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Siena G, di Nardo F, Contiero B, Milani C. Clinical use of the canine foetal kidney formula in dogs of different maternal sizes during the last ten days before parturition. Vet Res Commun 2023; 47:1653-1663. [PMID: 37095415 DOI: 10.1007/s11259-023-10120-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/04/2023] [Indexed: 04/26/2023]
Abstract
Data concerning the use of the canine foetal kidney length (L) formula in the prediction of parturition timing are still lacking. In our study, we aimed to evaluate the accuracy of the L formula in predicting the parturition date during the last 10 days of pregnancy. Twenty-five clinically healthy pregnant bitches, aged 2-9 years and weighing 3.5-52.2 kg, were ultrasonographically monitored from -11 to 0 days before parturition (dbp). Kidney L was measured for the three most caudal foetuses, and the parturition day was estimated using the kidney formula, whose accuracy was calculated as the percentage of cases estimated (ranges of ± 1 or ± 2 days) on the actual parturition date. A K-proportions test was performed to identify differences in the accuracy among maternal sizes and the sex ratio of pups, and a two-proportions z-test was performed to identify differences between litter size classes (≤ 7 vs. > 7 pups) and time ranges (-11/-5 and -4/0 dbp). An accuracy of 35% within ± 2 days was found in the range of -11/-5 dbp and an accuracy of 30% within ± 2 days was found in the range of -4/0 dbp. The accuracy differed between small (53% ±1 day and 60% ±2 days) and large (10% within ± 1 and ± 2 days) bitches (P = 0.019 within ± 1 day, and P = 0.007 within ± 2 days). For small litter sizes, the accuracy was 38% within ± 1 day and 44% within ± 2 days, and for large litter sizes, it was 14% within ± 1 and ± 2 days. A threshold value was found between litter size classes within ± 2 days. The use of the L formula during the last ten days of pregnancy did not seem to warrant good accuracy in the prediction of parturition date. Further studies on different maternal sizes should be performed.
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Affiliation(s)
- Giulia Siena
- Department of Animal Medicine, Production and Health, University of Padova, Via dell'Università, 16, Legnaro, PD, 35020, Italy.
| | - Francesca di Nardo
- Department of Animal Medicine, Production and Health, University of Padova, Via dell'Università, 16, Legnaro, PD, 35020, Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Via dell'Università, 16, Legnaro, PD, 35020, Italy
| | - Chiara Milani
- Department of Animal Medicine, Production and Health, University of Padova, Via dell'Università, 16, Legnaro, PD, 35020, Italy
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Rotheneder S, González-Grajales LA, Beck H, Bootz F, Bollwein H. Variability of bovine conceptus-related volumes in early pregnancy measured with transrectal three-dimensional ultrasonography. J Dairy Sci 2022; 105:4534-4546. [PMID: 35307186 DOI: 10.3168/jds.2021-21006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 02/01/2022] [Indexed: 11/19/2022]
Abstract
Up until now, bovine fetometry has been entirely based on 2-dimensional ultrasonography. Fetal size is estimated by several linear measurements such as crown-rump length (CRL). However, the advent of 3-dimensional ultrasonography (3D-US) provides in vivo access to the volumes of the fetus and its amniotic sac. The objective of this preliminary observational study was to determine the variability of conceptus-related volumes using transrectal 3D-US in dairy cows and to identify factors affecting them. Furthermore, relationships between the gained measurements and calf birth weight were investigated. In total, 315 Simmental and Holstein-Friesian dairy cows were transrectally examined at d 42 after breeding using a portable ultrasound device (Voluson I, GE Healthcare). Gestational volumes including fetal volume (FV) and amniotic sac volume (ASV) were determined with the software tool VOCAL (Virtual Organ Computer-Aided Analysis, GE Healthcare), whereas amniotic fluid volume (AFV) values were derived from the subtraction of FV from ASV. The CRL was determined by means of 3-dimensional data. The mean values and standard deviations for FV, ASV, AFV, and CRL were 1.47 ± 0.25 cm3, 5.86 ± 1.22 cm3, 4.38 ± 1.02 cm3, and 2.38 ± 0.18 cm, respectively. All gestational volumes and CRL values were affected by breed. In Simmental cattle, larger concepti were observed compared with pregnancies derived from Holstein-Friesian animals. Parity affected only ASV and AFV, with heifers showing greater values than lactating cows. The CRL was positively associated with milk protein content. It was not possible to predict calf weight at birth by using FV, ASV, or AFV; however, tendencies were found for ASV and AFV. The present study was the first to adopt 3D-US volumetry to assess early pregnancy development in dairy cattle. Our results showed that this method could be used successfully to identify minor variations in conceptus growth.
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Affiliation(s)
- S Rotheneder
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland; Tierarztpraxis Herrmann, Rankhofstraße 24, 79274 St. Märgen, Germany.
| | - L A González-Grajales
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
| | - H Beck
- Tierarztpraxis Dr. Bootz, Schlößlestraße 43, 88356 Ostrach, Germany
| | - F Bootz
- Tierarztpraxis Dr. Bootz, Schlößlestraße 43, 88356 Ostrach, Germany
| | - H Bollwein
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
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Becsek A, Tzanidakis N, Blanco M, Schmicke M, Bollwein H. Transrectal three-dimensional fetal volumetry in early pregnant mares: Relationships between maternal factors and equine fetal volume measurements. Theriogenology 2021; 174:20-26. [PMID: 34416560 DOI: 10.1016/j.theriogenology.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/24/2021] [Accepted: 08/05/2021] [Indexed: 12/28/2022]
Abstract
The aim of this study was to investigate the effects of maternal, hormonal, and fetal factors on early fetal volume (FV) measurements in mares obtained by three-dimensional (3D) ultrasound. Furthermore, postpartum parameters were explored in regard to their association with early FV. For this purpose, 149 German warmblood mares that were artificially inseminated and confirmed to be pregnant between days 14-16 of gestation, were examined transrectally at day 45 ± 1 of gestation with the portable 3D ultrasound device Voluson® i (GE, Zipf, Austria). FV was calculated by using the extension software Virtual Organ Computer-aided AnaLysis (VOCAL™). Two different mixed linear models were used to analyze associations between the investigated maternal and fetal factors and the FV. Explanatory variables investigated in the first model were: maternal age, parity, maternal weight, and body condition score, type of pregnancy (recipient or biological mother), barren status (lactating or non-lactating), fetal sex, progesterone (P4) and equine chorionic gonadotropin (eCG) concentrations; and in the second model outcome variables such as gestational length, birth weight, placental weight, fetal sex, and abortion were included in the analysis. The final models revealed a significant relation between FV and eCG (b = 0.011, P = 0.030), as well as with P4 (b = -0.053, P = 0.016), but interestingly P4 was negatively related to FV. Fetal sex showed the most prominent effect on FV (b = -0.256, P = 0.039), with female fetuses being smaller than male fetuses. In the second model none of the investigated parameters were related to early FV except for fetal sex (b = -0.328, P = 0.047), again with female fetuses being smaller. In summary, it was found that FV is related with eCG, P4 and fetal sex, but was no suitable predicting factor for the investigated outcome parameters. Furthermore, the findings suggest that sex specific growth differences exist already in early gestation. The detailed biological mechanism by which P4 and eCG affect fetal size has to be investigated in prospective studies.
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Affiliation(s)
- Angela Becsek
- Clinic of Reproductive Medicine, Vetsuisse Faculty, Winterthurerstrasse 260, 8057 Zürich, Switzerland.
| | - Nikolaos Tzanidakis
- Clinic of Reproductive Medicine, Vetsuisse Faculty, Winterthurerstrasse 260, 8057 Zürich, Switzerland.
| | - Miguel Blanco
- Gestüt Lewitz, PS Pferdehaltung GmbH, Lewitzhof 1, 19306 Neustadt-Glewe, Germany.
| | - Marion Schmicke
- Clinic for Cattle, University of Veterinary Medicine Hannover, 30173, Hannover, Germany.
| | - Heinrich Bollwein
- Gestüt Lewitz, PS Pferdehaltung GmbH, Lewitzhof 1, 19306 Neustadt-Glewe, Germany.
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Wataganara T, Yapan P, Moungmaithong S, Sompagdee N, Phithakwatchara N, Limsiri P, Nawapun K, Rekhawasin T, Talungchit P. Additional benefits of three-dimensional ultrasound for prenatal assessment of twins. J Perinat Med 2020; 48:102-114. [PMID: 31961794 DOI: 10.1515/jpm-2019-0409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 12/05/2019] [Indexed: 12/18/2022]
Abstract
Three-dimensional ultrasound (3DUS) may provide additional information for prenatal assessment of twins. It may improve the diagnostic confidence of dating, nuchal translucency (NT) and chorionicity assignment in twin pregnancies. The "virtual 3DUS placentoscopy" can guide selective fetoscopic laser photocoagulation (SFLP) to treat twin-twin transfusion syndrome (TTTS). Volumetric assessment of the dysmorphic acardiac twin with the Virtual Organ Computer-aided Analysis (VOCAL) software is more accurate than the conventional ultrasound measurement. Twin anemia polycythemia (TAP) sequence and selective intrauterine growth restriction (sIUGR) may be clinically monitored with 3DUS placental volume (PV) and power Doppler vascular indices. Congenital anomalies are more common in twins. Evaluation of fetal anomalies with 3DUS could assist perinatal management. The 3DUS power Doppler can provide a better understanding of true and false umbilical cord knots, which are commonly found in monoamniotic (MA) twins. Single demise in monochorionic (MC) twin pregnancies can cause severe neurologic morbidity in the surviving co-twin. Prenatal prediction of brain injury in the surviving co-twin with unremarkable neurosonographic examination is difficult. The 3DUS power Doppler may aid in prenatal detection of subtle abnormal cerebral perfusion. Prenatal assessment of conjoined twins with 3DUS is important if emergency postnatal surgical separation is anticipated. There is no significant additional advantage in using real-time 3DUS to guide prenatal interventions. Assessment of the cervix and pelvic floor during twin pregnancies is enhanced with 3DUS. Due to lack of high-quality studies, routine prenatal 3DUS in twin pregnancies needs to be balanced with risks of excessive ultrasound exposure.
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Affiliation(s)
- Tuangsit Wataganara
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Piengbulan Yapan
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Sakita Moungmaithong
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Nalat Sompagdee
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Nisarat Phithakwatchara
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pattarawan Limsiri
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Katika Nawapun
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Thanapa Rekhawasin
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pattarawalai Talungchit
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Becsek A, Tzanidakis N, Blanco M, Bollwein H. Transrectal three-dimensional fetal volumetry and crown-rump length measurement during early gestation in mares: Intra- and inter-observer reliability and agreement. Theriogenology 2018; 126:266-271. [PMID: 30590249 DOI: 10.1016/j.theriogenology.2018.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 11/08/2018] [Accepted: 11/15/2018] [Indexed: 10/27/2022]
Abstract
The aim of this study was to investigate if transrectal three-dimensional (3D) ultrasound is a reliable technique to measure equine fetal volume (FV) during early gestation in mares. In total 149 warmblood mares were examined once transrectally on days 45 ± 1 of pregnancy with a portable 3D ultrasound device (Voluson® i, GE Healthcare, Zipf, Austria). The following measurements were performed: Two-dimensional (2D) and 3D crown-rump length (CRL), FV using Virtual Organ Computer-aided AnaLysis (VOCAL™) software with rotational angles of 6° and 30°. To analyze intra- and inter-observer reliability (intraclass correlation coefficient (ICC)) and agreement (Bland-Altman's limits of agreement (LoA)) of FV measurements, images from 60 horse fetuses were selected and repeatedly analyzed by the same examiner (A) and by a second examiner (B). The time for each ultrasound examination (2D and 3D) and for the FV measurements was recorded. The 3D measured CRL was larger (P < 0.001) than the 2D CRL. Repeated measurements of 3D CRL showed a higher reliability (ICC = 0.91 (0.88-0.94), P < 0.001) and agreement (mean = 0.13%, 95% LoA: 7.45 to +7.19) compared to reliability (ICC = 0.50 (0.36-0.61), P < 0.001) and agreement (mean = -1.54%, 95% LoA: 23.29 to +20.21) of the CRL measurement in 2D mode. For intra-observer examinations, reliability was highest when using a rotational angle of 30° (ICC = 0.98 (0.97-0.99), P < 0.001). The inter-observer reliability of 3D measurements was good (ICC = 0.85 (0.67-0.92), P < 0.001). The extra time needed to perform the 3D scan ranged from 1 to 9 min and FV measurements lasted 03:30 ± 00:46 and 08:10 ± 01:05, for rotational angles of 30° and 6°, respectively. In conclusion, this study showed a high level of intra- and inter-observer reliability and agreement for FV measurements using VOCAL™. Furthermore, the 6° and 30° rotational angles can be used interchangeably, but test duration, reliability and agreement were better with the 30° rotational step method. The CRL measurements obtained with 3D mode probably reflects the true CRL, compared to the 2D measured CRL.
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Affiliation(s)
- Angela Becsek
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland.
| | - Nikolaos Tzanidakis
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland.
| | - Miguel Blanco
- Lewitz Stud, Lewitzhof 1, 19306, Neustadt-Glewe, Germany.
| | - Heinrich Bollwein
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland.
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Coelho Neto MA, Roncato P, Nastri CO, Martins WP. True Reproducibility of UltraSound Techniques (TRUST): systematic review of reliability studies in obstetrics and gynecology. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2015; 46:14-20. [PMID: 25175693 DOI: 10.1002/uog.14654] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 08/15/2014] [Accepted: 08/22/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To examine the quality of methods used and the accuracy of the interpretation of agreement in existing studies that examine the reliability of ultrasound measurements and judgments in obstetrics and gynecology. METHODS A systematic search of MEDLINE was performed on 25 March 2014, looking for studies that examined the reliability of ultrasound measurements and judgments in obstetrics and gynecology with evaluation of concordance (CCC) or intraclass (ICC) correlation coefficients or kappa as a main objective. RESULTS Seven hundred and thirty-three records were examined on the basis of their title and abstract, of which 141 full-text articles were examined completely for eligibility. We excluded 29 studies because they did not report CCC/ICC/kappa, leaving 112 studies that were included in our analysis. Two studies reported both ICC and kappa and were counted twice, therefore, the number used as the denominator in the analyses was 114. Only 16/114 (14.0%) studies were considered to be well designed (independent acquisition and blinded analysis) and to have interpreted the results properly. Most errors occurring in the studies are likely to overestimate the reliability of the method examined. CONCLUSIONS The vast majority of published studies examined had important flaws in design, interpretation and/or reporting. Such limitations are important to identify as they might create false confidence in the existing measurements and judgments, jeopardizing clinical practice and future research. Specific guidelines aimed at improving the quality of reproducibility studies that examine ultrasound methods should be encouraged.
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Affiliation(s)
- M A Coelho Neto
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo (DGO-FMRP-USP), Ribeirao Preto, Brazil
| | - P Roncato
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo (DGO-FMRP-USP), Ribeirao Preto, Brazil
- School of Health Technology - Ultrasonography School of Ribeirao Preto (FATESA-EURP), Ribeirao Preto, Brazil
| | - C O Nastri
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo (DGO-FMRP-USP), Ribeirao Preto, Brazil
| | - W P Martins
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo (DGO-FMRP-USP), Ribeirao Preto, Brazil
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Papastefanou I, Kappou D, Souka AP, Pilalis A, Chrelias C, Siristatidis C, Kassanos D. Reproducibility study of fetal 3-D volumetry in the first trimester: effect of fetal size and rotational angle of VOCAL software. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:877-883. [PMID: 24412167 DOI: 10.1016/j.ultrasmedbio.2013.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 11/06/2013] [Accepted: 11/11/2013] [Indexed: 06/03/2023]
Abstract
Intra- and inter-observer reproducibility of fetal volume measurement by 3-D ultrasound scan (using VOCAL [Virtual Organ Computer-Aided Analysis] software) in 27 fetuses at 7 to 13 wk was studied. For intra-observer variability, the mean difference (MD) and 95% limits of agreement (95% LOA) at 12°, 18° and 30° were MD(12) = 0.097, 95% LOA(12) = -0.87 to +1.06; MD(18) = 0.07, 95% LOA(18) = -1.31 to +1.45; and MD(30) = -0.07, 95% LOA(30) = -1.55 to +1.41. The standard deviation of the differences (SD(DIF)) increased with crown-rump length at 12° (p = 0.0016), 18° (p = 0.0011) and 30° (p = 0.02). For inter-observer variability, MD(12) = 0.15, 95% LOA(12) = -1.65 to +1.95; MD(18) = 0.042, 95% LOA(18) = -1.79 to +1.87; and MD(30) = 0.19, 95% LOA(30) = -1.24 to +1.62. SDDIF increased with crown-rump length at 18° (p = 0.0084) and 30° (p = 0.0073). The accuracy of fetal volume measurement was not influenced by rotational angle or fetal size. Precision deteriorated for wider rotational angles and larger fetuses.
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Affiliation(s)
- Ioannis Papastefanou
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece.
| | - Dimitra Kappou
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
| | - Athena P Souka
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
| | - Athanasios Pilalis
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
| | - Charalambos Chrelias
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
| | - Charalambos Siristatidis
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
| | - Dimitrios Kassanos
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens, Attikon University Hospital, Athens, Greece
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Barra DA, Lima JC, Mauad Filho F, Araujo Júnior E, Martins WP. Measuring fetal volume during late first trimester by three-dimensional ultrasonography using virtual organ computer-aided analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:1552-1559. [PMID: 23791355 DOI: 10.1016/j.ultrasmedbio.2013.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 02/02/2013] [Accepted: 02/07/2013] [Indexed: 06/02/2023]
Abstract
Our aim was to determine whether rotating the fetus over its largest axis and reducing the rotational step angle can improve reliability/agreement of fetal volume measurements obtained with three-dimensional ultrasonography (3-DUS). Two observers acquired three 3-DUS data sets for a fetus with a crown-rump length between 45 and 84 mm. These observers determined the fetal volume using virtual organ computer-aided analysis (VOCAL), by three different methods, with a rotational step angle of 30°: (1) minimal manipulation of the 3-DUS data set, fetus rotated over any axis; (2) manipulation of the 3-DUS data set until the fetus could be seen in a standardized manner, fetus rotated over its anteroposterior axis; (3) same 3-DUS data set manipulation, fetus rotated over its longitudinal axis. Intra- and inter-observer reliability/agreement was determined with intra-class correlation coefficients and limits of agreement. In addition, we tested the method that provided the best reliability/agreement results using 15° and 9° of rotational step angles. The time taken to manipulate 3-DUS and determine fetal volume was recorded. The best intra- and inter-observer reliability/agreement results were observed when the fetus was rotated over its longitudinal axis. Reducing rotational step angle to 15° or 9° did not further improve reliability/agreement. The observer took approximately 1 min to determine fetal volume using this method. Our findings indicate that fetal volume should be determined by rotating the fetus over its longitudinal axis, at a rotational step angle of 30°, which is relatively fast and allows analysis of fetal volume with good reliability and agreement.
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Affiliation(s)
- Daniela A Barra
- Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo (DGO-FMRP-USP), Ribeirao Preto, Brazil
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9
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The predictive value of first trimester fetal volume measurements, a prospective cohort study. Early Hum Dev 2013; 89:321-6. [PMID: 23253301 DOI: 10.1016/j.earlhumdev.2012.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Revised: 10/24/2012] [Accepted: 11/02/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To determine if fetal volume (FV) measurements with three-dimensional ultrasound in the first trimester of pregnancy can detect the fetus at risk for preterm birth and/or low birth weight. METHODS In this prospective cohort study, 538 participants were included during the routine first trimester ultrasound examination. Volume measurements were performed with VOCAL (9°). Firstly, the relation between FV and gestational age for a set of participants with normal pregnancies (training set), was assessed using multiple linear regression analysis, which was then used to determine the expected normal values. Secondly, for a new set of participants with normal pregnancies and a set of participants with complicated pregnancies (preterm birth and/or low birth weight), i.e. the validation set, the observed fetal volumes (FVobserved) were compared with their expected normal values (FVexpected) and expressed as a percentage of the expected normal value. The difference in mean percentage was then assessed with independent-samples t-test. Finally, logistic regression analysis was applied to the validation set to analyze the ability to predict the pregnancy outcome with FV calculation. RESULTS Linear regression analysis of FV as a predictor of preterm birth and/or low birth weight did not result in significant (p=0.630 and 0.290, respectively) or clinical relevant results (standardized effect sizes of 0.061 and 0.179, respectively). The predicting quality was also very low (AUC=0.508 and 0.545 respectively). CONCLUSIONS Fetal volume measurements in the first trimester of pregnancy are not useful as a prognostic tool for predicting pregnancies of high risk for preterm birth or a low birth weight.
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Smeets NAC, Prudon M, Winkens B, Oei SG. Fetal volume measurements with three dimensional ultrasound in the first trimester of pregnancy, related to pregnancy outcome, a prospective cohort study. BMC Pregnancy Childbirth 2012; 12:38. [PMID: 22640017 PMCID: PMC3406965 DOI: 10.1186/1471-2393-12-38] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 05/28/2012] [Indexed: 12/02/2022] Open
Abstract
Background First trimester growth restriction is associated with an increased risk of adverse birth outcomes (preterm birth, low birth weight and small for gestational age at birth). The differences between normal and abnormal growth in early pregnancy are small if the fetal size is measured by the crown-rump-length. Three-dimensional ultrasound volume measurements might give more information about fetal development than two-dimensional ultrasound measurements. Detection of the fetus with a small fetal volume might result in earlier detection of high risk pregnancies and a better selection of high risk pregnancies. Methods A prospective cohort study, performed at the Máxima Medical Centre, in Eindhoven-Veldhoven, the Netherlands. During the routine first trimester scan with nuchal translucency measurement 500 fetal volumes will be obtained. The gestational age is based on the first day of the last menstrual period in a regular menstrual cycle and by the crown-rump-length. The acquired datasets are collected and stored on a hard disk for offline processing and volume calculation. The investigator who performs the volume measurements is blinded for the results of the first trimester scan. The manual mode will be used to outline the Region Of Interest, the fetal head and rump, in all cross sections. The fetal volumes are calculated with a rotational step of 9°. First, the relation between fetal volume and gestational age, for a set of participants with normal pregnancies (training set), will be assessed. This model will then be used to determine expected values of fetal volume for a normal pregnancy, which will be referred to as expected normal values. Secondly, for a new set of participants with normal pregnancies and a set of participants with complicated pregnancies (together defined as validation set), the observed fetal volumes (FVobserved) are compared with their expected normal values (FVexpected) and expressed as a percentage of the expected normal value. The mean difference in percentage error between the set of normal versus complicated pregnancies will then be compared using the independent-samples t-test. Finally, logistic regression analysis will be applied to the validation set of participants to analyze the possibility of predicting the pregnancy outcome after fetal volume calculation in the first trimester, using this percentage error. Discussion After this study it is clear whether FV measurement in the first trimester can detect high risk pregnancies. If it is possible to detect these pregnancies, more intensive follow up in these pregnancies might result in fewer complicated pregnancies and fewer fetal morbidities.
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Affiliation(s)
- Nicol A C Smeets
- Department of Gynecology and Obstetrics, Atrium Medical Centre, Parkstad, Heerlen, The Netherlands.
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Smeets NAC, Dvinskikh NA, Winkens B, Oei SG. A new semi-automated method for fetal volume measurements with three-dimensional ultrasound: preliminary results. Prenat Diagn 2012; 32:770-6. [PMID: 22592970 DOI: 10.1002/pd.3900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Complications in pregnancy are suggested to be the result of intrauterine conditions in the first trimester of pregnancy. Three-dimensional ultrasound volume measurements might give more information, compared with two-dimensional measurements. Commonly available methods for volume measurements are not suited for daily practice. This is a report of preliminary results of a promising, more practical semi-automated method for volume calculations with three-dimensional ultrasound. METHOD Volume datasets of 16 objects (10.2-41.5 cm(3) ) were obtained. Euclidean shortening flow and Perona and Malik were used as image enhancement techniques. The image gradient was calculated. The points of interest were detected by the iso-intensity and the edge-detection technique. Volume measurements with Volume Computer-aided AnaLysis (VOCAL) are used as a reference. A volume dataset of a first trimester fetus was acquired to test this method in vivo. RESULTS The mathematical calculations with iso-intensity (Perona and Malik: average= -1.57 cm(3) , SD=4.05; and Euclidean shortening flow: average= -1.38 cm(3) , SD=2.47) showed results comparable with the VOCAL method (average= +1.28 cm(3) , SD=2.07). We also succeeded in detecting all voxels in the whole contour of a 12-week fetus. CONCLUSION Mathematical volume calculations are possible with the semi-automated method. We were able to apply this new method on a first trimester fetus. This new method is promising for future use in the daily practice.
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Affiliation(s)
- Nicol A C Smeets
- Department of Gynaecology and Obstetrics, Atrium Medical Centre, Parkstad, The Netherlands.
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