Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
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Ultrasound Obstet Gynecol · Nov 2011
Multicenter StudyGestational sac and embryonic growth are not useful as criteria to define miscarriage: a multicenter observational study.
We studied changes in mean gestational sac diameter (MSD) and embryonic crown-rump length (CRL) in intrauterine pregnancies of uncertain viability (IPUVs). We aimed to establish cut-off values for MSD and CRL growth that could be definitively associated with either viability or miscarriage, and to establish the relationship between growth in MSD and appearance of embryonic structures in the gestational sac. ⋯ There is an overlap in MSD growth rates between viable and non-viable IPUV. No cut-off exists for MSD growth below which a viable pregnancy could be safely excluded. A cut-off value for CRL growth of 0.2 mm/day was always associated with miscarriage. These data suggest that criteria to diagnose miscarriage based on growth in MSD and CRL are potentially unsafe. However, finding an empty gestational sac on two scans more than 7 days apart is highly likely to indicate miscarriage, irrespective of growth.
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Ultrasound Obstet Gynecol · Nov 2011
Maternal cardiac function in complicated twin pregnancy: a longitudinal study.
To evaluate longitudinally a cohort of twin pregnancies and to assess whether the occurrence of adverse pregnancy outcome may be related to specific maternal cardiac findings. ⋯ Maternal cardiac function in twin pregnancies complicated by pre-eclampsia or SGA neonates apparently does not undergo the profound longitudinal changes that occur in uneventful twin pregnancies.
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Ultrasound Obstet Gynecol · Oct 2011
Adnexal masses difficult to classify as benign or malignant using subjective assessment of gray-scale and Doppler ultrasound findings: logistic regression models do not help.
To develop a logistic regression model that can discriminate between benign and malignant adnexal masses perceived to be difficult to classify by subjective evaluation of gray-scale and Doppler ultrasound findings (subjective assessment) and to compare its diagnostic performance with that of subjective assessment, serum CA 125 and the risk of malignancy index (RMI). ⋯ About 7% of adnexal masses that are considered appropriate for surgical removal cannot be classified as benign or malignant by experienced ultrasound examiners using subjective assessment. Logistic regression models to estimate the risk of malignancy, CA 125 measurements and the RMI are not helpful in these masses.
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Ultrasound Obstet Gynecol · Sep 2011
Randomized Controlled Trial Meta AnalysisVaginal micronized progesterone and risk of preterm delivery in high-risk twin pregnancies: secondary analysis of a placebo-controlled randomized trial and meta-analysis.
Progesterone treatment reduces the risk of preterm delivery in high-risk singleton pregnancies. Our aim was to evaluate the preventive effect of vaginal progesterone in high-risk twins. ⋯ In high-risk twin pregnancies, progesterone treatment does not significantly improve outcome.