B. Tutschek

Intrapartum translabial ultrasound (ITU): sonographic landmarks and correlation with successful vacuum extraction

Having studied intrapartum translabial ultrasound (ITU) to define easily obtainable sonographic criteria during maternal pushing, we used it dynamically immediately before vacuum extraction to determine its use in predicting successful operative vaginal delivery.

Prenatal sonographic diagnosis of skeletal dysplasias

To assess the types and numbers of cases, gestational age at specific prenatal diagnosis and diagnostic accuracy of the diagnosis of skeletal dysplasias in a prenatal population from a single tertiary center.

A study of progress of labour using intrapartum translabial ultrasound, assessing head station, direction, and angle of descent.

Please cite this paper as: Tutschek B, Braun T, Chantraine F, Henrich W. A study of progress of labour using intrapartum translabial ultrasound, assessing head station, direction, and angle of descent. BJOG 2011;118:62–69.

Diffusion-weighted MR Imaging of the Placenta in Fetuses with Placental Insufficiency

PURPOSE To evaluate diffusion-weighted magnetic resonance (MR) imaging of the human placenta in fetuses with and fetuses without intrauterine growth restriction (IUGR) who were suspected of having placental insufficiency. MATERIALS AND METHODS The study was approved by the local ethics committee, and written informed consent was obtained. The authors retrospectively evaluated 1.5-T fetal MR images from 102 singleton pregnancies (mean gestation ± standard deviation, 29 weeks ± 5; range, 21-41 weeks). Morphologic and diffusion-weighted MR imaging were performed. A region of interest analysis of the apparent diffusion coefficient (ADC) of the placenta was independently performed by two observers who were blinded to clinical data and outcome. Placental insufficiency was diagnosed if flattening of the growth curve was detected at obstetric ultrasonography (US), if the birth weight was in the 10th percentile or less, or if fetal weight estimated with US was below the 10th percentile. Abnormal findings at Doppler US of the umbilical artery and histopathologic examination of specimens from the placenta were recorded. The ADCs in fetuses with placental insufficiency were compared with those in fetuses of the same gestational age without placental insufficiency and tested for normal distribution. The t tests and Pearson correlation coefficients were used to compare these results at 5% levels of significance. RESULTS Thirty-three of the 102 pregnancies were ultimately categorized as having an insufficient placenta. MR imaging depicted morphologic changes (eg, infarction or bleeding) in 27 fetuses. Placental dysfunction was suspected in 33 fetuses at diffusion-weighted imaging (mean ADC, 146.4 sec/mm(2) ± 10.63 for fetuses with placental insufficiency vs 177.1 sec/mm(2) ± 18.90 for fetuses without placental insufficiency; P < .01, with one false-positive case). The use of diffusion-weighted imaging in addition to US increased sensitivity for the detection of placental insufficiency from 73% to 100%, increased accuracy from 91% to 99%, and preserved specificity at 99%. CONCLUSION Placental dysfunction associated with growth restriction is associated with restricted diffusion and reduced ADC. A decreased ADC used as an early marker of placental damage might be indicative of pregnancy complications such as IUGR. SUPPLEMENTAL MATERIAL http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10092283/-/DC1.

Comparison between ultrasound parameters and clinical examination to assess fetal head station in labor.

Several ultrasound parameters, including intrapartum transperineal ultrasound (ITU) head station, angle of progression (AOP), head–perineum distance (HPD) and head‐symphysis distance (HSD), have been suggested to assess fetal head station during labor. The aim of this study was to analyze the relationship between these ultrasound parameters and to compare them with digital palpation.

Fetal tissue Doppler echocardiography: detection rates of cardiac structures and quantitative assessment of the fetal heart

Tissue Doppler echocardiography (TDE) has been developed in adult cardiology, but only recently has it been applied to fetal heart studies. We implemented TDE on a high‐resolution ultrasound system used for prenatal scanning by changing the Doppler settings, but without specific TDE equipment, to study cardiac tissue motion of normal fetuses in the second and third trimesters.

Proposal for standardized ultrasound descriptors of abnormally invasive placenta (AIP)

*The Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford, UK; †The Fetal Medicine Unit, John Radcliffe Hospital, Oxford, UK; ‡Department of Obstetrics and Division of Experimental Obstetrics, Study Group Perinatal Programming, Charité Campus Virchow, Berlin, Germany; §Department of Obstetrics and Gynecology, General Faculty Hospital, Charles University, Prague, Czech Republic; ¶Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; **Centre Hospitalier Régional Universitaire de Nancy, Université de Lorraine, Nancy, France; ††Fetomaternal Medical Center, Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; ‡‡Prenatal Zürich, Zürich, Switzerland; §§Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; ¶¶University of Liège, CHR de la Citadelle, Liège, Belgium *Correspondence. (e-mail: sally.collins@obs-gyn.ox.ac.uk)

Semi‐automatic segmentation of fetal cardiac cavities: progress towards an automated fetal echocardiogram

To develop a novel application of a tool for semi‐automatic volume segmentation and adapt it for analysis of fetal cardiac cavities and vessels from heart volume datasets.

Expression Analyses of Epidermal Growth Factor Receptor and HER-2/neu: No Advantage of Prediction of Recurrence or Survival in Breast Cancer Patients

The overexpression of two members of the erbB oncogene family-the epidermal growth factor receptor protein (EGF-R) and the HER-2/neu protein-in breast cancer has been investigated by numerous authors. Their exact role in breast cancer is still not defined. The simultaneous investigation of EGF-R and HER-2/neu in the same study population has only rarely been performed in breast cancer. Therefore, we analyzed the EGF-R and the HER-2/neu protein expression in 142 breast cancer specimens and 12 benign breast samples by immunohistochemistry. Results of the different expression analyses were compared with established clinicopathological parameters including estrogen and progesterone receptor status. In our study group EGF-R expression correlated with advanced tumor stage, axillary lymph node status and histological grade. HER-2/neu expression correlated with larger tumor size. Neither the evaluation of a single parameter of the erbB family nor the combination of both parameters showed a significant correlation with the disease-free and the overall survival of the individual patient with breast cancer. Only the expression of the progesterone receptor correlated with a better overall survival. Steroid hormone receptor expression and the expression of EGF-R and HER-2/ neu seem to be two independent phenomena in our samples of breast cancer. The simultaneous evaluation of EGF-R and HER-2/neu expression did not lead to new information of prognostic relevance.

Prenatal diagnosis of abnormally invasive placenta reduces maternal peripartum hemorrhage and morbidity

Abnormally invasive placenta (AIP) poses diagnostic and therapeutic challenges. We analyzed clinical cases with confirmed placenta increta or percreta.