1,721,002 research outputs found

    Sonography of fetal central nervous system

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    An overview on the principles of screening, diagnosis and management of fetal central nervous anomalie

    Ultrasonography of the Prenatal Brain

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    The book contains up to date information on sonography of the fetal central nervous system. The normal embyology and sonography of the developing central nervous system throughout gestation is reviewed, as well the appearance, differential diagnosis and prognosis of the congenital anomalies arising from this area

    Comparison of transvaginal sonography with digital examination and transabdominal sonography for the determination of fetal head position in the second stage of labor.

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    Objective: Precise determination of fetal head position in labor is a prerequisite for safe instrumental deliveries, and essential for the assessment of labor progress. Recent studies have cast serious doubts on the accuracy of the time-honored digital vaginal examination (DVE) in comparison to transabdominal ultrasound scans (TUS). However, transabdominal imaging is technically difficult with a deeply engaged fetal head in the second stage of labor. We examined the accuracy and time requirements of transvaginal scans (TVS) in the second stage of labor for determination of fetal head position. Study design: Sixty laboring women in the second stage of labor with a deeply engaged fetal head were examined by experienced nurse midwives and senior residents. Fetal head position was recorded as ‘‘time on a 12-hour clock.’’ Subsequently, TUS and TVS were independently performed by a skilled sonographer. Accuracy and time requirements for all 3 examinations were recorded. Results: Fetal head position could be determined in all cases by TVS, but not in 7 cases and 9 cases byDVEand TUS, respectively (P!.03; P!.008).Adiscrepancy of 60( or more between theDVE and TUS or TVS was found in 13/60 cases (21.7%) and 14/60 cases (23.3%), respectively. AR90( discrepancy was found in 9/60 cases (15%) and 12/60 cases (20%), respectively (P ! .02 for comparison of TUS and TVS). In 5 cases, the digital examination erroneously perceived an occiput posterior position as occiput anterior. No significant differences in fetal head position were detected between TUS and TVS, when the examination was technically feasible. The mean time (GSD) required for determining fetal head position was shortest for TVS (8.7G5.8 seconds) in comparison to DVE (22.7G 14.6 seconds; P ! .0001) or TAS (31.7G 19.1 seconds; P ! .0001)

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Sonographic examination of the fetal central nervous system: guidelines for performing the ‘basic examination’ and the ‘fetal neurosonogram’

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    Central nervous system (CNS) malformations are some of the most common of all congenital abnormalities. Neural tube defects are themost frequent CNS malformations and amount to about 1–2 cases per 1000 births. The incidence of intracranial abnormalities with an intact neural tube is uncertain as probably most of these escape detection at birth and only become manifest in later life. Long-term follow-up studies suggest however that the incidence may be as high as one in 100 births1. Ultrasound has been used for nearly 30 years as the main modality to help diagnose fetal CNS anomalies. The scope of these guidelines is to review the technical aspects of an optimized approach to the evaluation of the fetal brain in surveys of fetal anatomy, that will be referred to in this document as a basic examination. Detailed evaluation of the fetal CNS (fetal neurosonogram) is also possible but requires specific expertise and sophisticated ultrasound machines. This type of examination, at times complemented by three-dimensional ultrasound, is indicated in pregnancies at increased risk of CNS anomalies. In recent years fetal magnetic resonance imaging (MRI) has emerged as a promising new technique that may add important information in selected cases and mainly after 20–22 weeks, although its advantage over ultrasound remains debate
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