Systematic, noninvasive endometriosis diagnosis in transvaginal sonography by the Swiss Society of Ultrasound in Medicine.

We present a new systematic, comprehensive, checklist-based sonographic assessment of endometriosis in the female true pelvis. Emphasis is placed on practical skills teaching. The newly introduced White Sliding Line (WSL) is the core structure.

Sustained Physiological Stretch Induces Abdominal Skin Growth in Pregnancy.

Supraphysiological stretches are exploited in skin expanders to induce tissue growth for autologous implants. As pregnancy is associated with large levels of sustained stretch, we investigated whether skin growth occurs in pregnancy. Therefore, we combined a mechanical model of skin and the observations from suction experiments on several body locations of five pregnant women at different gestational ages.

Judging Urgency in 343 Ectopic Pregnancies Prior to Surgery - The Importance of Transvaginal Sonographic Diagnosis of Intraabdominal Free Blood.

Objectives: Assessing urgency in ectopic pregnancies (ECP) remains controversial since the disorder covers a large clinical spectrum. Severe conditions such as acute abdomen or hemodynamic instability are mostly related to intra-abdominal blood loss diagnosed as free fluid (FF) on transvaginal sonography (TVS). The aims of the current study were to investigate the value of FF and to assess other potentially predictive parameters for judging urgency.

Self-supervised representation learning for surgical activity recognition.

Purpose: Virtual reality-based simulators have the potential to become an essential part of surgical education. To make full use of this potential, they must be able to automatically recognize activities performed by users and assess those. Since annotations of trajectories by human experts are expensive, there is a need for methods that can learn to recognize surgical activities in a data-efficient way.

Audit of the first > 7500 noninvasive prenatal aneuploidy tests in a Swiss genetics center.

Objectives: Noninvasive prenatal testing (NIPT) is actually the most accurate method of screening for fetal chromosomal aberration (FCA). We used pregnancy outcome record to evaluate a complete data set of single nucleotide polymorphism-based test results performed by a Swiss genetics center.

Materials And Methods: The Panorama test assesses the risk of fetal trisomies (21, 18 and 13), gonosomal aneuploidy (GAN), triploidy or vanishing twins (VTT) and five different microdeletions (MD).

The Predictive Value of Decisive and Soft Ultrasound Criteria for Ectopic Pregnancy Identification in 321 Preoperative Cases.

Purpose:  To define the predictive value of morphological types (MTs) and further criteria in diagnosing ectopic pregnancy (ECP) by transvaginal sonography (TVS) prior to operative confirmation and treatment.

Materials And Methods:  Retrospective cohort analysis of 321 consecutive patients with suspected ECP who were advised to undergo operation.

Results:  ECP was investigated by TVS in all 321 patients.

[Pelvic Inflammatory Disease - Synergies between Family Practices and Gynaecological Specialised Assessment].

Pelvic Inflammatory Disease - Synergies between Family Practices and Gynaecological Specialised Assessment The 'pelvic inflammatory disease' (PID) describes an ascending inflammation of the upper female genital tract, beginning with a local cervicitis and proceeding to endometritis and adnexitis. It is a common clinical picture with rising numbers in recent years, and it occurs both in gynaecological and general practice. The symptoms are often unspecific, discrete or althogehter lacking.

Ultrasound simulation with deformable and patient-specific scatterer maps.

Purpose: Ray-tracing-based simulations model ultrasound (US) interactions with a custom geometric anatomical model, where US texture can be emulated via real-time point-spread function convolutions of a tissue scatterer representation. Such scatterer representations for realistic appearance are difficult to parameterize or model manually and do not respond to volumetric deformations such as those caused with tissue compression by the probe. Herein we utilize brightness mode (B-mode) estimated scatterer maps for ray tracing and propose to enhance the realism of ray-tracing-based simulations by incorporating dynamic speckle patterns that change compliant with tissue deformation.

Measuring tissue displacement of the anterior vaginal wall using the novel aspiration technique in vivo.

Little is known about the mechanical properties of pelvic floor structures and their role in the course and treatment of pelvic organ prolapse (POP). We hypothesize that in vivo mechanical properties of the vaginal wall are related to the appearance of POP and pre-and post-operative states. We used a suction device for intravaginal application, the aspiration device, to evaluate two in vivo mechanical parameters of the anterior vaginal wall, the load dependent tissue displacement and the initial displacement, by image analysis in pre- and post-menopausal women with (POP) and without (control) cystocele (POP: pre-menopausal: N = 6, post-menopausal: N = 19, control: pre-menopausal: N = 17, post-menopausal: N = 6).

Consistent reconstruction of 4D fetal heart ultrasound images to cope with fetal motion.

Purpose: 4D ultrasound imaging of the fetal heart relies on reconstructions from B-mode images. In the presence of fetal motion, current approaches suffer from artifacts, which are unrecoverable for single sweeps.

Methods: We propose to use many sweeps and exploit the resulting redundancy to automatically recover from motion by reconstructing a 4D image which is consistent in phase, space, and time.

Cervical length after cerclage: comparison between laparoscopic and vaginal approach.

Purpose: The aim of our study was to investigate the sonographic changes of the cervical length during pregnancy after the placement of a transvaginal cervical cerclage (TVC) or a laparoscopic abdominal cerclage (LAC) in patients with cervical insufficiency (CI).

Methods: Between January 2008 and March 2015, a retrospective analysis of all women undergoing a prophylactic laparoscopic (LAC group) or transvaginal (TVC group) cerclage due to cervical insufficiency was conducted. Nonparametric variables were analysed with the Mann-Whitney (U) test, and categorical-type outcomes were analysed with the Fisher's exact test.

Fundus Thickness Assessment by 3D Transvaginal Ultrasound Allows Metrics-Based Diagnosis and Treatment of Congenital Uterine Anomalies.

 The development of a metric fundus assessment and definition of the uterine fundus thickness (FTH) for supporting objective diagnosis and treatment of congenital uterine anomalies (CUAs).  A) In a prospective cohort study, FTH was systematically assessed by 3 D transvaginal ultrasound (TVS) in patients, who presented a normal uterus. B) The mean normal FTH recorded was applied to uteri with fundal protrusions and septations, and compared to two CUA classification systems (ASF and ESHRE/ESGE).

The mechanical role of the cervix in pregnancy.

Appropriate mechanical function of the uterine cervix is critical for maintaining a pregnancy to term so that the fetus can develop fully. At the end of pregnancy, however, the cervix must allow delivery, which requires it to markedly soften, shorten and dilate. There are multiple pathways to spontaneous preterm birth, the leading global cause of death in children less than 5 years old, but all culminate in premature cervical change, because that is the last step in the final common pathway to delivery.

In vivo assessment of the biomechanical properties of the uterine cervix in pregnancy.

Measuring the stiffness of the cervix might be useful in the prediction of preterm delivery or successful induction of labor. For that purpose, a variety of methods for quantitative determination of physical properties of the pregnant cervix have been developed. Herein, we review studies on the clinical application of these new techniques.

[Contraception - where ultrasound is of significant support].

The use of ultrasound is already routine in contraceptive procedures. One of the best examples is the transvaginal assessment of the IUD position. But ultrasound may improve safety and comfort to contraceptive procedures too, e.

Cervical softening occurs early in pregnancy: characterization of cervical stiffness in 100 healthy women using the aspiration technique.

Objective: To quantitatively describe the evolution of ectocervical stiffness in normal pregnancy.

Methods: The stiffness of ectocervical tissue was measured by using the aspiration method. This non-invasive technique allows to safely and objectively determine the pressure required to displace cervical tissue to a predefined deformation level (pcl ).

A novel procedure for the mechanical characterization of the uterine cervix during pregnancy.

An in-vivo measurement procedure is presented to characterize the mechanical behavior of human uterine cervix during pregnancy. Based on the aspiration method, a new instrument was developed to provide an inherently safe and easy-to-use mechanical testing technique. Initial measurements were performed on non-pregnant women to develop an appropriate measurement protocol.

Hysteroscopic placement of tubal sterilization implants: virtual reality simulator training.

Study Objective: To assess face and construct validity of a new virtual reality (VR) training simulator for hysteroscopic placement of tubal sterilization implants.

Design: Nonrandomized, controlled trial comparing responses and performance of novices and experts on the simulator.

Design Classification: Canadian task force II-1.

Establishing construct validity of a virtual-reality training simulator for hysteroscopy via a multimetric scoring system.

Background: The aims of this study are to determine construct validity for the HystSim virtual-reality (VR) training simulator for hysteroscopy via a new multimetric scoring system (MMSS) and to explore learning curves for both novices and experienced surgeons.

Methods: Fifteen relevant metrics had been identified for diagnostic hysteroscopy by means of hierarchical task decomposition. They were grouped into four modules (visualization, ergonomics, safety, and fluid handling) and individually weighted, building the MMSS for this study.

Assessment of the in vivo biomechanical properties of the human uterine cervix in pregnancy using the aspiration test: a feasibility study.

Objective: To date no diagnostic tool is yet available to objectively assess the in vivo biomechanical properties of the uterine cervix during gestation.

Methods: We show the first clinical application of an aspiration device to assess the in vivo biomechanical properties of the cervix in pregnancy with the aim to describe the physiological biomechanical changes throughout gestation in order to eventually detect pregnant women at risk for cervical insufficiency (CI).

Results: Out of 15 aspiration measurements, 12 produced valid results.

Uterus models for use in virtual reality hysteroscopy simulators.

Objectives: Virtual reality models of human organs are needed in surgery simulators which are developed for educational and training purposes. A simulation can only be useful, however, if the mechanical performance of the system in terms of force-feedback for the user as well as the visual representation is realistic. We therefore aim at developing a mechanical computer model of the organ in question which yields realistic force-deformation behavior under virtual instrument-tissue interactions and which, in particular, runs in real time.

Pressure-dependent hydrometra dimensions in hysteroscopy.

Aim: To investigate the relation between intrauterine pressures and volumes for virtual-reality-based surgical training in hysteroscopy.

Material And Methods: Ten fresh extirpated uteri were insufflated by commercial hysteroscopy pump and imaged by computer tomography (CT) under intrauterine air pressure in distension-collapse cycles between 0 , 20 (150 mmHg), and 0 kPa, performing a CT scan at every step at about 2.7 kPa (20 mmHg).

Constitutive modeling of human liver based on in vivo measurements.

In vivo aspiration experiments on human livers are analyzed and material parameters for a non-linear-viscoelastic constitutive model are determined. A novel procedure is applied for the inverse analysis that accounts for the initial tissue deformation in the experiment and for the non-homogeneity of liver tissue. A numerical model is used consisting of a surface layer (capsule) and an underlying non-linear-viscoelastic solid (parenchyma).

Inverse finite element characterization of the human myometrium derived from uniaxial compression experiments.

The low strain-rate behavior of the human myometrium under compression was determined. To this end, uniaxial, unconstrained compression experiments were conducted on a total of 25 samples from three excised human uteri at strain rates between 0.001 s(-1) and 0.

Evaluation of a new virtual-reality training simulator for hysteroscopy.

Background: To determine realism and training capacity of HystSim, a new virtual-reality simulator for the training of hysteroscopic interventions.

Methods: Sixty-two gynaecological surgeons with various levels of expertise were interviewed at the 13(th) Practical Course in Gynaecologic Endoscopy in Davos, Switzerland. All participants received a 20-min hands-on training on the simulator and filled out a four-page questionnaire.