Differential item functioning for lesbians, bisexual, and heterosexual women in the center for epidemiological studies depression scale.

This study assessed whether the Center for Epidemiological Studies Depression Scale (CES-D) functions equivalently in assessing depressive symptom severity in lesbian, bisexual, and heterosexual women. Using differential item functioning methods, the authors examined (a) whether there is a bias in CES-D total scores and in individual item scores and (b) whether there are differences across female sexuality groups in the construct of depression assessed by the CES-D. Data were collected anonymously online from 273 women.

Selective reduction of multifetal pregnancies to twins improves outcome over nonreduced triplet gestations.

Objective: Our purpose was to evaluate effects of multifetal pregnancy reduction on pregnancy complications and birth weights of remaining twin fetuses compared with expectantly managed triplets and nonreduced twins.

Study Design: Medical records of 54 triplet pregnancies, 59 twin pregnancies resulting from multifetal pregnancy reduction, and 88 sets of twins conceived with assisted reproductive techniques and delivered at New York Hospital after 24 weeks were retrospectively reviewed. Birth weights were corrected for gestational age at delivery by use of a formula derived from composite standardized growth curves.

Amniotic fluid accumulation in the first trimester.

Amniotic fluid volume was estimated sonographically in 507 of 977 first trimester pregnancies with living fetuses and in 99 of 227 instances of missed abortion. Volume is correlated with fetal length, cross referenced by average heart rate for living fetuses. Fluid volume increases exponentially after 9 weeks, consistent with the onset of renal function.

Smaller parts scanning of the fetus.

Current instrumentation provides capabilities for minute fetal anatomic exploration and for integrative physiologic inference. This extends the complexity of the study and the diagnostic obligation of the examiner. The direction of study and clarification of findings devolve increasingly upon pathology and pathophysiology rather on than prior imaging experience.

Human fetal upper respiratory tract function as revealed by ultrasonography.

The respiratory functions of the oropharynx, larynx, and trachea of normal human fetuses in utero were explored by means of real-time, two-dimensional ultrasonography combined with color-flow and spectral Doppler analysis. Coronal and transverse images revealed the maturation of coordinated respiratory activity of these structures in the late second and early third trimesters. Observation of the effects of these movements upon the flow of amniotic fluid in the fetal respiratory tract provides an appreciation of the early role of the upper airway in the modulation of fetal breathing.

Ecologic physiology of the fetus. Ultrasonography of supply-line deprivation syndromes.

Supply-line deprivation is a major source of developmental fetal pathology. Clinical surveys have tended to emphasize the role of placental failure, although the umbilical cord may also be a site of injury. Supply-line limitations are met by a series of active fetal compensatory maneuvers.

Technical improvement for ultrasonic study of the endometrium.

Ultrasound imaging has evolved technically. Large-aperture, multielement array systems achieve improved spatial, contrast, and temporal resolutions. These advances are useful for detailed study of the endometrium, especially for early detection of neoplastic disease and premalignant risk factors, assessment and management of infertility, monitoring the course of early pregnancy at--and about--the time of implantation and, possibly, for increasing knowledge about symptomatic conditions, such as dysmenorrhea.

Fetal ear length.

A prenatal standard for ear length was developed from ultrasonic images of 180 normal subjects. Length increased from about 6 mm at 15 weeks to 33 mm at term and was well fit by linear regression (r2 = .96).

Fetal hyaloid artery: timing of regression with US.

Large-aperture, dynamically focused ultrasonic imaging permits noninvasive, anatomic study of the eye at the millimeter level in the second and third trimesters of pregnancy. The authors report their observations of the hyaloid artery in 210 of 219 fetuses examined with this technique. This vessel is seen in fetuses of 20 weeks gestational age or less and regresses spontaneously at the start of the third trimester.

The diagnosis of fetal hydrocephalus prior to 22 weeks.

The prenatal diagnosis of hydrocephalus is described in 11 cases between 17 and 21 weeks using two sonographic criteria. These sonographic findings involve the asymmetrical appearance of the choroid plexus and the size and configuration of the anterior horns of the lateral ventricles. We have found that these criteria can accurately diagnose fetal hydrocephalus in the first half of the second trimester.

Management of infants with prenatal ultrasound diagnosis of airway obstruction by teratoma.

We report a case of a cervical teratoma that was diagnosed prenatally. In anticipation of potential upper airway obstruction, resources were mobilized to the operating room at the time of planned cesarean section. The neonate developed respiratory distress, and her airway was secured.

Ultrasound guidance for selected dilatation and evacuation procedures.

Intraoperative ultrasound was used as an adjunct in difficult dilatation and evacuation (D&E) procedures for first-trimester abortions. This technique was useful in eight technically difficult D&Es in the presence of acute retroflexion, acute anteflexion, cervical stenosis and lower uterine segment fibroids.

An algorithmic approach to accurate ultrasonic fetal weight estimation.

A flexible model is proposed for estimation of fetal weight from biparietal, occipitofrontal, and average abdominal diameters and femoral shaft length. Individual formulas are selected by gestational age-independent decision rules that reflect fetal body proportions. The correlation coefficient for observed and predicted weight was .

Fetal lumbar spine: measuring axial growth with US.

Ultrasound (US) can be used to visualize vertebral segments, suggesting a quantitative means of studying vertebral column growth in utero and thus a means of detecting developmental abnormalities. US images of the lumbar spine were obtained in 128 clinically normal fetuses between the gestational age of 11 through 41 weeks. A large-aperture, dynamically focused US system capable of regional magnification was used.

Management of an infant with prenatal ultrasound diagnosis of upper airway obstruction.

We report a case in which a cervical teratoma was diagnosed antenatally in the mid third trimester. In anticipation of potential upper airway obstruction, resources were mobilized to the operating room at the time of the planned cesarean section. The neonate was unable to breathe, but his airway was secured without delay.

Ultrasonic fetal ophthalmology.

The fetal eye is studied ultrasonically during the second and third trimesters with a large aperture, dynamically focused imaging system. The globe, lens, iris, pupil, and cornea can be resolved separately, and extraocular structures including muscles, retro-orbital fat, and optic nerve may be visualized. The hyaloid artery is seen before 20 weeks and regresses by 25 weeks gestational age.

Fetal lung development: compressibility as a measure of maturity.

Fetal lung maturation involves a number of separate developmental processes. An ultrasonic technique is reported for grading the dynamic behavior of the right middle lobe or lingula in the second or third trimesters on ultrasound (US) study. Fetal lungs are stiff initially.