Fetal brain biometry and cortical development in congenital heart disease: A prospective cross sectional study.

Objective: To evaluate brain biometry and cortical development by neurosonography in fetuses with congenital heart defect (CHD) and evaluate differences among different type of CHD.

Methods: In a prospective cross sectional study singleton fetus with CHD were matched with controls and grouped into two categories according to the predicted severity of cerebral arterial oxygen deficit induced by the CHD: Group A mildly reduced or normal and Group B moderately to severely reduced. Neurosonography was done at 30-33 weeks to obtain measurements of corpus callosum (CC), cerebellar vermis (CV), Sylvian fissure (SF) insula, parieto-occipital fissure (POF), and calcarine sulci fissures (CSF).

5D CNS+ Software for Automatically Imaging Axial, Sagittal, and Coronal Planes of Normal and Abnormal Second-Trimester Fetal Brains.

The purpose of this study was to test new 5D CNS+ software (Samsung Medison Co, Ltd, Seoul, Korea), which is designed to image axial, sagittal, and coronal planes of the fetal brain from volumes obtained by 3-dimensional sonography. The study consisted of 2 different steps. First in a prospective study, 3-dimensional fetal brain volumes were acquired in 183 normal consecutive singleton pregnancies undergoing routine sonographic examinations at 18 to 24 weeks' gestation.

First trimester placental volume and three dimensional power doppler ultrasonography in type I diabetic pregnancies.

Objective: This study aimed to investigate the placental volume and three dimensional (3D) power Doppler vascularization in type I diabetic pregnancies during the first trimester

Methods: 3D-power Doppler ultrasonography of the placenta was performed at 11+0-13+6 weeks in 32 pregnancies complicated by type I diabetes. Placental volume, vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were calculated using a standardized setting.

Results: In nine pregnancies, a poor first trimester glycemic control was present as expressed by HbA1c levels  ≥ 7%, whereas in the remaining 23 mothers, the HbA1c concentrations were <7%.

Satisfactory rate of postprocessing visualization of standard fetal cardiac views from 4-dimensional cardiac volumes acquired during routine ultrasound practice by experienced sonographers in peripheral centers.

The aim of this study was to evaluate the feasibility of visualizing standard cardiac views from 4-dimensional (4D) cardiac volumes obtained at ultrasound facilities with no specific experience in fetal echocardiography. Five sonographers prospectively recorded 4D cardiac volumes starting from the 4-chamber view on 500 consecutive pregnancies at 19 to 24 weeks' gestation undergoing routine ultrasound examinations (100 pregnancies for each sonographer). Volumes were sent to the referral center, and 2 independent reviewers with experience in 4D fetal echocardiography assessed their quality in the display of the abdominal view, 4-chamber view, left and right ventricular outflow tracts, and 3-vessel and trachea view.

Assessment of corpus callosum biometric measurements at 18 to 32 weeks' gestation by 3-dimensional sonography.

Objectives: The purposes of this study were to construct reference limits for corpus callosum dimensions measured on images reconstructed from 3-dimensional (3D) sonography and to evaluate the reproducibility of these measurements.

Methods: Three-dimensional sonographic volumes were acquired transabdominally from an axial view of the head in 361 fetuses cross-sectionally studied at 18 to 32 weeks' gestation. Offline analysis of the fetal brain midsagittal plane was used to evaluate the length and area of the corpus callosum and corpus callosum-cavum septi pellucidi complex.

Histomorphometric characteristics of first trimester chorionic villi in pregnancies with low serum pregnancy-associated plasma protein-A levels: relationship with placental three-dimensional power doppler ultrasonographic vascularization.

Objective: To evaluate histomorphometric vascular characteristics from samples obtained by chorionic villus sampling (CVS) in pregnancies with low serum pregnancy-associated plasma protein-A (PAPP-A) levels and to relate these findings to three-dimensional (3D) placental volume and power Doppler vascularization.

Methods: Immediately before CVS, placental 3D-power Doppler ultrasonography was performed at 11 + 0 to 13 + 6 weeks in 12 pregnancies with PAPP-A concentrations <0.3 multiples of median (MoM) as well as in 11 control women.

Role of sonographic automatic volume calculation in measuring fetal cardiac ventricular volumes using 4-dimensional sonography: comparison with virtual organ computer-aided analysis.

Objective: The purpose of this study was to compare the agreement and reliability of virtual organ computer-aided analysis (VOCAL) and sonographic automatic volume calculation (sonoAVC) for measurements of ventricular volume from fetal heart data sets acquired by 4-dimensional sonography with spatiotemporal image correlation (STIC).

Methods: We studied 45 volumes from fetuses with normal (n = 30) and abnormal (n = 15) hearts. Spatiotemporal image correlation data sets were frozen in end systole and end diastole, and ventricular volumes were measured with VOCAL and sonoAVC.

Umbilical vein blood flow at 11 + 0 to 13 + 6 weeks of gestation.

Objective: To establish reference intervals for fetal umbilical vein (UV) diameter, UV time averaged maximum velocity (TAMXV) and UV flow (UVBF) at 11 + 0 to 13 plus; 6 weeks of gestation and to determine the intraobserver reliability of these measurements.

Methods: We considered, in a cross-sectional study, 162 fetuses from uncomplicated singleton pregnancies at 11 + 0 to 13 + 6 weeks of gestation. UV diameter and TAMXV were measured in its intraabdominal portion by real-time and Doppler ultrasonography and UVBF calculated.

First-trimester placental volume and vascularization measured by 3-dimensional power Doppler sonography in pregnancies with low serum pregnancy-associated plasma protein a levels.

Objective: The purpose of this study was to investigate the first-trimester placental volume and 3-dimensional (3D) power Doppler vascularization of pregnancies with low serum pregnancy-associated plasma protein A (PAPP-A) levels and to relate these findings to pregnancy outcomes.

Methods: Three-dimensional power Doppler sonography of the placenta was performed at gestational ages of 11 weeks to 13 weeks 6 days in 84 pregnancies with PAPP-A concentrations of less than 0.4 multiple of the median (MoM).

The significance of visualising coronary blood flow in early onset severe growth restricted fetuses with reverse flow in the ductus venosus.

Objective: To evaluate the incidence and significance of coronary blood flow visualisation in early onset severe intrauterine growth restriction (IUGR) fetuses and to assess its relationship with the presence of reverse flow in ductus venosus (DV).

Methods: The examination of coronary artery was performed at a gestational age <26 weeks in 19 IUGR fetuses from mothers without medical complications and characterised by the presence of reverse flow in DV. Visualisation or non-visualisation of coronary circulation were compared with fetal and neonatal outcome.

Effects of maternal cigarette smoking on placental volume and vascularization measured by 3-dimensional power Doppler ultrasonography at 11+0 to 13+6 weeks of gestation.

Objective: We sought to establish the effect of maternal smoking on placental volume and vascularization in early gestation.

Study Design: Three-dimensional power Doppler ultrasonography of the placenta was performed at 11+0 to 13+6 weeks in 80 pregnancies categorized according to cigarette consumption: group A never smoked, B smoking < 10 cigarettes/day, C smoking 10-20 cigarettes/day, and D smoking > 20 cigarettes/day. Using a standardized setting, placental volume and vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were calculated.

Relationship between aortic isthmus and ductus venosus velocity waveforms in severe growth restricted fetuses.

Objective: To evaluate the incidence of abnormalities in velocity waveforms from ductus venosus (DV) and aortic isthmus (AoI) in fetuses with intrauterine growth restriction (IUGR) and their reciprocal temporal relationship.

Methods: DV and AoI velocity waveforms were recorded in 31 IUGR fetuses characterized either by absent end diastolic (20) or reverse flow (11) in umbilical artery. Abnormal velocity waveforms in DV and AoI were defined in presence of reverse diastolic flows.

Use of the 3-vessel view to record Doppler velocity waveforms from the aortic isthmus in normally grown and growth-restricted fetuses: comparison with the long aortic arch view.

Objective: Aortic isthmus (AoI) velocity waveforms are considered powerful indicators of hemodynamic deterioration in intrauterine growth-restricted (IUGR) fetuses. However, technical difficulties in sampling AoI velocity waveforms from the longitudinal aortic arch (LAA) have limited its clinical application thus far. In this study, we tested the possibility of recording AoI velocity waveforms from the 3-vessel (3V) view of the fetal mediastinum and comparing the agreement of these measurements with recordings from the LAA.

Examination of the fetal heart by four-dimensional ultrasound with spatiotemporal image correlation during routine second-trimester examination: the 'three-steps technique'.

Objective: To prospectively analyze the accuracy and rapidity of four-dimensional (4D) ultrasonography with spatiotemporal image correlation (STIC) in the assessment of four-chamber view and outflow tracts in unselected fetuses and in fetuses with congenital heart defects (CHD) at 19-23 weeks of gestation.

Materials And Methods: 112 consecutive pregnancies undergoing routine second-trimester ultrasonographic scan and 10 pregnancies with fetuses with CHD affecting the great arteries formed the study group. From the four-chamber view, volumes of the fetal heart were acquired by the STIC technique and stored for a later offline analysis that was performed by two examiners blinded to the characteristics of the fetuses.

Role of tomographic ultrasound imaging with spatiotemporal image correlation for identifying fetal ventricular septal defects.

Objective: The purpose of this study was to test the possibility of diagnosing ventricular septal defects (VSDs) by using tomographic ultrasound imaging (TUI) on 4-dimensional volumes of the fetal chest obtained with spatiotemporal image correlation and the color Doppler function.

Methods: We retrospectively evaluated the 4-dimensional spatiotemporal image correlation volumes of 8 fetuses with VSDs (single in 7 and double in 1) between 20 and 33 weeks' gestation. The data were analyzed to determine whether VSDs were correctly identified in at least 1 of 7 automatically generated TUI displays.

Application of automated sonography on 4-dimensional volumes of fetuses with transposition of the great arteries.

Objective: The purpose of this study was to assess, in second-trimester fetuses with transposition of the great arteries (TGA), the performance of software (sonographically based volume computer-aided analysis) that automatically retrieves diagnostic cardiac planes from a 4-dimensional volume of the fetal chest obtained with spatiotemporal image correlation.

Methods: We retrospectively evaluated the 4-dimensional spatiotemporal image correlation volumes of 12 fetuses with TGA (complete TGA, 10 cases; correct TGA, 2 cases). The data were analyzed to determine whether the target diagnostic planes, that is, cardiac plane 1 (left ventricle outflow tract) and cardiac plane 2 (right ventricle outflow tract), were correctly identified in at least 1 of the 7 automatically generated tomographic sonographic image displays and whether they allowed diagnosis of TGA.

Fetal cardiac stroke volume determination by four-dimensional ultrasound with spatio-temporal image correlation compared with two-dimensional and Doppler ultrasonography.

Objective: To assess the agreement of stroke volume (SV) measured with two-dimensional (2D) ultrasonography with Doppler capability (vs) four-dimensional (4D) with spatiotemporal image correlation (STIC) in normal and growth restricted fetuses.

Methods: 2D Doppler and 4D STIC were used to measure SV of 40 normal fetuses at 20 to 22 and 28 to 32 weeks, and 16 growth-restricted fetuses at 26 to 34 weeks of gestation. Intraclass correlation was used to evaluate the agreement between left and right SV obtained by the two techniques, and proportionate Bland-Altman plots constructed.

First trimester uterine Doppler and three-dimensional ultrasound placental volume calculation in predicting pre-eclampsia.

Objective: To compare the efficacy of uterine artery Doppler velocimetry and three-dimensional ultrasound placental volume calculation alone or in combination in predicting at 11-14 weeks of gestation those pregnancies who will develop pre-eclampsia.

Study Design: This was a prospective study of 348 nulliparous women scheduled for a routine prenatal ultrasound examination at 11-14 weeks. Color and pulsed wave Doppler was used to obtain uterine artery flow velocity waveforms transabdominally and the mean pulsatility index (PI) of the uterine arteries was calculated.