1,720,968 research outputs found
Outcome of fetuses with early increased nuchal translucency: systematic review and meta-analysis
No full textObjective: Nuchal translucency (NT) has been the mainstay of the first-trimester screening assessment for fetal aneuploidies. Although NT is typically measured between 11 and 14 weeks' gestation when fetal crown–rump length (CRL) is between 45 and 85 mm, recent studies suggest that fetuses with increased NT measured in the early first trimester of pregnancy are also at high risk of aneuploidy, genetic disorders or adverse pregnancy outcomes. The aim of this systematic review was to report the outcomes of fetuses with early increased NT before 11 weeks' gestation. Methods: MEDLINE, EMBASE and Cochrane databases were searched from inception to August 2024. The inclusion criteria were studies reporting the outcome of fetuses with increased NT, defined according to an absolute cut-off or percentile in the original publication, and a CRL < 45 mm. The primary outcome was a composite score of adverse pregnancy outcome, including the presence of either chromosomal, genetic or structural anomalies, or perinatal loss. The secondary outcomes explored were: resolution of increased NT at the 11–14-week scan; chromosomal anomaly; copy-number variant detected on chromosomal microarray; single-gene disorder detected on next-generation sequencing; structural anomaly; perinatal loss, defined as the occurrence of miscarriage or fetal loss; and termination of pregnancy. All outcomes were explored in the overall population of fetuses with early increased NT, according to the resolution or persistence of increased NT and according to different NT thickness (2.5–3.4 mm, 3.5–4.4 mm and ≥ 4.5 mm). Random effects meta-analysis of proportions was used to combine the data and results were reported as pooled proportions with 95% CI. Results: Five studies (401 fetuses with CRL < 45 mm presenting with increased NT) were included in the systematic review and three of these (269 fetuses) were included in the meta-analysis. Composite adverse pregnancy outcome complicated 42.0% (95% CI, 18.5–67.6%) of pregnancies presenting with early increased NT. Chromosomal or genetic anomaly at either pre- or postnatal assessment was reported in 40.2% (95% CI, 12.8–71.5%) of cases. Structural anomaly was identified on ultrasound in 5.9% (95% CI, 3.4–9.1%) of fetuses with early increased NT, and perinatal loss occurred in 9.7% (95% CI, 6.4–13.5%) of cases. Of the fetuses presenting with increased NT in the early first trimester of pregnancy, 48.8% (95% CI, 30.6–67.1%) showed resolution of the increased NT at the 11–14-week scan, and the increased NT persisted in 51.2% (95% CI, 32.9–69.4%). Composite adverse pregnancy outcome occurred in 64.2% (95% CI, 51.8–75.6%) of fetuses in which increased NT was persistent at the 11–14-week scan and in 19.4% (95% CI, 8.8–33.0%) of those in which the increased NT resolved. Finally, when considering different cut-offs of NT thickness, adverse pregnancy outcome occurred in 31.9% (95% CI, 14.4–52.6%) of fetuses with NT between 2.5 and 3.4 mm, 50.4% (95% CI, 30.1–70.7%) of those with NT between 3.5 and 4.4 mm and 70.2% (95% CI, 32.0–94.9%) of those with NT ≥ 4.5 mm. Conclusion: Increased NT measured in the early first trimester of pregnancy is associated with an increased risk of adverse pregnancy outcome, chromosomal, genetic and structural anomalies, and perinatal loss, even in case of its resolution at the time of the 11–14-week scan. © 2025 International Society of Ultrasound in Obstetrics and Gynecology
Comment on "is fetal magnetic resonance imaging indicated when ultrasound isolated mild ventriculomegaly is present in pregnancies with no risk factors?".
No full textShoulder dystocia simulation program: evaluation of learning from practical obstetric multi-professional training and its impact on patient outcomes
No full textObjective. Shoulder dystocia is one of the major leading cause of both maternal and neonatal morbidity and mortality. Simulation teaching has largely become a part of the training.
Materials and Methods. A questionnaire was administered to maternity staff who had attended a simulator training course. Participants were midwives, gynecologists, and residents. We used the four levels Kirkpatrick’s Evaluation. The efficacy by participants’ responses to three specific questions.
Results. 178 questionnaires were completed. An experience of shoulder dystocia before occurred to 87% specialists in obstetrics and gynecology, 82% midwives, and 56% residents. Within six months, 26 specialists, 20 midwives and 5 residents experienced a case of shoulder dystocia. From the exploratory analysis, it was found that 43 specialists encountered shoulder dystocia both before and after attending the course. The training course on solving shoulder dystocia demonstrated significant effectiveness (X2 7.9354, p=0.004848). The model in the R environment suggests that training did not significantly enhance skills or confidence in managing shoulder dystocia, indicating the training course effective.
Conclusions. Shoulder dystocia is an unpredictable and unpreventable obstetric emergency with serious consequences. It is therefore mandatory for obstetricians and labor ward staff to be skilled in managing rare and potentially fatal emergencies. The present study, albeit based on individual training formation, involved different labor ward professionals such as obstetricians, residents, and midwives. The training course has proven to be effective, particularly for those without prior experience with shoulder dystocia. A national-wide program, represents a known way to improve outcomes in shoulder dystocia
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Elevated maternal serum α-fetoprotein level in a fetus with Beckwith-Wiedemann syndrome in a second trimester of pregnancy.
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