In Vivo Demonstration of a Real-Time Temporal SNR Acoustic Output Adjustment Method.

This work proposes a novel method of temporal signal-to-noise ratio (SNR)-guided adaptive acoustic output adjustment and demonstrates this approach during in vivo fetal imaging. Acoustic output adjustment is currently the responsibility of sonographers, but ultrasound safety studies show recommended as low as reasonably achievable (ALARA) practices are inconsistently followed. This study explores an automated ALARA method that adjusts the mechanical index (MI) output, targeting imaging conditions matching the temporal noise perception threshold.

Human Observer Sensitivity to Temporal Noise During B-Mode Ultrasound Scanning: Characterization and Imaging Implications.

This work measures temporal signal-to-noise ratio (SNR) thresholds that indicate when random noise during ultrasound scanning becomes imperceptible to expert human observers. Visible noise compromises image quality and can potentially lead to non-diagnostic scans. Noise can arise from both stable acoustic sources (clutter) or randomly varying electronic sources (temporal noise).

Validation of a sonographic checklist for the detection of histologic placenta accreta spectrum.

Background: To standardize research terminology and to reduce unanticipated placenta accreta spectrum, the European Working Group for Abnormally Invasive Placenta developed a consensus checklist for reporting suspected placenta accreta spectrum observed during an antenatal ultrasound. The diagnostic accuracy of the European Working Group for Abnormally Invasive Placenta checklist has not been assessed.

Objective: This study aimed to test the performance of the European Working Group for Abnormally Invasive Placenta sonographic checklist in predicting histologic placenta accreta spectrum.

An Automated Region-Selection Method for Adaptive ALARA Ultrasound Imaging.

The objective of this work was to develop an automated region of the interest selection method to use for adaptive imaging. The as low as reasonably achievable (ALARA) principle is the recommended framework for setting the output level of diagnostic ultrasound devices, but studies suggest that it is not broadly observed. One way to address this would be to adjust output settings automatically based on image quality feedback, but a missing link is determining how and where to interrogate the image quality.

A prospective blinded comparison of second trimester fetal measurements by expert and novice readers using low-cost novice-acquired 3D volumetric ultrasound.

Rationale And Objectives: Two-dimensional (2D) ultrasound (US) is operator dependent, requiring operator skill and experience to selectively identify and record planes of interest for subsequent interpretation. This limits the utility of US in settings in which expert sonographers are unavailable. Three-dimensional (3D) US acquisition of an anatomic target, which enables reconstruction of any plane through the acquired volume, might reduce operator dependence by providing any desired image plane for interpretation, without identification of target planes of interest at the time of acquisition.

Multidisciplinary approach to manage antenatally suspected placenta percreta: updated algorithm and patient outcomes.

Background: Due to the significant morbidity and mortality associated with placenta percreta, alternative management options are needed. Beginning in 2005, our institution implemented a multidisciplinary strategy to patients with suspected placenta percreta. The purpose of this study is to present our current strategy, maternal morbidity and outcomes of patients treated by our approach.

Medical and surgical treatment of placenta percreta to optimize bladder preservation.

Background: Placenta percreta is associated with significant morbidity and mortality. Interventions are dictated by hemodynamic stability, desire to retain future fertility, and efforts to reduce surgical morbidity at time of delivery.

Cases: Two cases of antenatally diagnosed placenta percreta with bladder invasion are presented.

Preterm premature rupture of membrane management--inpatient versus outpatient: a retrospective review.

The purpose of this study was to evaluate the outcome of patients with preterm premature rupture of membranes (PPROM) managed as inpatients who would have been candidates for outpatient management by prior published criteria. A retrospective review of medical records of PPROM subjects enrolled in a prospective cohort study was performed. Similar criteria to those established in a randomized trial for home management of PPROM by Carlan et al were applied.

First trimester screening.

Screening for aneuploidy has traditionally been reserved for women of advanced maternal age. More recent advances in serum screening and ultrasound technology have allowed women of all ages to be offered screening in the second and even first trimester. These methods and their effectiveness are discussed.

Prenatal diagnosis of a trauma-related fetal epidural hematoma.

Background: Prenatal diagnosis of fetal intracranial hemorrhage has important etiologic, management, and prognostic implications. Ultrasonography and magnetic resonance imaging (MRI) have been used to identify and evaluate this condition. We present the first reported case of epidural hematoma diagnosed prenatally.