How automated techniques ease functional assessment of the fetal heart: Applicability of two-dimensional speckle-tracking echocardiography for comprehensive analysis of global and segmental cardiac deformation using fetalHQ®.

Background: Prenatal echocardiographic assessment of fetal cardiac function has become increasingly important. Fetal two-dimensional speckle-tracking echocardiography (2D-STE) allows the determination of global and segmental functional cardiac parameters. Prenatal diagnostics is relying increasingly on artificial intelligence, whose algorithms transform the way clinicians use ultrasound in their daily workflow.

Semi-Automatic Measurement of Fetal Cardiac Axis in Fetuses with Congenital Heart Disease (CHD) with Fetal Intelligent Navigation Echocardiography (FINE).

Congenital heart disease (CHD) is one of the most common organ-specific birth defects and a major cause of infant morbidity and mortality. Despite ultrasound screening guidelines, the detection rate of CHD is limited. Fetal intelligent navigation echocardiography (FINE) has been introduced to extract reference planes and cardiac axis from cardiac spatiotemporal image correlation (STIC) volume datasets.

A Clinical Approach to Semiautomated Three-Dimensional Fetal Brain Biometry-Comparing the Strengths and Weaknesses of Two Diagnostic Tools: 5DCNS+ and SonoCNS.

(1) Objective: We aimed to evaluate the accuracy and efficacy of AI-assisted biometric measurements of the fetal central nervous system (CNS) by comparing two semiautomatic postprocessing tools. We further aimed to discuss the additional value of semiautomatically generated sagittal and coronal planes of the CNS. (2) Methods: Three-dimensional (3D) volumes were analyzed with two semiautomatic software tools, 5DCNS+™ and SonoCNS™.

How Automated Techniques Ease Functional Assessment of the Fetal Heart: Applicability of MPI+™ for Direct Quantification of the Modified Myocardial Performance Index.

(1) Objectives: In utero functional cardiac assessments using echocardiography have become increasingly important. The myocardial performance index (MPI, Tei index) is currently used to evaluate fetal cardiac anatomy, hemodynamics and function. An ultrasound examination is highly examiner-dependent, and training is of enormous significance in terms of proper application and subsequent interpretation.

Application of Semiautomatic Fetal Intelligent Navigation Echocardiography (FINE) in Twin Pregnancies: Half the Work or Twice the Effort?

Objective: To assess the performance of fetal intelligent navigation echocardiography (FINE, 5D Heart™) for automated volumetric investigation of the fetal heart in twin pregnancies.

Methods: Three hundred twenty-eight twin fetuses underwent fetal echocardiography in the second and third trimesters. Spatiotemporal image correlation (STIC) volumes were obtained for a volumetric investigation.

Primary ovarian leiomyoma: a rare ovarian tumour.

After performing laparoscopic unilateral adnexectomy in a 53-year-old woman for a rapidly grown unilateral adnexal mass, pathologists reported a primary ovarian leiomyoma with no genuine ovarian tissue. This rare diagnosis is found in less than 100 reports after systematic literature review, a greater number of asymptomatic ovarian leiomyomas can be expected. Thorough preoperative diagnostic measures are essential as rare cases of malignancy have been described.

Vascular Choroidal Alterations in Uncomplicated Third-Trimester Pregnancy.

(1) Purpose: To evaluate the anatomy and perfusion of choroidal substructures in third-trimester pregnant women using optical coherence tomography (OCT) and OCT angiography (OCTA) imaging. (2) Methods: In this cross-sectional study, women in their third trimester of uncomplicated pregnancy and non-pregnant age-matched women were recruited. Participants underwent enhanced depth imaging (EDI) OCT and OCTA.

Applicability of a semiautomated volumetric approach (5D CNS+™) for detailed antenatal reconstruction of abnormal fetal CNS anatomy.

Background: The aim of this study was to evaluate the accuracy and reliability of a semiautomated volumetric approach (5D CNS+™) when examining fetuses with an apparent abnormal anatomy of the central nervous system (CNS).

Methods: Stored 3D volumes extracted from a cohort of > 1.400 consecutive 2nd and 3rd trimester pregnancies (range 15-36 gestational weeks) were analyzed using the semiautomatic software tool 5D CNS+™, enabling detailed reconstruction of nine diagnostic planes of the fetal brain.

Maximal Reduction of STIC Acquisition Time for Volumetric Assessment of the Fetal Heart-Benefits and Limitations of Semiautomatic Fetal Intelligent Navigation Echocardiography (FINE) Static Mode.

(1) Objective: To scrutinize the reliability and the clinical value of routinely used fetal intelligent navigation echocardiography (FINE) static mode (5DHeartStatic™) for accelerated semiautomatic volumetric assessment of the normal fetal heart. (2) Methods: In this study, a total of 296 second and third trimester fetuses were examined by targeted ultrasound. Spatiotemporal image correlation (STIC) volumes of the fetal heart were acquired for further volumetric assessment.

[Pattern of opinions of young physicians in gynecology and obstetrics in northern Germany].

Background: The new generation of physicians has disruptive effects and also does not stop at the discipline of obstetrics and gynecology. The discourse is still focused on Generation Y (1980-1994). In order to offer a constructive working environment to the new generation, time is pressing.

: Obstetric Phantoms of Madame Du Coudray .

For 300 years now, obstetrics has drawn on the concept of simulation training to not only teach anatomy and physiology theoretically, but to literally infuse it practically. In an 18 century scientific culture, which was predominantly patriarchal, the French royal midwife Angelique Marguerite Le Boursier du Coudray excelled in this field. Using , one of the first obstetric phantoms, she taught thousands of midwives and even physicians.

Lennart Nilsson (1922-2017) - Pioneer of embryo photography and his work .

'Making the invisible visible' is a requirement of a coveted prize for scientific photography - the - which is named after the pioneer of human embryo photography. There is no way of avoiding his influence if the hitherto invisible is to be made visible, the intangible almost tangible, the unimaginable made imaginable, and mysteries otherwise hidden from the human eye are to be processed in a popular-scientific way and visualized in an artistic way by means of scientific-medical imaging techniques. Whilst Lennart Nilsson used state-of-the-art imaging technology within the rapidly evolving field of endoscopy, he also created what is probably the best-selling illustrated book of all times with contributing to both the further understanding of early prenatal development, as well as achieving worldwide popularity.

The Use of Artificial Intelligence in Automation in the Fields of Gynaecology and Obstetrics - an Assessment of the State of Play.

The long-awaited progress in digitalisation is generating huge amounts of medical data every day, and manual analysis and targeted, patient-oriented evaluation of this data is becoming increasingly difficult or even infeasible. This state of affairs and the associated, increasingly complex requirements for individualised precision medicine underline the need for modern software solutions and algorithms across the entire healthcare system. The utilisation of state-of-the-art equipment and techniques in almost all areas of medicine over the past few years has now indeed enabled automation processes to enter - at least in part - into routine clinical practice.

Presence of Cervical Vertebral Anomalies with Concomitant Non-Communicating Hydrocephalus and Multicystic Kidney in a Female Fetus: Where VACTERL-H Meets MURCS.

Background: Congenital multisystemic lesions with co-occurrence of non-random malformations, such as VACTERL-H or MURCS association, often pose serious threads to the newborn and still constitute an antenatal diagnostic dilemma.

Case Report: A malformed fetus with VACTERL-H association at 20 gestational weeks had a skin-covered neural tube defect (NTD) of the lower cervical spine, concomitant hydrocephalus, as well as unilateral multicystic dysplastic kidney and the suspicion of mullerian duct anomaly as potentially assigned to MURCS association.

Discussion/conclusion: We were able to demonstrate how well-defined, standardized volumetric reconstruction of diagnostic views displaying fetal pathology might aid early and precise diagnosis of multi-organ malformations.

Lymphangioma of the fetal neck within the PIK3CA-related-overgrowth spectrum (PROS): A case report.

The delineation of the prenatal diagnostic key features of PIK3CA-related overgrowth spectrum disorders will assume a crucial part in future and a prenatal diagnosis of the causing mutations would provide physicians with a simplified interdisciplinary perinatal management.

Semiautomatic Assessment of Fetal Fractional Limb Volume for Weight Prediction in Clinical Praxis: How Does It Perform in Routine Use?

Objectives: Semiautomatic fractional limb volume (FLV) models have recently produced promising results for fetal birth weight (BW) estimation. We tested those models in a more unselected population hypothesizing that the FLV models would improve accuracy and precision of fetal BW estimation compared to the Hadlock model.

Methods: We compared the performance of different BW prediction models: Hadlock (biparietal diameter [BPD], abdominal circumference (AC), femur diaphysis length) and modified Lee thigh volume (TVol) and arm volume (AVol) (BPD, AC, automated fractional TVol, and AVol).

Feasibility of Semiautomatic Fetal Intelligent Navigation Echocardiography for Different Fetal Spine Positions: A Matter of "Time"?

Objectives: We investigated the feasibility of a semiautomatic approach for assessments of the fetal heart (fetal intelligent navigation echocardiography [FINE]) in cases of optimal and unfavorable fetal spine positions.

Methods: In this study, a total of 1693 spatiotemporal image correlation volumes of first-, second-, and third-trimester fetuses were evaluated by experts using the FINE approach. The data were analyzed regarding proper reconstruction of the diagnostic cardiac planes depending on the fetal spine position.

Validation of a semiautomated volumetric approach for fetal neurosonography using 5DCNS+ in clinical data from > 1100 consecutive pregnancies.

Objective: The aim of this study was to evaluate the validity of a semiautomated volumetric approach (5DCNS+) for the detailed assessment of the fetal brain in a clinical setting.

Methods: Stored 3D volumes of > 1100 consecutive 2nd and 3rd trimester pregnancies (range 15-36 gestational weeks) were analyzed using a workflow-based volumetric approach 5DCNS+, enabling semiautomated reconstruction of diagnostic planes of the fetal central nervous system (CNS). All 3D data sets were examined for plane accuracy, the need for manual adjustment, and fetal-maternal characteristics affecting successful plane reconstruction.

Semiautomatic Fetal Intelligent Navigation Echocardiography Has the Potential to Aid Cardiac Evaluations Even in Less Experienced Hands.

Objectives: To investigate the interobserver and intraobserver variability and corresponding learning curve in a semiautomatic approach for a standardized assessment of the fetal heart (fetal intelligent navigation echocardiography [FINE]).

Methods: A total of 30 stored spatiotemporal image correlation volume data sets of second-trimester fetuses were evaluated by 3 physicians with different levels of expertise in fetal echocardiography by using the FINE approach. Data were analyzed regarding the examination time and proper reconstruction of the diagnostic cardiac planes.

Neural Tube Defects in Embryonic Life: Lessons Learned From 340 Early Pregnancy Failures.

Objectives: The aim of this study was to evaluate the feasibility of sonographic assessment of the embryonic/fetal neural tube in nonviable pregnancies and to determine the defect incidence.

Methods: Prospective analysis of transvaginally acquired 3-dimensional (3D) multiplanar and 3D surface-rendered volume sets of 340 cases of missed abortion between March 2010 and September 2015 was performed. Data regarding karyotype and postmortem examination as well as demographic features and the outcomes of subsequent pregnancies were evaluated.

Confirmation of etiology in fetal hydrops by sonographic evaluation of fluid allocation patterns.

Objective: To evaluate patterns of fluid allocations in different etiologies of hydrops fetalis.

Study Design: This report is a retrospective cohort study on 20,395 fetal sonographic evaluations in a single tertiary center from 2000 to 2014. Special emphasis was placed on the exact description of the distinct fluid allocation sites in each fetus.