaneous vaginal delivery, while operative vaginal delivery and Cesarean delivery was performed in 11 (39.3%) and nine (32.1%) cases, respectively. Multivariable logistic regression analysis showed that the CCA (adjusted odds ratio (aOR), 2.15 (95% CI, 1.22–3.78); P = 0.008) and nulliparity (aOR, 0.20 (95% CI, 0.06–0.76); P = 0.02) were associated independently with persistent OP position at birth. Moreover, the CCA showed an area under the receiver‐operating‐characteristics curve of 0.69 (95% CI, 0.56–0.82); P = 0.005) for the prediction of persistent OP position. The optimal cut‐off value of the CCA was 36.5°, and was associated with a sensitivity of 0.82 (95% CI, 0.63–0.94), specificity of 0.50 (95% CI, 0.35–0.65), positive predictive value of 0.49 (95% CI, 0.34–0.64), negative predictive value of 0.83 (95% CI, 0.64–0.94), positive likelihood ratio of 1.64 (95% CI, 1.18–2.29) and negative likelihood ratio of 0.36 (95% CI, 0.15–0.83). Conclusions: Our data show that, within a population of women with fetal OP position at the beginning of the second stage of labor, the sonographic fetal head attitude measured by means of the CCA might help in the identification of fetuses at risk of persistent OP position. Such findings can be useful for patient counseling when OP position is diagnosed at full cervical dilatation. Further studies should investigate if the CCA might select patients who may benefit from manual rotation of the fetal head. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objectives: To describe the appearance and size of the ganglionic eminence (GE) in normal fetuses on midtrimester three‐dimensional (3D) neurosonography and to report on the association between GE alterations (cavitation or enlargement) and malformation of cortical development (MCD). Methods: This was a prospective multicenter cohort study of normal fetuses and a retrospective analysis of pathological cases with MCD. From January 2022 to June 2022, patients attending our tertiary centers for an expert fetal brain scan were recruited for the purpose of the study. A 3D volume of the fetal head, starting from the sagittal plane, was acquired in apparently normal fetuses using a transabdominal or transvaginal approach. Stored volume datasets were then evaluated independently by two expert operators. Two measurements (longitudinal diameter and transverse diameter) of the GE in the coronal view were obtained twice by each operator. Intra‐ and interobserver measurement variation was calculated. Reference ranges for GE measurements were calculated in the normal population. A previously stored volume dataset of 60 cases with MCD was also analyzed independently by the two operators using the same method in order to assess if GE abnormalities (cavitation or enlargement) were present. Postnatal follow‐up was obtained in all cases. Results: In the study period, 160 normal fetuses between 19 and 22 weeks of gestation were included in the study. The GE was visible in the coronal plane on 3D neurosonography in 144 (90%) cases and was not clearly visible in the remaining 16 (10%) cases. The intra‐ and interobserver agreement was almost perfect for the longitudinal diameter, with an intraclass correlation coefficient (ICC) of 0.90 (95% CI, 0.83–0.93) and 0.90 (95% CI, 0.86–0.92), respectively, and substantial for the transverse diameter, with an ICC of 0.80 (95% CI, 0.70–0.87) and 0.64 (95% CI, 0.53–0.72), respectively. A retrospective analysis of 50 cases with MCD in the second trimester showed that GE enlargement was present in 12 cases and GE cavitation was present in four cases. Conclusions: Systematic assessment of the GE in fetuses at 19–22 weeks of gestation is feasible on 3D neurosonography, with good reproducibility in normal cases. Cavitation or enlargement of the GE can be demonstrated in fetuses with MCD. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This article, titled "OC19.08: Effectiveness of the antihypertensive therapy based on maternal hemodynamic findings in women with HDP: a multicentre prospective study," discusses a study that aimed to compare the effectiveness of appropriate and inappropriate antihypertensive therapy in women with hypertensive disorders of pregnancy (HDP). The study included 152 women and assessed their hemodynamic profile before prescribing antihypertensive therapy. The results showed that women who received appropriate therapy had a lower occurrence of severe hypertension and were more likely to achieve target blood pressure values within 48-72 hours compared to those who received inappropriate therapy. The study suggests that considering the maternal hemodynamic profile when prescribing antihypertensive therapy can lead to better outcomes for women with HDP. [Extracted from the article]

This article, titled "Circulating angiogenic factors levels in women with hypertensive disorders of pregnancy according to the baseline hemodynamic findings," explores the relationship between hemodynamic phenotype and the predictive value of sFLT‐1/PlGF ratio for adverse outcomes in women with hypertensive disorders of pregnancy (HDP). The study included a cohort of women with new-onset HDP and assessed their hemodynamic parameters using USCOM-1A. The results showed that the sFLT1/PlGF ratio was significantly higher in women with a hypodynamic profile, and there was a significant association between the ratio and adverse maternal and neonatal outcomes in this group. Overall, the findings suggest that the sFLT1/PlGF ratio is associated with adverse outcomes only in women with a hypodynamic profile. [Extracted from the article]

This article, published in the journal Ultrasound in Obstetrics & Gynecology, explores the correlation between angiogenetic biomarkers, urinary protein values, and the presence of maternal ascites in women with new-onset Hypertensive Disorders of Pregnancy (HDP). The study included 80 patients with new-onset HDP and found a linear correlation between the SFLT-1/PlGF ratio and 24-hour urinary protein values. Additionally, higher values of the SFLT-1/PlGF ratio were associated with higher levels of urinary protein and a higher incidence of maternal ascites. The findings suggest a potential link between these biomarkers and the severity of HDP. [Extracted from the article]

This article, titled "EP12.14: Postpartum sonographic measurement of the inferior vena cava and correlation with hemoglobin levels," discusses a study conducted to evaluate the correlation between the diameter of the Inferior Vena Cava (IVC), the Collapsibility Index (CI), and the drop in hemoglobin levels 24 hours after delivery. The study included 47 women who underwent an elective Caesarean Delivery at term. The results showed that there was no correlation between the IVC diameter or the CI and a drop in hemoglobin levels of ≥2g. Therefore, the study suggests that the IVC diameter and CI measured 2 hours after delivery are not associated with a significant drop in hemoglobin levels. [Extracted from the article]

This article, published in the journal Ultrasound in Obstetrics & Gynecology, describes a study conducted at two referral Fetal Medicine units to examine the sonographic features of the caudo-thalamic (CT) groove in the third trimester of pregnancy. The study included a cohort of normal fetuses who underwent 3D ultrasound of the fetal brain, and the results showed that the CT groove was consistently visible in the majority of cases. Additionally, the researchers found five cases with abnormal appearance of the groove, which suggests that abnormal findings at this level can be detected during antenatal brain ultrasound. The study provides valuable insights into fetal neurosonography and its potential for detecting abnormalities. [Extracted from the article]

This article, titled "EP19.15: Intrapartum assessment of head-perineum distance: a comparative study of measurements obtained with and without compression of perineal soft tissues," presents the findings of a study that aimed to evaluate and compare measurements of the head-perineum distance (HPD) obtained with and without compression of the perineal soft tissues. The study involved a series of singleton pregnancies and used transperineal sonography to evaluate the HPD. The results showed a good correlation and reproducibility between the HPD measured with and without compression, and it was also found that the body mass index at delivery may impact the difference in measurements. [Extracted from the article]

This article discusses the role of 3D ultrasound and Doppler technologies in visualizing the medullary veins of the central nervous system (CNS) in fetal imaging. The accurate imaging of these veins is important for diagnosing CNS malformations. The article presents images and case studies that demonstrate the use of Doppler technologies sensitive to low-velocity flow in visualizing the medullary veins and identifying disruptions in their anatomy. The authors suggest that these technologies have the potential to aid in the diagnosis of complex cerebral anomalies. [Extracted from the article]