Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
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Ultrasound Obstet Gynecol · Oct 2008
Case ReportsUltrasonographic visualization of balloon placement for uterine tamponade in massive primary postpartum hemorrhage.
This case report is the first documentation of ultrasonographic confirmation of positioning of a Sengstaken-Blakemore balloon catheter (SBEC) in the management of massive postpartum hemorrhage. The sonongraphic position, while incorrect according to conventional use of uterine balloon catheters, raises the possibility of an alternative mechanism of action of the balloon: not uterine cavity tamponade but hydrostatic pressure directly around the uterine arteries, a mechanism akin to mechanical uterine artery embolization or ligation. If this hypothesis is correct, it not only elucidates how balloon tamponade works but also challenges current thinking on how postpartum hemorrhage should be managed effectively. Future studies are required to corroborate this hypothesis and we believe that sonographic confirmation of balloon catheter location should be an integral part of uterine balloon tamponade in women with massive primary postpartum hemorrhage.
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Ultrasound Obstet Gynecol · Oct 2008
Multicenter StudyPrenatal prediction of survival in isolated diaphragmatic hernia using observed to expected total fetal lung volume determined by magnetic resonance imaging based on either gestational age or fetal body volume.
To compare the predictive value of the prenatal observed to expected (o/e) lung volume as measured by fetal magnetic resonance imaging (MRI), based on an algorithm using either the gestational age or fetal body volume (FBV), for neonatal survival of fetuses with isolated congenital diaphragmatic hernia (CDH). ⋯ In fetuses with isolated CDH, lung volume as measured by fetal MRI was significantly correlated with survival. Prediction tended to be better by o/e TFLV based on FBV rather than gestational age. The difference in the prediction of survival between o/e TFLV based on FBV or gestational age was dependent on fetal biometry.
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Ultrasound Obstet Gynecol · Oct 2008
Multicenter StudyQuantification of intrathoracic liver herniation by magnetic resonance imaging and prediction of postnatal survival in fetuses with congenital diaphragmatic hernia.
To quantify the degree of intrathoracic liver herniation by magnetic resonance imaging (MRI) and evaluate its effect on postnatal survival in fetuses with isolated congenital diaphragmatic hernia (CDH). ⋯ In expectantly managed CDH fetuses, assessment of LiTR using MRI provided prediction of postnatal survival independently from o/e TFLV.
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Ultrasound Obstet Gynecol · Oct 2008
Comparative StudyMaternal cardiac function in normotensive and pre-eclamptic intrauterine growth restriction.
To compare maternal cardiac function between pregnancies complicated by normotensive and pre-eclamptic intrauterine growth restriction (IUGR). ⋯ In normotensive IUGR and pre-eclamptic IUGR there is a similar alteration in maternal left ventricular systolic function, but there is greater impairment in maternal diastolic function in pre-eclamptic IUGR.