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Journal: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology

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Measurement of endometrial thickness is an important tool in the assessment of women with postmenopausal bleeding, but the role of endometrial thickness measurement by ultrasound in asymptomatic women is unclear. The aims of this study were to determine: (1) the normal endometrial thickness measured by ultrasonography, (2) the prevalence of serious endometrial pathology and (3) the sensitivity and specificity of endometrial thickness measurement by transvaginal ultrasonography (TVS) for diagnosing premalignant and malignant endometrial disease in asymptomatic postmenopausal women.

Concepts: Cancer, Sensitivity and specificity, Endometrial cancer

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To test the hypothesis that the performance of first-trimester screening for pre-eclampsia (PE) by a method that uses Bayes' theorem to combine maternal factors with biomarkers is superior to that defined by current National Institute for Health and Care Excellence (NICE) guidelines.

Concepts: Bayes' theorem

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There is no consensus in current practice guidelines whether IVF/ICSI conception represents an indication for performing a fetal echocardiogram. The aim of the study is to assess whether CHD occurs more often with the use of in-vitro-fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) techniques as compared to spontaneous pregnancies.

Concepts: Pregnancy, Fetus, Fertility, Congenital heart defect, Congenital heart disease

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To review clinical validation or implementation studies of maternal blood cell-free (cf) DNA analysis and define the performance of screening for fetal trisomies 21, 18 and 13 and sex chromosome aneuploidies.

Concepts: DNA, Gene, Cancer, Eukaryote, Chromosome, Cytogenetics, Meiosis, Aneuploidy

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The majority of patients with chronic or gestational hypertension do not develop pre-eclampsia. Home blood-pressure monitoring (HBPM) has the potential to offer a more accurate and acceptable means of monitoring hypertensive patients during pregnancy compared with traditional pathways of frequent outpatient monitoring. The aim of this study was to determine whether HBPM reduces visits to antenatal services and is safe in pregnancy.

Concepts: Pregnancy, Hypertension, Prenatal development, Blood pressure, Obstetrics, Gestational age

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Objective: A meta-analysis was performed to summarize the accumulated data on the screening performance of second-trimester sonographic markers for fetal trisomy 21. Methods: We conducted a literature search to identify 47 studies between 1995 and September 2012 that provided data on the incidence of sonographic markers in trisomy 21 and euploid fetuses at 14-24 weeks' gestation. Weighted independent estimations of detection rate, false positive rate, positive and negative likelihood ratios (LR) of markers were calculated. Results: The pooled estimates of positive and negative LR 5.85 (95% CI 5.04-6.80) and 0.80 (95% CI 0.75-0.86) for intracardiac echogenic focus, 25.78 (95% CI 12.85-51.73) and 0.94 (95% CI 0.91-0.98) for ventriculomegaly, 19.18 (95% CI 11.55-31.84) and 0.80 (95% CI 0.75-0.86) for increased nuchal fold, 10.82 (95% CI 8.43-13.72) and 0.90 (95% CI 0.86-0.94) for hyperechogenic bowel, 7.77 (95% CI 6.22-9.71) and 0.92 (95% CI 0.89-0.96) for mild hydronephrosis, 3.72 (95% CI 2.79-4.97) and 0.80 (95% CI 0.73-0.88) for short femur, 4.81 (95% CI 3.49-6.62) and 0.74 (95% CI 0.63-0.88) for short humerus, 21.48 (95% CI 11.48-40.19) and 0.71 (95% CI 0.57-0.88) for ARSA and 23.26 (95% CI 14.23-38.03) and 0.46 (95% CI 0.36-0.58) for absent or hypoplastic nasal bone. The combined negative LR, by multiplying the values of individual markers, was 0.13 (95% CI 0.05-0.29) when short femur but not short humerus was included and 0.12 (95% CI 0.06-0.29) when short humerus but not short femur was included. Conclusion: Presence of sonographic markers increases and absence decreases the risk for trisomy 21. In the case of most isolated markers there is only a small effect on modifying the pre-test odds for trisomy 21, but with ventriculomegaly, nuchal fold thickness and ARSA there is a 3-4 fold increase in risk and with hypoplastic nasal bone a 6-7 fold increase. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

Concepts: Fetus, Type I and type II errors, John Wiley & Sons, Nasal bone, Absenteeism, Likelihood-ratio test

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Perineal cysts are quite frequent, almost 2% of women developing symptoms related to Bartholin or Gartner cysts. In most cases these cysts derive from embryological remnants or ectopic tissue, or form as epithelial inclusion cysts. These structures are usually asymptomatic unless they are complicated by infection. We report the sonographic and magnetic resonance imaging characteristics of a large perineal cyst diagnosed during the first trimester of an uncomplicated pregnancy, followed by conservative management during pregnancy and surgical excision in the puerperium. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

Concepts: Childbirth, Surgery, Nuclear magnetic resonance, Magnetic resonance imaging, Antiseptic, Excision, Bartholin's cyst

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