Wiley
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Cơ quản chủ quản: John Wiley and Sons Ltd , WILEY
Lĩnh vực:
Medicine (miscellaneous)Reproductive MedicineRadiology, Nuclear Medicine and ImagingObstetrics and GynecologyRadiological and Ultrasound Technology
Các bài báo tiêu biểu
Applying the right statistics: analyses of measurement studies Abstract The study of measurement error, observer variation and agreement between different methods of measurement are frequent topics in the imaging literature. We describe the problems of some applications of correlation and regression methods to these studies, using recent examples from this literature. We use a simulated example to show how these problems and misinterpretations arise. We describe the 95% limits of agreement approach and a similar, appropriate, regression technique. We discuss the difference vs. mean plot, and the pitfalls of plotting difference against one variable only. We stress that these are questions of estimation, not significance tests, and show how confidence intervals can be found for these estimates. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Tập 22 Số 1 - Trang 85-93 - 2003
Reliability, repeatability and reproducibility: analysis of measurement errors in continuous variables
Tập 31 Số 4 - Trang 466-475 - 2008
Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group
Tập 48 Số 3 - Trang 318-332 - 2016
Cesarean scar pregnancy: issues in management Abstract Objective To evaluate our experience with the diagnosis and treatment of Cesarean scar pregnancy. Methods During a 6‐year period, 12 cases of Cesarean scar pregnancy were diagnosed using transvaginal color Doppler sonography and treated conservatively to preserve fertility. Incidence, gestational age, sonographic findings, β ‐human chorionic gonadotropin ( β ‐hCG) levels, flow profiles of transvaginal color Doppler ultrasound, and methods of treatment were recorded. Results The incidence of Cesarean scar pregnancy was 1:2216 and its rate was 6.1% in women with an ectopic pregnancy and at least one previous Cesarean section. Gestational age at diagnosis ranged from 5 + 0 to 12 + 4 weeks. The time interval from the last Cesarean section to the diagnosis of Cesarean scar pregnancy ranged from 6 months to 12 years. High‐velocity and low‐impedance subtrophoblastic flow (resistance index, 0.38) persisted until β ‐hCG declined to normal. Patients were treated as follows: transvaginal ultrasound‐guided injection of methotrexate into the embryo or gestational sac (n = 3), transabdominal ultrasound‐guided injection of methotrexate (n = 2), transabdominal ultrasound‐guided injection of methotrexate followed by systemic methotrexate administration (n = 2), systemic methotrexate administration alone (n = 2), dilatation and curettage (n = 2), or local resection of the gestation mass (n = 1). Eleven of the 12 patients preserved their reproductive capacity; the remaining patient, treated by dilatation and curettage, underwent a hysterectomy because of profuse vaginal bleeding. The Cesarean scar mass regressed from 2 months to as long as 1 year after treatment. Uterine rupture occurred in one patient during the following pregnancy at 38 + 3 weeks' gestational age. Conclusion Ultrasound‐guided methotrexate injection emerges as the treatment of choice to terminate Cesarean scar pregnancy. Surgical or invasive techniques, including dilatation and curettage are not recommended for Cesarean scar pregnancy due to high morbidity and poor prognosis. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.
Tập 23 Số 3 - Trang 247-253 - 2004
A screening program for trisomy 21 at 10–14 weeks using fetal nuchal translucency, maternal serum free β‐human chorionic gonadotropin and pregnancy‐associated plasma protein‐A Abstract Objective To examine the potential impact of combining maternal age with fetal nuchal translucency thickness and maternal serum free β‐human chorionic gonadotropin (β‐hCG) and pregnancy‐associated plasma protein‐A (PAPP‐A) in screening for trisomy 21 at 10–14 weeks of gestation. Methods Maternal serum free β‐hCG and PAPP‐A were measured by Kryptor, a random access immunoassay analyzer using time‐resolved amplified cryptate emission, in 210 singleton pregnancies with trisomy 21 and 946 chromosomally normal controls, matched for maternal age, gestation and sample storage time. In all cases the fetal crown–rump length and nuchal translucency thickness had been measured by ultrasonography at 10–14 weeks of gestation and maternal blood had been obtained at the time of the scan. The distributions (in multiples of the median; MoM) of free β‐hCG and PAPP‐A (corrected for maternal weight) and fetal nuchal translucency (NT) were determined in the trisomy 21 group and the controls. Likelihood ratios for the various marker combinations were calculated and these were used together with the age‐related risk for trisomy 21 in the first trimester to calculate the expected detection rate of affected pregnancies, at a fixed false‐positive rate, in a population with the maternal age distribution of pregnancies in England and Wales. Results In a population with the maternal age distribution of pregnancies in England and Wales, it was estimated that, using the combination of maternal age, fetal nuchal translucency thickness and maternal serum free ß‐hCG and PAPP‐A, the detection of trisomy 21 pregnancies would be 89% at a fixed false‐positive rate of 5%. Alternatively, at a fixed detection rate of 70%, the false‐positive rate would be 1%. The inclusion of biochemical parameters added an additional 16% to the detection rate obtained using NT and maternal age alone. Conclusions Rapid diagnostic technology like Kryptor, which can provide automated reproducible biochemical measurements within 30 min of obtaining a blood sample, will allow the development of interdisciplinary one‐stop clinics for early fetal assessment. Such clinics will be able to deliver improved screening sensitivity, rapidly and more efficiently, leading to reduced patient anxiety and stress. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Tập 13 Số 4 - Trang 231-237 - 1999
Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group
Tập 46 Số 3 - Trang 284-298 - 2015
Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination’ and the ‘fetal neurosonogram’
Tập 29 Số 1 - Trang 109-116 - 2007
Perinatal morbidity and mortality in early‐onset fetal growth restriction: cohort outcomes of the trial of randomized umbilical and fetal flow in Europe (<scp>TRUFFLE</scp>) ABSTRACT Objectives Few data exist for counseling and perinatal management of women after an antenatal diagnosis of early‐onset fetal growth restriction. Yet, the consequences of preterm delivery and its attendant morbidity for both mother and baby are far reaching. The objective of this study was to describe perinatal morbidity and mortality following early‐onset fetal growth restriction based on time of antenatal diagnosis and delivery. Methods We report cohort outcomes for a prospective multicenter randomized management study of fetal growth restriction (Trial of Randomized Umbilical and Fetal Flow in Europe (TRUFFLE )) performed in 20 European perinatal centers between 2005 and 2010. Women with a singleton fetus at 26–32 weeks of gestation, with abdominal circumference < 10th percentile and umbilical artery Doppler pulsatility index > 95th percentile, were recruited. The main outcome measure was a composite of fetal or neonatal death or severe morbidity: survival to discharge with severe brain injury, bronchopulmonary dysplasia, proven neonatal sepsis or necrotizing enterocolitis. Results Five‐hundred and three of 542 eligible women formed the study group. Mean ± SD gestational age at diagnosis was 29 ± 1.6 weeks and mean ± SD estimated fetal weight was 881 ± 217 g; 12 (2.4%) babies died in utero . Gestational age at delivery was 30.7 ± 2.3 weeks, and birth weight was 1013 ± 321 g. Overall, 81% of deliveries were indicated by fetal condition and 97% were by Cesarean section. Of 491 liveborn babies, outcomes were available for 490 amongst whom there were 27 (5.5%) deaths and 118 (24%) babies suffered severe morbidity. These babies were smaller at birth (867 ± 251 g) and born earlier (29.6 ± 2.0 weeks). Death and severe morbidity were significantly related to gestational age, both at study entry and delivery and also with the presence of maternal hypertensive morbidity. The median time to delivery was 13 days for women without hypertension, 8 days for those with gestational hypertension, 4 days for pre‐eclampsia and 3 days for HELLP syndrome. Conclusions Fetal outcome in this study was better than expected from contemporary reports: perinatal death was uncommon (8%) and 70% survived without severe neonatal morbidity. The intervals to delivery, death and severe morbidity were related to the presence and severity of maternal hypertensive conditions. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.
Tập 42 Số 4 - Trang 400-408 - 2013
Maternal age and adverse pregnancy outcome: a cohort study ABSTRACT Objective To examine the association between maternal age and a wide range of adverse pregnancy outcomes after adjustment for confounding factors in obstetric history and maternal characteristics .Methods This was a retrospective study in women with singleton pregnancies attending the first routine hospital visit at 11 + 0 to 13 + 6 weeks' gestation. Data on maternal characteristics, and medical and obstetric history were collected and pregnancy outcomes ascertained. Maternal age was studied, both as a continuous and as a categorical variable. Regression analysis was performed to examine the association between maternal age and adverse pregnancy outcome including pre‐eclampsia, gestational hypertension, gestational diabetes mellitus (GDM ), preterm delivery, small‐for‐gestational age (SGA ) neonate, large‐for‐gestational age (LGA ) neonate, miscarriage, stillbirth and elective and emergency Cesarean section .Results The study population included 76 158 singleton pregnancies with a live fetus at 11 + 0 to 13 + 6 weeks. After adjusting for potential maternal and pregnancy confounding variables, advanced maternal age (defined as ≥ 40 years) was associated with increased risk of miscarriage (odds ratio (OR ), 2.32 (95% CI , 1.83–2.93) ; P < 0.001), pre‐eclampsia (OR , 1.49 (95% CI , 1.22–1.82) ; P < 0.001), GDM (OR , 1.88 (95% CI , 1.55–2.29) ; P < 0.001), SGA (OR , 1.46 (95% CI , 1.27–1.69) ; P < 0.001) and Cesarean section (OR , 1.95 (95% CI , 1.77–2.14) ; P < 0.001), but not with stillbirth, gestational hypertension, spontaneous preterm delivery or LGA .Conclusions Maternal age should be combined with other maternal characteristics and obstetric history when calculating an individualized adjusted risk for adverse pregnancy complications. Advanced maternal age is a risk factor for miscarriage, pre‐eclampsia, SGA , GDM and Cesarean section, but not for stillbirth, gestational hypertension, spontaneous preterm delivery or LGA . Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd .
Tập 42 Số 6 - Trang 634-643 - 2013
Prevention of perinatal death and adverse perinatal outcome using low‐dose aspirin: a meta‐analysis ABSTRACT Objective To compare early vs late administration of low‐dose aspirin on the risk of perinatal death and adverse perinatal outcome. Methods Databases were searched for keywords related to aspirin and pregnancy. Only randomized controlled trials that evaluated the prophylactic use of low‐dose aspirin (50–150 mg/day) during pregnancy were included. The primary outcome combined fetal and neonatal death. Pooled relative risks (RR ) with their 95% CIs were compared according to gestational age at initiation of low‐dose aspirin (≤ 16 vs > 16 weeks of gestation). Results Out of 8377 citations, 42 studies (27 222 women) were included. Inclusion criteria were risk factors for pre‐eclampsia, including: nulliparity, multiple pregnancy, chronic hypertension, cardiovascular or endocrine disease, prior gestational hypertension or fetal growth restriction, and/or abnormal uterine artery Doppler. When compared with controls, low‐dose aspirin started at ≤ 16 weeks' gestation compared with low‐dose aspirin started at >16 weeks' gestation was associated with a greater reduction of perinatal death (RR = 0.41 (95% CI , 0.19–0.92) vs 0.93 (95% CI , 0.73–1.19), P = 0.02), pre‐eclampsia (RR = 0.47 (95% CI , 0.36–0.62) vs 0.78 (95% CI , 0.61–0.99), P < 0.01), severe pre‐eclampsia (RR = 0.18 (95% CI , 0.08–0.41)
vs 0.65 (95% CI , 0.40–1.07), P < 0.01), fetal growth restriction (RR = 0.46 (95% CI , 0.33–0.64) vs 0.98 (95% CI , 0.88–1.08), P < 0.001) and preterm birth (RR = 0.35 (95% CI , 0.22–0.57) vs 0.90 (95% CI , 0.83–0.97), P < 0.001). Conclusion Low‐dose aspirin initiated at ≤ 16 weeks of gestation is associated with a greater reduction of perinatal death and other adverse perinatal outcomes than when initiated at >16 weeks. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.
Tập 41 Số 5 - Trang 491-499 - 2013