Uterine fibroids and non-informative cell-free DNA screening results.

Objective: Uterine fibroids are monoclonal tumors, which are often genetically abnormal and associated with false-positive genome-wide cell-free DNA (cfDNA) screening results, particularly when large. It is plausible that fibroids may also increase the risk of cfDNA failure by affecting fetal fraction or due to their genetic anomalies confounding cfDNA algorithms. We aimed to investigate a possible association between fibroids and cfDNA non-informative results.

First-trimester ventriculomegaly in fetuses with callosal agenesis: Cause or association?

The sonographic findings in four fetuses presenting with ventriculomegaly at first-trimester ultrasound that were subsequently diagnosed as having agenesis of the corpus callosum (ACC) are described. The diagnosis of early ventriculomegaly was suspected subjectively by identification of increased cerebrospinal fluid within the lateral ventricles and confirmed by measuring choroid plexus-to-lateral ventricle length and area ratios. Subsequent scans revealed complete ACC in two cases and partial ACC in the other two.

Ultrasound findings and detection of fetal abnormalities before 11 weeks of gestation.

Objective: To determine the proportion of major fetal structural abnormalities that can be detected before 11 gestational weeks.

Methods: We conducted a retrospective study of individual patient files at a tertiary provider of obstetric and gynecological ultrasound in Melbourne, Australia. All women who had a pre-cell-free DNA ultrasound with a crown-rump length of less than 45 mm and had one or more ultrasounds at a later gestation were included in the analysis.

Outcomes following the detection of fetal edema in early pregnancy prior to non-invasive prenatal testing.

Objective: To investigate the incidence of structural and chromosomal abnormalities in cases of fetal edema on early ultrasound prior to non-invasive prenatal testing (NIPT).

Methods: A retrospective study of women undergoing pre-NIPT ultrasound with fetal crown-rump length (CRL) of 28 to 44 mm was conducted at a tertiary obstetric ultrasound clinic in Melbourne, Australia. Cases of reported fetal edema were included, and subclassified as isolated nuchal edema (>2.

The importance of ultrasound preceding cell-free DNA screening for fetal chromosomal abnormalities.

Objective: This study aims to determine the incidence of ultrasound findings that may change clinical management on the day of blood-sampling for cell-free DNA (cfDNA) screening.

Methods: A retrospective study was conducted at a tertiary provider of obstetric and gynecological ultrasound in Melbourne, Australia. Individual patient files were reviewed and results were collated for maternal characteristics, pre-cfDNA ultrasound reports, results and test characteristics of both cfDNA and diagnostic testing, and genetic counselling notes.

Ultrasound Appearances of the Acrania-Anencephaly Sequence at 10 to 14 Weeks' Gestation.

Objectives: The acrania-anencephaly sequence is a lethal condition with a high detection rate in experienced hands after 10 weeks' gestation. However, earlier in gestation, many cases remain undetected. Different phenotypic appearances have been described and might help increase the detection rate in less experienced hands and also earlier in gestation.

Cranial sonographic markers of fetal open spina bifida at 11 to 13 weeks of gestation.

Objectives: To compare the sonographic signs of spina bifida obtained on axial and sagittal views of the fetal head between 11 and 13+6 weeks of gestation.

Methods: This was a retrospective study including 27 cases of spina bifida and 1003 randomly selected controls. Indirect markers of spina bifida were evaluated on stored ultrasound images.

The gap between the aorta and the superior vena cava: A sonographic sign of persistent left superior vena cava and associated abnormalities.

Objectives: To assess the distance between the right superior vena cava (SVC) and the aorta in fetuses with bilateral superior vena cava as a possible sonographic marker for this.

Methods: This was a nested case-control study including 20 cases of bilateral SVC and 40 gestational age-matched controls. The distance between the right SVC and the aorta was measured at the level of the three-vessel trachea view in stored images, as well as the diameters of the aorta and the right SVC.

How to perform a sonographic morphological assessment of the fetus at 11-14 weeks of gestation.

Introduction: First-trimester ultrasound is widely accepted as part of standard care in many countries. With improvements in equipment, expertise and increasing number of technical studies describing imaging techniques, the detection rate for major fetal anomalies in the first trimester continues to rise and can be as high as 60% in high-risk populations.

Methods: We set out to create a systematic pictorial guide for trained ultrasound providers to describe the common anatomical structures that are identifiable in the first trimester with provided images.

Guidelines for the performance of the first trimester ultrasound.

The purpose of this document is to guide ultrasound practitioners in providing accurate information on the assessment of gestational age, viability and fetal development in the first trimester. In the presence of twins and higher order multiple pregnancies, it is also intended to assess chorionicity and amnionicity which have implications for risk assessment and continuing antenatal care. This guideline has been adopted by the ASUM Council and is applicable to all ultrasound practitioners.

Maxillo-occipital line: a sonographic marker for screening of open spina bifida in the first trimester of pregnancy.

To describe a new first-trimester sonographic landmark the maxillo-occipital line which may be useful for early screening of open spina bifida. Maxillo-occipital line was prospectively evaluated in 100 low-risk pregnancies at the time of first-trimester sonographic screening examination between 11 and 13 + 6 weeks' gestation. All the pregnant women subsequently had a normal second-trimester scan and normal outcomes.

Comparison of management regimens following ultrasound diagnosis of nontubal ectopic pregnancies: a retrospective cohort study.

Objective: To review management options for nontubal ectopic pregnancies.

Design: Retrospective cohort study.

Setting: Tertiary hospital in Melbourne, Australia.

Three-dimensional imaging of the uterus: The value of the coronal plane.

Advent in three-dimensional (3D) imaging technology has seen 3D ultrasound establish itself as a useful adjunct complementary to traditional two-dimensional imaging of the female pelvis. This advantage largely arises from its ability to reconstruct the coronal plane of the uterus, which allows further delineation of many gynecological disorders. 3D imaging of the uterus is now the preferred imaging modality for assessing congenital uterine anomalies and intrauterine device localization.

Factors influencing access to psychiatric treatment in persons with schizophrenia: A qualitative study in a rural community.

Purpose: In low and middle-income countries, about 80% of those who need mental health services do not receive them. Reasons for this have not been systematically studied. In this qualitative study, we explored this issue in a rural community of South India among schizophrenia patients.

Schedule of factors influencing access to psychiatric treatment in persons with schizophrenia: validity and pilot testing.

Background: A substantial proportion of patients with severe mental disorders remain untreated in India. Qualitative research has highlighted the complex interplay of multiple factors that preclude schizophrenia patients in rural Indian settings from accessing treatment.

Aims: (a) To establish the face and content validities of an interview schedule titled "Schedule of Factors Influencing Access (SOFIAc) to Psychiatric Treatment in Persons with Schizophrenia", which comprehensively assesses the factors that prevent schizophrenia patients from accessing psychiatric treatment.