On-to-on versus on-to-out nuchal translucency measurements.

Objective: To analyze variables affecting the differences between on-to-on and on-to-out methods of nuchal translucency measurement.

Design: Prospective comparison of two methods of caliper placement.

Subjects: A total of 245 women undergoing transabdominal and 37 women undergoing transvaginal nuchal translucency scanning.

Localization of p43 placental isoferritin in human maternal-fetal tissue interface.

Objective: Human placental isoferritin, which is composed of a 43-kd protein subunit, is exclusively reactive with the CM-H9 monoclonal antibody. The p43 exerts immunosuppressive activity during pregnancy. The aim of this study was to localize the expression of p43 in the maternal-fetal tissue interface during normal gestation.

Serum inhibin A levels in pregnant women with systemic lupus erythematosus or antiphospholipid syndrome.

Maternal serum inhibin A levels are increased on average in pregnancies affected by Down syndrome (DS). However, some reports have found increased serum levels in women with pre-eclamptic toxaemia as well. In the current study, maternal serum inhibin A was retrospectively measured in a series of 32 serum samples from pregnant women previously diagnosed as having either systemic lupus erythematosus (SLE) or primary antiphospholipid syndrome (APS).

Implementation of nuchal translucency image-scoring method during ongoing audit.

Objective: The aim of this study was to evaluate the contribution of an ongoing audit, using the image-scoring method, to the quality of nuchal translucency images and to set the basic standards required from the examiners.

Design: Evaluation of nuchal translucency images, before, during and after the implementation of an ongoing audit, without knowledge of the time period or the examiner.

Subjects: A total of 315 nuchal translucency scans were performed by three examiners.

Comparison of nuchal translucency measurement and mid-gestation serum screening in assisted reproduction versus naturally conceived singleton pregnancies.

It has been reported that second-trimester serum markers may be affected by assisted reproduction leading to a higher false-positive rate. The current study compares 10-14 week nuchal translucency (NT) measurement and early mid-trimester serum screening in pregnancies resulting from assisted reproduction versus naturally conceived pregnancies. 75 pregnant women with a singleton pregnancy achieved by assisted reproduction underwent both 10-14 weeks NT measurement and second-trimester triple test and were followed throughout gestation.

Antenatal screening for Down's syndrome in assisted reproductive pregnancies.

The wide use of assisted conception methods has risen dramatically. The greater proportion of singletons, twins and high order of multiplicity conceived by those methods have already focused the medical community to various obstetric complications. Recently, there have been suggestions that the levels of mid-gestation serum markers, particularly human chorionic gonadotrophin (HCG), might be affected by assisted conception, leading to higher false-positive results.

White coat hypertension and pregnancy outcome.

The presence and outcome effect of white coat hypertension in pregnancy was determined with 24-h ambulatory blood pressure (BP) monitoring. Sixty women presenting with high clinic BP (>/=140/90 mm Hg) in the second trimester were included. Patients were divided into two groups based on daytime ambulatory BP findings: <135/85 mm Hg, white coat hypertension (n = 37); >/=135/85 mm Hg, 'true' hypertension (n = 23).

Comparison of nuchal translucency measurement and second-trimester triple serum screening in twin versus singleton pregnancies.

Maternal serum screening for Down syndrome (DS) in twin pregnancies poses difficulties due to a lack of precise biochemical information about each co-twin. The current study attempts, for the first time, to compare two screening methods: nuchal translucency (NT) measurement and serum screening for DS, in twin pregnancies. 60 women with twin pregnancies (study group) underwent both first-trimester NT scanning and mid-trimester triple-marker serum screening, and were followed throughout their gestation.

The feasibility of nuchal translucency measurement in higher order multiple gestations achieved by assisted reproduction.

Nuchal translucency (NT) measurement for screening chromosomal abnormalities and detecting fetal anomalies is an effective ultrasonographic marker, originally developed for singleton pregnancies. This study sought to evaluate the feasibility of NT measurements in higher order multiple gestations. Pregnant patients who conceived following assisted reproduction and were carrying three or more fetuses were enrolled in the study.

Utilization of the nuchal translucency image-scoring method during training of new examiners.

Training of new examiners, utilizing 1st-trimester nuchal translucency ultrasound screening, is mandatory for obtaining reproducible measurements. This study examined the contribution of the nuchal translucency image-scoring method to the process of training and its utilization as an objective tool of image evaluation and a tool for approving qualification. The study included an evaluation of the performance of two new examiners (examiners A and B) before and after intervention, using the image-scoring method.

Development of the fetal uterus between 19 and 38 weeks of gestation: in-utero ultrasonographic measurements.

In-utero assessment of the internal female genitalia is important for determination of fetal gender in fetuses with suspected genital tract anomalies. We therefore measured fetal uterine transverse width and circumference from 19 weeks of gestation until term, using transvaginal and transabdominal high-resolution ultrasound techniques in order to establish nomograms. A prospective, cross-sectional study on 180 normal singleton pregnancies was performed.

Smith-Lemli-Opitz syndrome presenting with persisting nuchal oedema and non-immune hydrops.

Smith-Lemli-Opitz syndrome (SLO) is a recognized clinical entity with distinctive anomalies. Recently it has been shown that a specific defect in cholesterol metabolism, 7-dehydroxycholesterol reductase deficiency, causes the multiple abnormalities seen in SLO. There have been two reports of first-trimester nuchal translucency associated with SLO.

Can nuchal cord cause transient increased nuchal translucency thickness?

When detected in a first trimester scan, an increased thickness of nuchal translucency (NT) may be associated with chromosomal, cardiac or genetic disorders. However, less attention has been devoted to the outcome of those fetuses who have confirmed normal anatomies and karyotyping, but have abnormal first trimester scans. Thus, a challenging new issue is how to counsel such cases of transient increased NT in which the translucency rapidly vanishes with no evidence of other underlying abnormalities.

Maternal serum placental isoferritin levels in pregnant women with abnormal uterine artery Doppler velocemitry.

High levels of placental isoferritin (PLF), which is an immunosuppressive cytokine, have been demonstrated in the sera of pregnant women. In the current study, 41 pregnant patients at high risk for placento-vascular complications, such as preeclamptic toxemia (PET) and/or intrauterine growth retardation (IUGR) were preselected if abnormal uterine artery Doppler measurements appeared at the time of the 20th-22nd gestational week scan. Concomitantly, venous blood was collected from each patient.

Nuchal translucency audit: a novel image-scoring method.

Objective: The aim of this study was to evaluate the feasibility and reproducibility of a novel image-scoring method of first-trimester nuchal translucency measurement as an objective tool of ongoing audit and training.

Design: This was an independent evaluation of nuchal translucency images by three separate reviewers unaware of the examiner.

Subjects: There were 105 consecutive singleton pregnancies undergoing first-trimester screening.

[Trisomy 18 anomalies on sonography and calculated risk of chromosomal abnormalities during first trimester].

Trisomy 18 is a chromosomal disorder giving multiple anomalies. Its frequency depends on maternal age. We report a 28-year-old woman in her first pregnancy, who underwent first trimester scanning for screening.

Placental isoferritin levels in pregnant patients with systemic lupus erythematosus and/or antiphospholipid syndrome.

Problem: Low serum placental isoferritin (PLF), an immunosuppressive cytokine-like protein, was found in women with underlying placento-vascular dysfunction, such as intrauterine growth retardation and preeclamptic toxemia. The possible contribution of this placental product in the assessment of pregnant patients with either systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS) was investigated.

Method Of Study: Seventy-five healthy pregnant women used as controls and 25 preselected pregnant patients with either SLE and/or APS were enrolled in the study.

Pelvic splenosis mimicking endometriosis, causing low abdominal mass and pain.

Splenosis is the heterotopic autotransplantation of splenic tissue that usually follows traumatic splenectomy. The clinical significance of these splenic implants and the need for surgical removal is debatable. A case of a 35 year old woman, with post-traumatic splenectomy presenting with low abdominal pain and pelvic mass is reported.

Placental isoferritin in gestational diabetes mellitus.

Background: Serum placental isoferritin, an immunosuppressive cytokine like protein, was found to be elevated in type I diabetes at diagnosis and low in high risk pregnant women. Further to this observation, the possible role of this placental product was assessed in pregnant women with gestational diabetes mellitus.

Methods: A comparative study.

Comparison of placental isoferritin levels in maternal serum and coelomic and amniotic fluids during first trimester human gestation.

Placental isoferritin (PLF) is present in serum at high concentrations throughout normal gestation. The current study compared PLF concentrations in first trimester maternal serum with those of amniotic and coelomic fluids in 25 healthy, pregnant women. Use of a specific enzyme-linked immunosorbent assay indicated concentrations high (22 +/- 3 U/ml) in maternal serum, whereas significantly lower values were detected in both coelomic and amniotic fluids (5 +/- 2 and 3 +/- 2 U/ml, respectively, P < 0.

Three-dimensional transvaginal sonography of conjoined twins at 10 weeks: a case report.

Early and accurate prenatal diagnosis of conjoined twins is still a challenge, and is important when planning a favorable outcome for the mother and infants. We present a case diagnosed with transvaginal and three-dimensional ultrasound at 10 weeks of gestation, and discuss the contribution of this relatively new scanning modality.

Image magnification does not contribute to the repeatability of caliper placement in measuring nuchal translucency thickness.

The objective of this study was to assess whether nuchal translucency image magnification contributes to the repeatability of caliper placement. Twenty-seven women undergoing first-trimester ultrasound screening at 11-14 weeks were examined by two qualified examiners. Fetal nuchal translucency thickness was measured twice by each examiner on a regular-sized image and subsequently on the same still image magnified.

Recurrent heterotopic pregnancy after repeated in-vitro fertilization treatment.

We report a rare clinical case of recurrent heterotopic pregnancy in the same patient following in-vitro fertilization treatments. A 27 year old woman, who suffered from infertility for the last 4 years due to male factor, was being treated by intracytoplasmic sperm injection which resulted in two episodes of combined intrauterine and tubal pregnancy, in a 1 year period. The first ended in emergency salpingectomy by laparotomy and missed intrauterine abortion.

Hepatic mesenchymal hamartoma: a pediatric tumor that may be diagnosed prenatally.

Hepatic mesenchymal hamartoma is a benign tumor, defined as an excessive focal overgrowth of mature normal cells and stroma native to the liver. The increasing popularity of antenatal scanning has resulted in in utero diagnosis of congenital malformations and anomalies that previously became apparent only after delivery. Herein, we present a rare case of fetal mesenchymal hamartoma of the liver, which was initially sonographically detected at 29 weeks of gestation.

Human decidua-associated protein (hDP) 200 identified as a monoclonal rheumatoid factor is not an acute phase reactant.

Problem: The role of human decidua associated protein (hDP) 200, identified as a monoclonal rheumatoid factor, has not been determined yet. This study examines if this protein, being an immunoglobulin, participates in the inflammatory processes involving the uterus.

Method: Uterine fluid samples were obtained prospectively from two groups of women: the study group, containing 26 women with laparoscopically verified pelvic inflammatory disease (PID), and the control group, containing 34 regularly cycling, fertile women, referred to the Family Planning Clinic.