1,721,214 research outputs found
Pocket Brain, an interactive, web-based ultrasound atlas of normal and abnormal fetal brain development
Full text linkThe teaching of ultrasound involves various modalities, including direct tuition by a teacher, supervised acquisition and application of practical skills, and observation of educational normal and pathological specimens. Some aspects can be achieved by self-study, using multimedia material and ultrasound simulators. Imaging data are well suited to transformation into digital learning objects. Using appropriately converted obstetric and gynecological ultrasound volume data, we have shown previously that such digital objects can be used with regular computer equipment, via a freely available storage and interactive display format, QuickTime Virtual reality. Mobile devices, including smartphones, are ubiquitous in medicine, but a recent literature review found only a limited number of publications
regarding the use of reference applications by physicians or medical students6. Until recently, due to the lack of a universal standard, interactive imaging content was not available for widespread use on stationary and mobile devices. Here, we extend the existing uses of virtual reality imaging for ultrasound to a web-based, cross-platform reference application, using a new standard format (hypertext markup language level, revision 5 (HTML5)), compatible with current mobile devices, to display interactive volume imaging data. Using ultrasound volume datasets from clinical cases with known outcomes, acquired from normal and abnormal mid-trimester fetal brains, as described previously4, we created ‘Pocket Brain’, an interactive onlinemultimedia atlas of fetal brain anatomy and pathology for stationary andmobile devices
Brain views that benefit from three-dimensional ultrasound
No full textPURPOSE OF REVIEW: Fetal central nervous system malformations are among the most common congenital anomalies. Whereas simple axial views are sufficient for basic fetal brain examination, other important views are essential for a more detailed examination, which are sometimes challenging to obtain. Three-dimensional ultrasound can be helpful in obtaining standardized and reproducible images of many difficult fetal brain views. The aim of the present review is to explore the most recent evidence on the utility and technique of three-dimensional ultrasound in the examination of the fetal brain, with particular emphasis on the brain views that benefit from three-dimensional ultrasound. RECENT FINDINGS: The article describes the various techniques of acquisition and analyses of three-dimensional ultrasound volumes of the fetal brain and their usefulness in the assessment of normal and abnormal fetal brain anatomy. Three-dimensional ultrasound has also permitted the application of many new technologies, such as artificial intelligence and deep machine learning. Recently, thanks to high-quality three-dimensional ultrasound, fetal cortical development can be assessed quantitatively and reliably. SUMMARY: Three dimensional ultrasound can help as a complementary tool to two-dimensional ultrasound in the assessment of the fetal brain development and malformations. In addition, it paves the way for the application of promising technologies in the evaluation of fetal brain. VIDEO ABSTRACT: A video summarizing the findings of the article. The video illustrates the various approaches and techniques applied for the examination of the fetal brain using three-dimensional ultrasound. Furthermore, the advantages and future perspectives of the application of three-dimensional ultrasound in the examination of the fetal brain are discussed, http://links.lww.com/COOG/A74
Traditionally vs sonographically coached pushing in second stage of labor: a pilot randomized controlled trial
No full textObjective: To investigate the usefulness of visual biofeedback using transperineal ultrasound to improve coached pushing during the active second stage of labor in nulliparous women. Methods: This was a randomized controlled trial of low-risk nulliparous women in the active second stage of labor. Patients were allocated to either coached pushing aided by visual demonstration on transperineal ultrasound of the progress of the fetal head (sonographic coaching) or traditional coaching. Patients in both groups were coached by an obstetrician for the first 20 min of the active second stage of labor and, subsequently, the labor was supervised by a midwife. Primary outcomes were duration of the active second stage and increase in the angle of progression at the end of the coaching process. Secondary outcomes included the incidence of operative delivery and complications of labor. Results: Forty women were recruited into the study. Those who received sonographic coaching had a shorter active phase of the second stage (30 min (interquartile range (IQR), 24–42 min) vs 45 min (IQR, 39–55 min); P = 0.01) and a greater increase in the angle of progression (13.5° (IQR, 9–20°) vs 5° (IQR, 3–9.5°); P = 0.01) in the first 20 min of the active second stage of labor than did those who had traditional coaching. No differences were found in the secondary outcomes between the two groups. Conclusion: Our preliminary data suggest that transperineal ultrasound may be a useful adjunct to coached pushing during the active second stage of labor. Further studies are required to confirm these findings and better define the benefits of this approach. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd
Sonographic diagnosis of congenital anomalies during the first trimester
No full textCurrent ultrasound technology allows an examination of fetal anatomy and the detection of anomalies at 12-15 weeks. Studies assessing the accuracy of early sonographic diagnosis prior to 15 weeks of pregnancy were reviewed. In expert hands the detection rate is about 40 per cent for major extra-cardiac anomalies and 65 per cent for major cardiac defects. However, due to technical and practical limitations, sonographic assessment of fetal anatomy in the first trimester cannot replace the midtrimester scan and should be restricted to couples whose fetus is at increased risk for malformation
Intracranial Hemorrhage, Cysts, Tumors, and Destructive Lesions
No full textDestructive cerebral lesions are the result of an insult to a normally developed fetal brain. The most common causes are hemorrhage, hypoxia-ischemia, and infections. However, the pathophysiology is unclear in many cases. The prognosis is usually poor. This chapter describes the main features of fetal intracranial destructive lesions, including intracranial hemorrhages, porencephaly, hydranencephaly, and schizencephaly. Other intracranial lesions that develop late in gestation, including intracranial cysts and intracranial tumors, are also described
Fetal cerebral magnetic resonance imaging, neurosonography and the brave new world of fetal medicine
No full textUltrasound imaging of the abnormal fetal brain in virtual reality
No full textOBJECTIVES: In fetal ultrasound imaging, teaching and experience are of paramount importance to improve prenatal detection rates of fetal abnormalities. Yet both aspects depend on exposure to normal and, in particular, abnormal 'specimens'. We aimed to generate a number of simple virtual reality (VR) objects of the fetal central nervous system for use as educational tools. METHODS: We applied a recently proposed algorithm for the generation of fetal VR object movies to the normal and abnormal fetal brain and spine. Interactive VR object movies were generated from ultrasound volume data from normal fetuses and fetuses with typical brain or spine anomalies. Pathognomonic still images from all object movies were selected and annotated to enable recognition of these features in the object movies. RESULTS: Forty-six virtual reality object movies from 22 fetuses (two with normal and 20 with abnormal brains) were generated in an interactive display format (QuickTime) and key images were annotated. The resulting .mov files are available for download from the website of this journal. CONCLUSIONS: VR object movies can be generated from educational ultrasound volume datasets, and may prove useful for teaching and learning normal and abnormal fetal anatomy
Coronavirus disease 2019 during pregnancy: a systematic review of reported cases
No full textObjective: This study aimed to conduct a systematic review of the clinical outcomes reported for pregnant patients with coronavirus disease 2019. Data Sources: The PubMed, CINAHL, and Scopus databases were searched using a combination of key words such as “Coronavirus and/or pregnancy,” “COVID and/or pregnancy,” “COVID disease and/or pregnancy,” and “COVID pneumonia and/or pregnancy.” There was no restriction of language to allow collection of as many cases as possible. Study Eligibility Criteria: All studies of pregnant women who received a coronavirus disease 2019 diagnosis using acid nucleic test, with reported data about pregnancy, and, in case of delivery, reported outcomes, were included. Study Appraisal and Synthesis Methods: All the studies included have been evaluated according to the tool for evaluating the methodological quality of case reports and case series described by Murad et al. Results: Six studies that involved 51 pregnant women were eligible for the systematic review. At the time of the report, 3 pregnancies were ongoing; of the remaining 48 pregnant women, 46 gave birth by cesarean delivery, and 2 gave birth vaginally; in this study, 1 stillbirth and 1 neonatal death were reported. Conclusion: Although vertical transmission of severe acute respiratory syndrome coronavirus 2 infection has been excluded thus far and the outcome for mothers and neonates has been generally good, the high rate of preterm delivery by cesarean delivery is a reason for concern. Cesarean delivery was typically an elective surgical intervention, and it is reasonable to question whether cesarean delivery for pregnant patients with coronavirus disease 2019 was warranted. Coronavirus disease 2019 associated with respiratory insufficiency in late pregnancies certainly creates a complex clinical scenario
The maternal pelvic floor and labor outcome
No full textVaginal birth is the major cause of pelvic floor damage. The development of transperineal ultrasound has improved our understanding of the relationship between vaginal birth and pelvic floor dysfunction. The female pelvic floor dimensions and function can be assessed reliably in pregnant women. Maternal pushing associated with pelvic floor muscle relaxation is the central requirement of vaginal birth. Many studies have evaluated the role of the pelvic floor on labor outcomes. Smaller levator hiatal dimensions and incomplete or absent levator ani muscle relaxation seem to be associated with a longer duration of the second stage of labor and a higher risk of cesarean and operative deliveries. Here, we presented an overview of the current knowledge of the correlation between female pelvic floor dimension and function, as assessed by transperineal ultrasound, and labor outcome
- …
