Comparing transabdominal and transvaginal cervical length measurements at mid-trimester fetal anomaly scan: The impact of bladder fullness and lower uterine contractions.

Purpose: To assess the effects of bladder fullness and lower uterine contractions ultrasound on transabdominal and transvaginal cervical length measurements at the mid-trimester fetal anomaly scan (FAS).

Methods: Transabdominal and transvaginal cervical length measurements from 925 mid-trimester FAS examinations were retrospectively analysed. Images were assessed for lower uterine contraction and bladder fullness using a novel qualitative assessment.

Diagnostic tests for the prediction of histological chorioamnionitis and funisitis in pregnant women with preterm premature rupture of membranes: A systematic review.

Background: Infection of the amniotic cavity is an important driver and/or consequence of preterm prelabour rupture of membranes (PPROM). Prediction of infection is challenging, limiting guidance for interventions during the antenatal period. Infection typically triggers a host inflammatory response, and non-invasive indirect markers of the maternal or fetal inflammatory response have been reported in the context of PPROM and intra-amniotic infection.

The relationship between falling insulin requirements and serial ultrasound measurements in women with preexisting diabetes: a prospective cohort study.

Introduction: A large fall in insulin requirements (FIR) in women with diabetes is associated with adverse clinical outcomes but previous studies have not examined its relation with serial ultrasound parameters.

Objective: To determine whether FIR is associated with alteration in umbilical artery Doppler parameters and fetal growth restriction (FGR) in women with preexisting diabetes.

Methods: Serial obstetric Doppler ultrasounds were conducted 2 weekly from 28 weeks gestation in women with Type 1 and Type 2 diabetes who were being treated with insulin.

Awareness and utilisation of advanced gynaecological ultrasound in the preoperative work-up of women planning surgery for endometriosis: A survey of RANZCOG fellows and trainees.

Background: Endometriosis-specific (advanced gynaecological) ultrasound is recommended as part of preoperative work-up of women with suspected endometriosis.

Aim: To evaluate the awareness and utilisation of advanced gynaecological ultrasound in the preoperative work-up of women with suspected endometriosis among active RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) fellows and trainees.

Materials And Methods: Anonymous online survey invitations were emailed to all active RANZCOG fellows in Australia and New Zealand.

Uterine didelphys with dicavitary twin gestation: A case report.

Uterine didelphys is a rare type of congenital uterine anomaly resulting from incomplete fusion of the paramesonephric ducts during embryogenesis. We report the case of a 27-year-old multiparous woman who presented with ovulation-induced dicavitary dichorionic diamniotic twins in known uterine didelphys. At 29 + 5 weeks of gestation, the patient had preterm prelabour rupture of membranes followed by threatened preterm labour in the right uterus only, which settled with tocolysis.

Anthropometric and ultrasound measures of maternal adiposity in the first trimester of pregnancy.

Aim: Estimations of central adiposity in pregnancy is a difficult undertaking due to physiological changes that occur in the body. Therefore, the value of some anthropometric measures particularly in pregnancy, such as body mass index (BMI), waist and hip measures are in doubt. The aim was to compare ultrasound (US) measured abdominal subcutaneous fat (USSFT) with other simple anthropometric methods for obesity assessment, evaluating these measures in pregnancy.

The Association of Falling Insulin Requirements With Maternal Biomarkers and Placental Dysfunction: A Prospective Study of Women With Preexisting Diabetes in Pregnancy.

Objective: To investigate the association of falling insulin requirements (FIR) among women with preexisting diabetes with adverse obstetric outcomes and maternal biomarkers longitudinally in pregnancy.

Research Design And Methods: A multicenter prospective cohort study of 158 women (41 with type 1 diabetes and 117 with type 2 diabetes) was conducted. Women with FIR of ≥15% from the peak total daily dose after 20 weeks' gestation were considered case subjects ( = 32).

Maternal abdominal subcutaneous fat thickness as a predictor for adverse pregnancy outcome: a longitudinal cohort study.

Objective: To assess maternal abdominal subcutaneous fat thickness (SFT) measured by ultrasound as an independent predictor of adverse pregnancy outcomes.

Design: A prospective longitudinal cohort study performed on pregnancies delivered between 2012 and 2014.

Setting: Sydney, Australia.

Sonographically detected caesarean section scar defects and menstrual irregularity.

The purpose of this study was to estimate the frequency of post-caesarean section scar defects (PCSD) on transvaginal ultrasound and to correlate these with the presence of abnormal menstrual bleeding. We reviewed the pelvic ultrasound images of 318 women referred for a gynaecological scan in a private women's ultrasound clinic. The incidence of defects at the expected location of a caesarean scar was evaluated and then correlated with patient responses to a questionnaire on abnormal menstrual bleeding.

Retained intrauterine fetal bone as a rare cause of secondary infertility.

Retention of intrauterine fetal bone is a rare cause of secondary infertility that should be considered when ultrasound demonstrates strongly shadowing echodensities in the endometrial space. It seems that the bone acts as an intrauterine contraceptive device as long as it is present in the cavity. Hysteroscopy is both diagnostic and therapeutic, with a generally good prognosis for future fertility in the absence of coexisting factors.

Three-dimensional ultrasound imaging of the levator hiatus in late pregnancy and associations with delivery outcomes.

Objective: To determine the correlations between dimensions of the levator hiatus in late pregnant nulliparous women, mode of delivery and length of second stage.

Methods: This was a prospective observational pilot study of 61 nulliparous women seen and examined between 36 and 40 weeks of pregnancy. A translabial ultrasound examination was undertaken, and three-dimensional volumes comprising the levator hiatus were recorded at rest, during a pelvic floor muscle contraction and on Valsalva.

Predicting operative delivery.

Objective: Unplanned operative delivery (vaginal or abdominal) is associated with maternal anxiety, maternal and neonatal morbidity and increased resource use. We aimed to identify potential predictors for emergency operative delivery.

Methods: This was a prospective observational study of 202 nulliparous women in a tertiary antenatal unit between 36 and 40 weeks' gestation.

Levator trauma after vaginal delivery.

Objective: To date, the evidence on pelvic floor injury in labor remains sketchy due to a lack of prospective studies comparing pelvic floor imaging before and after childbirth. We intended to define the incidence of major trauma to the pubovisceral muscle.

Methods: A total of 61 nulliparous women were seen at 36-40 weeks of gestation in a prospective observational study.

Measuring engagement of the fetal head: validity and reproducibility of a new ultrasound technique.

Objective: Fetal head engagement can be assessed by translabial ultrasound and has been shown to be predictive of delivery mode. We attempted to validate the technique by comparing ultrasound with abdominal and vaginal palpation. Reproducibility was tested in a blinded test-retest series.

Ectopic pregnancy in lower segment uterine scar.

A case of ectopic pregnancy in a lower uterine segment scar following previous Caesarean section is reported. A significant scar defect may result in deep implantation within the myometrium with the risk of persistent pain and bleeding followed inevitably by uterine rupture. In this report we discuss a number of management options.