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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 102 (1995), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To evaluate the feasibility of measuring first trimester nuchal translucency in an unselected population, to assess the relationship with gestation and maternal age and to measure reproducibility.Design A prospective observational study.Setting University College Hospital, London.Subjects One thousand and four women attending for a routine first trimester dating scan between eight and thirteen weeks of gestation. Measurements of nuchal translucency were attempted in 1368 (80.-3%) and successful in 1127 (82% of attempts).Results Nuchal translucency is most easily measured at 11 weeks of gestation. If a cut-off of ≥ 3 mm is used, 6% of unselected fetuses between eight and thirteen weeks of gestation are classified as abnormal. Nuchal translucency increases with gestational but not maternal age. Reproducibility is poor: by repeating measurements with a different operator, the same operator using a different still image, or the same operator using the same still image, 18.8%, 173% or 12.4% of nuchal translucency measurements, respectively, change their classification as normal or abnormal.Conclusions If nuchal translucency ≥ 3 mm were used as an indication for karyotyping, 6% of the normal pregnant population would be screen positive. However, the percentage will vary greatly depending on the gestational age profile of the screened population. The poor reproducibility of nuchal translucency measurement could diminish its usefulness as a screening test for Down's syndrome.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 102 (1995), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To investigate first trimester nuchal translucency 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:14700328:BJO386:ges" location="ges.gif"/〉 3 mm as a screening test for aneuploidy in the normal pregnant population.Design A pilot observational study.Setting University College Hospital, London.Subjects One thousand one hundred and twenty-seven women had measurements of nuchal translucency at the time of their dating scan (8–13 weeks of gestation).Results Seventy fetuses (6%) had a nuchal translucency ≥ 3 mm. Five karyotypically abnormal fetuses were identified by standard routine techniques (three trisomy 21, two trisomy 18), all in high risk mothers (239 years). Only two had nuchal translucency ≥ 3 mm (one trisomy 21, one trisomy 18).Conclusions Although nuchal translucency measurement is feasible and promising, there is at present insufficient data to warrant its introduction for screening of the general population, or to replace traditional second trimester screening.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 103 (1996), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 99 (1992), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To review antenatal and intrapartum assessment of pregnancies complicated by gastroschisis.Design Retrospective descriptive study.Setting University College Hospital, London.Subjects 24 consecutive cases of gastroschisis between 1986 and 1991.Results The gestational age at sonographic diagnosis was 20.3 weeks (SD 6.77) and at birth was 36.5 weeks (SD 2.06). There were 21 live births, all with good surgical outcome. There were 16 vaginal deliveries and eight caesarean sections. The elective sections were for oligohydramnios and dilated bowel (1) and clinically suspected growth retardation (1); the intrapartum caesarean sections were for fetal distress (4) and premature breech presentation (2). There were six with dilated gut on ultrasound; one of these ended in a stillbirth. There was a significant association between gut dilatation and caesarean section for fetal distress (P= 0.004). There was also a significant association between meconium staining and fetal distress (P= 0.021). Of these babies, 46% were ≤ third centile for corrected birth weight.Conclusions While half of the babies with gastroschisis were small for gestational age at birth, reliable antenatal prediction of birth weight is difficult. Gut dilatation may be an indicator of either antenatal or intrapartum fetal distress, but does not correlate with poor neonatal surgical outcome. We suggest close antenatal surveillance of fetal wellbeing in all cases of gastroschisis because, in addition to growth retardation, many show some evidence of fetal distress and 12.5% end in stillbirth, even when appropriately grown.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 99 (1992), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To characterize amniotic pressure (AP) in pregnancies with normal amniotic fluid volume.Design Observational study, mainly cross-sectional.Setting Fetal medicine unit within a tertiary referral hospital.Subjects Patients undergoing transamniotic invasive procedures in whom amniotic fluid volume was subjectively assessed as normal on ultrasound. Those beyond 16 weeks with a deepest vertical pool on ultrasound 〈3.0 or 〉8.0 cm were excluded. Overall 194 pregnancies were studied on 232 occasions between 7 and 38 weeks gestation.Interventions Manometry readings referenced to the top of the maternal abdomen were obtained via a fluid-filled line from the needle hub and either connected to a pressure transducer (n= 190) or held vertically against a ruler (n−42).Main outcome measures AP in mm Hg, AP corrected for gestational age (z scores), semi-quantitative ultrasonic indices of amniotic fluid volume, clinical variables.Results AP in singleton pregnancies increased with advancing gestation (P〈0.001), and the sigmoid-shaped regression curve plateaued in the mid-trimester. AP z scores were not influenced by volume-related phenomena such as twin gestation, the deepest vertical pool, or amniotic fluid index, nor by maternal age, parity, gravidity, fetal sex, or subsequent spontaneous preterm delivery.Conclusions These findings suggest that AP is not principally determined by intrauterine volume. We speculate that AP, which reflects change in uterine tension as a function of radius, may instead be determined by gestation-specific anatomical and hormonal influences on gravid uterine musculature. A reference range for AP has been constructed for use in amnioinfusion and amnioreduction procedures.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. In a prospective randomized study, 36 patients with spontaneous rupture of the membranes of ≥4 h duration were stimulated with 3 mg vaginal prostaglandin E2 pessaries or intravenous oxytocin. Oxytocin stimulation was associated with shorter labours and a lower incidence of abnormal cervimetric progress. Of the patients given prostaglandin pessaries, 40% required a second dose after 4 h for slow progress; 45% of the primigravidae subsequently developed abnormal labour which was corrected by augmentation with oxytocin in all cases. One caesarean section was carried out for disproportion, and the remaining 35 patients were delivered vaginally. Prostaglandin pessaries were not associated with an increased incidence of hyperstimulation or sepsis. In conclusion, although PGE2 pessaries are safe in spontaneous rupture of the membranes, intravenous oxytocin is more efficient in stimulating labour.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Real-time ultrasound scanning of ovarian follicles was performed during 61 cycles in 22 infertile patients being treated with sequential injections of human menopausal gonadotrophin (hMG) and human chorionic gonadotrophin (hCG). Total 24-h urinary oestrogens were estimated (and in 13 cycles plasma oestradiol) but the amount of gonadotrophin given was based mainly on the ultrasound findings. A retrospective analysis of the results showed that there was a poor statistical correlation between the diameter of the largest follicle and the total urinary oestrogens (r= 0.39) and with the level of plasma oestradiol (r= 0.56), although similar clinical information was obtained by all methods. Ovulation was induced in 58 cycles when the leading follicle had a mean diameter of 20–25 mm (mean 21.3 mm); follicular rupture was observed in 57 cycles and in these cases there was biochemical evidence of luteinization (plasma progesterone 〉15 nmol/1; total urinary pregnanediol 〉8 μmol/24h). Three patients (three cycles) were not given hCG; one developed micropolycystic ovaries and two showed evidence of hyperstimulation (one follicle 〉25 mm diameter, three or more follicles 20–25 mm diameter). Twelve patients became pregnant, all with single fetuses. Subsequently one aborted, one had an ectopic pregnancy, three gave birth to normal babies at term and seven pregnancies are continuing. Real-time ultrasound scanning of ovarian follicles is a simple, practical method for monitoring follicular growth during the administration of hMG and predicting the response to hCG.
    Type of Medium: Electronic Resource
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