" " Exploring the Experiences of Black and Hispanic Parents following a Congenital Heart Disease Diagnosis.

 Congenital heart disease (CHD) is an important contributor to pediatric morbidity and mortality. Unfortunately, disparities in the diagnosis and treatment of CHD exist across racial and ethnic groups. The objective of this study was to share the experiences of Hispanic and Black families with CHD to better understand their needs.

In Vivo Demonstration of a Real-Time Temporal SNR Acoustic Output Adjustment Method.

This work proposes a novel method of temporal signal-to-noise ratio (SNR)-guided adaptive acoustic output adjustment and demonstrates this approach during in vivo fetal imaging. Acoustic output adjustment is currently the responsibility of sonographers, but ultrasound safety studies show recommended as low as reasonably achievable (ALARA) practices are inconsistently followed. This study explores an automated ALARA method that adjusts the mechanical index (MI) output, targeting imaging conditions matching the temporal noise perception threshold.

The Quantification of Muscle Activation During the Loaded Carry Movement Pattern.

The 'loaded carry' is a popular resistance training activity that activates core musculature across multiple movement planes while the body is in locomotion. 'Hold' exercises are similar to carry exercises but lack the locomotive aspect. Both carry and hold exercises can be completed bilaterally (farmer's carry (FC) and hold (FH)) or unilaterally (suitcase carry (SC) and hold (SH)).

Human Observer Sensitivity to Temporal Noise During B-Mode Ultrasound Scanning: Characterization and Imaging Implications.

This work measures temporal signal-to-noise ratio (SNR) thresholds that indicate when random noise during ultrasound scanning becomes imperceptible to expert human observers. Visible noise compromises image quality and can potentially lead to non-diagnostic scans. Noise can arise from both stable acoustic sources (clutter) or randomly varying electronic sources (temporal noise).

Validation of a sonographic checklist for the detection of histologic placenta accreta spectrum.

Background: To standardize research terminology and to reduce unanticipated placenta accreta spectrum, the European Working Group for Abnormally Invasive Placenta developed a consensus checklist for reporting suspected placenta accreta spectrum observed during an antenatal ultrasound. The diagnostic accuracy of the European Working Group for Abnormally Invasive Placenta checklist has not been assessed.

Objective: This study aimed to test the performance of the European Working Group for Abnormally Invasive Placenta sonographic checklist in predicting histologic placenta accreta spectrum.

A Comparison of Muscle Recruitment Across Three Straight-Legged, Hinge-Pattern Resistance Training Exercises.

Hinge exercises are critical to building a balanced resistance training program in concert with 'knee-dominant' (e.g., squat, lunge) exercises.

Management of Preterm Premature Rupture of Membranes in the Late Preterm Period.

Importance: For patients who present with prelabor rupture of membrane (PROM) in the late preterm period (34 to 36 6/7 weeks), management remains unclear due to lack of consensus. However, recent guidelines have suggested that shared decision-making may be used and expectant management can be considered up to 37 0/7 weeks.

Objective: In this article, we review the contemporary studies comparing the risks and benefits of immediate delivery versus expectant management for patients with late preterm prelabor rupture of membranes (PPROM).

An Automated Region-Selection Method for Adaptive ALARA Ultrasound Imaging.

The objective of this work was to develop an automated region of the interest selection method to use for adaptive imaging. The as low as reasonably achievable (ALARA) principle is the recommended framework for setting the output level of diagnostic ultrasound devices, but studies suggest that it is not broadly observed. One way to address this would be to adjust output settings automatically based on image quality feedback, but a missing link is determining how and where to interrogate the image quality.

The Role of Perinatal Palliative Care in Fetal Neurology.

Objectives: Many serious or life-threatening neurologic conditions are first diagnosed during the fetal period, often following a routine ultrasound or sonographic evaluation after an abnormal aneuploidy screen. Such conditions represent a worrisome or unexpected finding for expectant parents, making the perinatal period a critical time point to engage and empower families encountering complex neurologic clinical scenarios. This review covers the role of perinatal palliative care in these settings.

An Automated ALARA Method for Ultrasound: An Obstetric Ultrasound Feasibility Study.

Objectives: Ultrasound users are advised to observe the ALARA (as low as reasonably achievable) principle, but studies have shown that most do not monitor acoustic output metrics. We developed an adaptive ultrasound method that could suggest acoustic output levels based on real-time image quality feedback using lag-one coherence (LOC).

Methods: Lag-one coherence as a function of the mechanical index (MI) was assessed in 35 healthy volunteers in their second trimester of pregnancy.

Physician Barriers and Facilitators for Screening for Congenital Heart Disease With Routine Obstetric Ultrasound: A National United States Survey.

Objectives: Prenatal detection of congenital heart disease with obstetric screening remains at less than 50% in most population studies, far from what is thought to be achievable. We sought to identify barriers/facilitators for screening from the perspective of interpreting physicians and to understand how these barriers/facilitators may be associated with interpretation of screening images.

Methods: Our mixed-methods studies included 4 focus groups in centers across the United States with obstetric, maternal-fetal medicine, and radiology providers who interpreted obstetric ultrasound studies.

Clinical Utility of Fetal Short-Lag Spatial Coherence Imaging.

In this study, we evaluate the clinical utility of fetal short-lag spatial coherence (SLSC) imaging. Previous work has documented significant improvements in image quality with fetal SLSC imaging as quantified by measurements of contrast and contrast-to-noise ratio (CNR). The objective of this study was to examine whether this improved technical efficacy is indicative of the clinical utility of SLSC imaging.

Multidisciplinary approach to manage antenatally suspected placenta percreta: updated algorithm and patient outcomes.

Background: Due to the significant morbidity and mortality associated with placenta percreta, alternative management options are needed. Beginning in 2005, our institution implemented a multidisciplinary strategy to patients with suspected placenta percreta. The purpose of this study is to present our current strategy, maternal morbidity and outcomes of patients treated by our approach.

In vivo application of short-lag spatial coherence and harmonic spatial coherence imaging in fetal ultrasound.

Fetal scanning is one of the most common applications of ultrasound imaging and serves as a source of vital information about maternal and fetal health. Visualization of clinically relevant structures, however, can be severely compromised in difficult-to-image patients due to poor resolution and the presence of high levels of acoustical noise or clutter. We have developed novel coherence-based beamforming methods called Short-Lag Spatial Coherence (SLSC) imaging and Harmonic Spatial Coherence imaging (HSCI), and applied them to suppress the effects of clutter in fetal imaging.

Religiosity is an important part of coping with grief in pregnancy after a traumatic second trimester loss.

Women (n = 15) who were pregnant after a traumatic late pregnancy loss (termination because of fetal death or serious anomalies) completed psychometric screening tests and scales, including the Perinatal Grief Scale (PGS), the Impact of Event Scale (IES), the Duke Depression Inventory (DDI), the Generalized Anxiety Disorder-7 (GAD), and the Hoge Scale for Intrinsic Religiosity (IR). Despite a mean elapsed time since the prior loss of 27 (range, 7-47) months, half (7/15, 47%) of the combined groups had high levels of grief on the PGS. Multiple positive scores on psychometric tests were frequent: Sixty percent (9/15) had high scores on the PGS Active Grief subscale or on the IES.

Medical and surgical treatment of placenta percreta to optimize bladder preservation.

Background: Placenta percreta is associated with significant morbidity and mortality. Interventions are dictated by hemodynamic stability, desire to retain future fertility, and efforts to reduce surgical morbidity at time of delivery.

Cases: Two cases of antenatally diagnosed placenta percreta with bladder invasion are presented.

Preterm premature rupture of membrane management--inpatient versus outpatient: a retrospective review.

The purpose of this study was to evaluate the outcome of patients with preterm premature rupture of membranes (PPROM) managed as inpatients who would have been candidates for outpatient management by prior published criteria. A retrospective review of medical records of PPROM subjects enrolled in a prospective cohort study was performed. Similar criteria to those established in a randomized trial for home management of PPROM by Carlan et al were applied.

Severe factor V deficiency presenting with intracranial haemorrhage during gestation.

We present a case of intracranial haemorrhage detected by ultrasound at 36 weeks gestation in a foetus who was ultimately diagnosed with severe factor V deficiency. An abnormality of the foetal heart rate, auscultated at a routine antenatal visit, prompted an investigation that led to an ultrasound examination and detection of an intracranial haemorrhage and low amniotic fluid volume. An intrauterine foetal demise was averted.

First trimester screening.

Screening for aneuploidy has traditionally been reserved for women of advanced maternal age. More recent advances in serum screening and ultrasound technology have allowed women of all ages to be offered screening in the second and even first trimester. These methods and their effectiveness are discussed.

Prenatal diagnosis of a trauma-related fetal epidural hematoma.

Background: Prenatal diagnosis of fetal intracranial hemorrhage has important etiologic, management, and prognostic implications. Ultrasonography and magnetic resonance imaging (MRI) have been used to identify and evaluate this condition. We present the first reported case of epidural hematoma diagnosed prenatally.