Ultrasound Obstet Gynecol [JOURNAL]
Sun
200 papers
RSS
McClenahan P, Mak J, Uzuner C
… +5 more
, Espada Vaquero M, Reid S, Eathorne A, Condous G, IDEA Group Collaborators
Ultrasound Obstet Gynecol
· 2026 May · PMID 41920757
·
Full text
OBJECTIVE: To determine the diagnostic performance of each additional step of the four-step International Deep Endometriosis Analysis (IDEA) consensus protocol for predicting the presence of deep endometriosis (DE) on tr...OBJECTIVE: To determine the diagnostic performance of each additional step of the four-step International Deep Endometriosis Analysis (IDEA) consensus protocol for predicting the presence of deep endometriosis (DE) on transvaginal ultrasound. METHODS: This was an international multicenter observational cohort study of data collected prospectively between August 2018 and November 2019, with analysis performed retrospectively. Individuals with symptoms and/or signs suggestive of endometriosis were recruited from tertiary gynecological services, underwent pelvic transvaginal ultrasound assessment according to the IDEA consensus protocol and underwent laparoscopy for excision of endometriosis. Sensitivity, specificity, accuracy, positive (PPV) and negative (NPV) predictive values, and positive (LR+) and negative (LR-) likelihood ratios for individual and cumulative steps of the IDEA protocol in diagnosing DE were calculated with corresponding 95% CIs. Visual diagnosis at laparoscopy was used as the reference standard. RESULTS: In total, 640 participants were recruited, of whom 467 were included in the analysis. With the addition of each step of the four-step IDEA consensus protocol, the cumulative sensitivity for diagnosing DE increased progressively, from 0.65 (95% CI, 0.59-0.71) for Step 1 only to 0.94 (95% CI, 0.90-0.97) for Steps 1-4, the specificity decreased from 0.78 (95% CI, 0.72-0.84) to 0.58 (95% CI, 0.52-0.65), the accuracy increased from 0.71 (95% CI, 0.67-0.75) to 0.78 (95% CI, 0.74-0.81), PPV decreased from 0.78 (95% CI, 0.73-0.82) to 0.73 (95% CI, 0.70-0.76), NPV increased from 0.65 (95% CI, 0.61-0.69) to 0.89 (95% CI, 0.83-0.92), LR+ decreased from 3.02 (95% CI, 2.30-3.69) to 2.27 (95% CI, 1.93-2.67) and LR- decreased from 0.44 (95% CI, 0.37-0.53) to 0.10 (95% CI, 0.06-0.17). CONCLUSIONS: This validation study supports the use of the comprehensive four-step IDEA consensus protocol in detecting DE and justifies referral for specialist imaging in cases of suspected endometriosis. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Armengol-Alsina M, Bonacina E, Dalmau M
… +7 more
, Temprado J, Valenzuela I, Codina-Solà M, Viñas-Jornet M, Rodó C, Mendoza M, Collaborators
Ultrasound Obstet Gynecol
· 2026 Apr · PMID 41906976
·
Full text
OBJECTIVES: To assess the value of placental insufficiency markers for estimating the risk of genetic anomalies in fetuses with isolated early-onset fetal growth restriction (FGR), defined as an estimated fetal weight ≤ ...OBJECTIVES: To assess the value of placental insufficiency markers for estimating the risk of genetic anomalies in fetuses with isolated early-onset fetal growth restriction (FGR), defined as an estimated fetal weight ≤ 3 percentile diagnosed ≤ 28 + 6 weeks' gestation. METHODS: We performed a retrospective analysis of data collected prospectively from cases that attended Vall d'Hebron University Hospital, Barcelona, Spain, between February 2016 and December 2022. Singleton pregnancies diagnosed with isolated early-onset FGR between 20 + 0 and 28 + 6 weeks' gestation were eligible for inclusion. Cases in which a pathogenic or likely pathogenic fetal genetic abnormality was detected by chromosomal microarray (CMA) or whole-exome sequencing (WES) were identified. Cases were stratified by soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio (< 38 vs ≥ 38), PlGF level (< 100 vs ≥ 100 pg/mL), mean uterine artery (UtA) pulsatility index (PI) (< 95 vs ≥ 95 percentile) and fetal Doppler (normal vs abnormal) at the time of FGR diagnosis. Abnormal fetal Doppler was defined as a PI > 95 percentile in the umbilical artery or ductus venosus, or a middle cerebral artery PI or cerebroplacental ratio < 5 percentile. The prevalence of genetic anomalies in each subgroup was compared with that of the overall cohort. Additionally, combinations of markers of placental insufficiency were investigated to determine whether specific combinations could improve the ability to identify cases at risk of genetic anomaly. RESULTS: In the total cohort of 238 cases of isolated early-onset FGR, seven (2.9%) cases of genetic anomaly were detected. Of these, 2/7 (28.6%) were detected by prenatal or postnatal CMA and 5/7 (71.4%) by postnatal WES. Fetal Doppler alone and UtA-PI alone did not identify subgroups with a significantly different prevalence of genetic abnormality compared with the overall cohort. In contrast, a sFlt-1/PlGF ratio < 38 and PlGF level ≥ 100 pg/mL defined subgroups with a significantly higher prevalence of genetic abnormality, while no genetic anomalies were found in cases with a sFlt-1/PlGF ratio ≥ 38 or PlGF level < 45 pg/mL. Furthermore, smaller subgroups combining markers of placental insufficiency identified cases at significantly higher or lower risk of FGR-related genetic anomaly. CONCLUSIONS: Placental insufficiency markers, particularly the sFlt-1/PlGF ratio and PlGF level, may enable refined risk stratification of genetic anomalies in cases of isolated early-onset FGR, which could be used to provide individualized prenatal counseling and to optimize the use of WES. Furthermore, combining markers of placental insufficiency, such as UtA-PI and fetal Doppler, may improve risk stratification, potentially defining smaller subgroups with a higher prevalence of genetic anomalies, for which WES may provide greater diagnostic yield. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Rondagh M, van der Spoel JW, Lopriore E
… +7 more
, Spekman JA, de Vries LS, van Klink JMM, Tollenaar LSA, Slaghekke F, Steggerda SJ, Groene SG
Ultrasound Obstet Gynecol
· 2026 Apr · PMID 41906972
·
Full text
OBJECTIVES: The primary objective of this study was to evaluate the prevalence, type and severity of pre- and postnatal brain injury in monochorionic twins with twin anemia-polycythemia sequence (TAPS). Secondary objecti...OBJECTIVES: The primary objective of this study was to evaluate the prevalence, type and severity of pre- and postnatal brain injury in monochorionic twins with twin anemia-polycythemia sequence (TAPS). Secondary objectives were to conduct within-pair comparisons between donor and recipient twins of structural cranial ultrasound (cUS) measurements and to evaluate the association between brain injury and neurodevelopmental outcome in TAPS. METHODS: This was a single-center retrospective cohort study including cases of spontaneous and postlaser TAPS delivered at the Leiden University Medical Center, Leiden, The Netherlands, between May 2002 and December 2024. We evaluated all available pre- and postnatal neuroimaging, including ultrasound and magnetic resonance imaging, to identify brain injury. Structural measurements were obtained from cUS performed within 3 days after birth, and were included only if high-quality images were available for both cotwins. Neurodevelopmental outcome was evaluated using standardized age-appropriate assessments for cognitive and motor development. RESULTS: A total of 256 infants were included from 132 pregnancies (124 twin pairs and eight single survivors). Brain injury was observed in 16.8% (43/256) of infants, of which 93.0% (40/43) had a postnatal origin. There was no significant difference in the prevalence of brain injury between cases of spontaneous TAPS (13.5% (20/148)) and postlaser TAPS (21.3% (23/108)) (P = 0.1). Severe brain injury was observed in 7.4% (19/256) of the infants, with no significant difference between donor twins (6.5% (8/124)) and recipient twins (8.3% (11/132)) (P = 0.54). Lower gestational age at birth was an independent risk factor for brain injury (odds ratio, 1.31 (95% CI, 1.15-1.50); P < 0.01). Among infants with moderate-to-severe neurodevelopmental impairment (NDI), 57.1% (8/14) had evidence of brain injury. Brain injury alone did not account for the impairment in 71.4% (10/14) of cases with moderate-to-severe NDI. CONCLUSIONS: Brain injury was observed in approximately one-fifth of infants with TAPS, was primarily postnatal in origin and was strongly associated with preterm birth. In the majority of infants with moderate-to-severe NDI, the impairment could not be explained by the observed severe brain injury alone, emphasizing its probable multifactorial origin. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Kagan KO, Bissinger AL, Roth O
… +4 more
, Sonek J, Hoopmann M, Ville Y, Enders M
Ultrasound Obstet Gynecol
· 2026 Apr · PMID 41906968
·
Full text
OBJECTIVE: To estimate the residual risk of maternal-fetal transmission after primary cytomegalovirus (CMV) infection in the periconceptional period or the first trimester in women treated with valacyclovir, and to asses...OBJECTIVE: To estimate the residual risk of maternal-fetal transmission after primary cytomegalovirus (CMV) infection in the periconceptional period or the first trimester in women treated with valacyclovir, and to assess whether the presence of glycoprotein B2 (gB2)-specific immunoglobulin (Ig)-G antibodies on immunoblot analysis refines fetal risk prediction. METHODS: This was a retrospective single-center study conducted at University Hospital Tübingen, Tübingen, Germany, between October 2023 and June 2025. Pregnant women with a primary CMV infection diagnosed < 14 weeks' gestation who received valacyclovir (8 g/day) were included in the study. The diagnosis of a recent primary CMV infection was based on maternal serology results, specifically positive anti-CMV-immunoglobulin (Ig)-G and -IgM levels, and low or intermediate IgG avidity. Additionally, prior to initiation of valacyclovir treatment, the presence or absence of glycoprotein B (gB)2-specific IgG antibodies was determined using a commercial line immunoblot. The primary outcome was maternal-fetal transmission of CMV detected at the time of second-trimester amniocentesis. RESULTS: Eighty-five women met the inclusion criteria, including 47 with periconceptional and 38 with first-trimester maternal CMV infection. Median maternal and gestational age at the time of diagnosis of primary maternal CMV infection were 33.1 (interquartile range (IQR), 29.9-34.9) years and 7.4 (IQR, 6.4-8.9) weeks, respectively. Amniocentesis was performed at a median gestational age of 20.6 (IQR, 20.1-21.0) weeks. Overall, maternal-fetal transmission was detected in 7/85 (8.2%) cases at the time of amniocentesis. All CMV transmissions occurred in women without gB2-specific IgG antibodies (7/55 (12.7%)), while no transmissions occurred in those with gB2-specific IgG antibodies (0/30 (0%)) (P = 0.048). CONCLUSIONS: In women with a primary CMV infection treated with valacyclovir, the presence of gB2-specific IgG antibodies on immunoblot analysis identifies a subgroup with a low residual risk of maternal-fetal transmission. Incorporating gB2-specific IgG antibodies status into risk stratification may improve patient counseling and clinical decision-making. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Moro F, Ciancia M, Berardino SD
… +15 more
, Baldassari G, Mascilini F, Ciccarone F, Nero C, Tran HE, Pasciuto T, Boldrini L, Giannarelli D, Ledger A, Bourne T, Froyman W, Timmerman D, Valentin L, Fagotti A, Testa AC
Ultrasound Obstet Gynecol
· 2026 Apr · PMID 41906961
·
Full text
OBJECTIVE: The primary aim of this study was to develop and internally validate ultrasound-based radiomics models to discriminate between all types of benign and malignant adnexal masses. The secondary aim was to compare...OBJECTIVE: The primary aim of this study was to develop and internally validate ultrasound-based radiomics models to discriminate between all types of benign and malignant adnexal masses. The secondary aim was to compare the performance of the radiomics models with that of the Assessment of Different NEoplasias in the adneXa (ADNEX) model. METHODS: This was a retrospective, observational, single-center study, for which all patients with an adnexal mass that were included in the ongoing International Ovarian Tumor Analysis phase-5 and phase-7 studies and were examined using ultrasound between January 2012 and December 2023 at Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy, were eligible for inclusion. Inclusion criteria were: adnexal mass detected by ultrasound; surgical removal of the adnexal mass within 180 days after the ultrasound examination; histological confirmation of an adnexal mass; and absence of a synchronous malignant tumor. Patients without digital ultrasound images saved in DICOM format were excluded. The patient cohort was split randomly into training and validation sets using a stratified split with a ratio of 70:30, to preserve the proportion of benign and malignant cases in the two sets. Two machine-learning models for discriminating between benign and malignant adnexal masses were built using one image per tumor, with 5-fold cross-validation for hyperparameter tuning, and were tested on the validation set. The variables used in model building were patient age, serum CA 125 level and the radiomics features that differed significantly between benign and malignant tumors (determined using the Mann-Whitney U-test with Benjamini-Hochberg correction) and were not redundant based on Pearson correlation analysis. Histology was the reference standard. We assessed the discriminative performance of the radiomics models using the area under the receiver-operating-characteristics curve (AUC) and classification performance using sensitivity and specificity at the optimal cut-off of each model to classify the mass as malignant, as determined by Youden's index. The diagnostic performance of the developed radiomics models was compared with that of the ADNEX model (AUC, sensitivity and specificity at the 10% risk-of-malignancy cut-off, which is the recommended threshold for clinical use of the ADNEX model). RESULTS: In total, 4501 patients met the inclusion criteria. Among these, 2428 patients were excluded owing to an absence of ultrasound images or images unsuitable for radiomics analysis. Overall, a total of 2073 patients were included in the analysis, of whom 803 (38.7%) had a histologically confirmed malignant tumor. In the validation set (n = 622, including 254 malignancies), the clinical-radiomics model trained using the eXtreme Gradient Boosting algorithm, including age, serum CA 125 level and 14 selected radiomics features, achieved the highest performance, with an AUC of 0.89 (95% CI, 0.86-0.92), sensitivity of 0.83 (95% CI, 0.79-0.88) and specificity of 0.81 (95% CI, 0.77-0.85) at the optimal cut-off (31% risk of malignancy, based on Youden's index). At a 10% risk-of-malignancy cut-off, it had a sensitivity of 0.94 (95% CI, 0.91-0.97) and specificity of 0.48 (95% CI, 0.42-0.53). The ADNEX model had an AUC of 0.95 (95% CI, 0.93-0.97), sensitivity of 0.97 (95% CI, 0.95-0.99) and specificity of 0.72 (95% CI, 0.68-0.77) at the 10% risk-of-malignancy cut-off in the validation set. CONCLUSIONS: Our results support further exploration of radiomics analysis for distinguishing between benign and malignant adnexal masses in larger study populations. Future studies should consider using multiple images per tumor and testing alternative model-building methods, and should perform external validation to assess the generalizability of the radiomics models. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Sileo FG, Khalil A, Binder J
… +17 more
, Brunelli E, Chianchiano N, Coutinho CM, D'Antonio F, Döbert M, Fichera A, Gielchinsky Y, Hecher K, Iacovella C, Malone S, Martinez-Varea A, Nørgaard LN, Rodo C, Simões T, Slaghekke F, Yinon Y, Collaborators
Ultrasound Obstet Gynecol
· 2026 Apr · PMID 41906959
·
Full text
OBJECTIVE: The aim of this study was to evaluate the perinatal outcomes of monochorionic diamniotic (MCDA) twin pregnancies complicated by early twin-to-twin transfusion syndrome (TTTS) treated with fetoscopic laser surg...OBJECTIVE: The aim of this study was to evaluate the perinatal outcomes of monochorionic diamniotic (MCDA) twin pregnancies complicated by early twin-to-twin transfusion syndrome (TTTS) treated with fetoscopic laser surgery (FLS), and to compare rates of fetal survival across Quintero stages. METHODS: This was a multicenter retrospective cohort study of MCDA pregnancies complicated by TTTS diagnosed ≤ 18 weeks' gestation (early TTTS) that underwent FLS from January 2007 to August 2023. Monoamniotic twins, triplets or higher-order multiple gestations, and pregnancies complicated by genetic or structural anomalies were excluded. Demographic data, gestational age at diagnosis and at FLS, Quintero stage at diagnosis and details of management of the pregnancy, including complications and perinatal outcomes, were obtained from patient records at each participating center. The primary outcome was survival at 28 days after birth. RESULTS: In total, 678 MCDA pregnancies with early TTTS were identified, of which 550 underwent FLS. Of these, 485 cases had a known pregnancy outcome and were therefore included. The median gestational age at diagnosis was 17 + 0 (interquartile range (IQR), 16 + 3 to 17 + 4) weeks, and median gestational age at FLS was 17 + 4 (IQR, 17 + 0 to 17 + 6) weeks. The most common Quintero stage at diagnosis was Stage III (46.0% (223/485)). At least one postoperative complication occurred in 36.5% (177/485) of cases, including preterm prelabor rupture of membranes, intrauterine fetal demise of the cotwin, vaginal bleeding, septostomy and pregnancy loss. Dual-twin survival was reported in 51.5% (250/485) of cases, while survival of at least one twin was reported in 76.7% (372/485). There were no surviving fetuses in 23.3% (113/485) of pregnancies. When considering cases diagnosed ≤ 16 weeks, the rate of survival of at least one twin was 87.5% for cases diagnosed at Quintero Stages I-II vs 59.5% for Stages III-IV (P = 0.019). CONCLUSIONS: The diagnosis and management of TTTS ≤ 18 weeks are more complex than those of TTTS diagnosed > 18 weeks. More early-TTTS cases were diagnosed at Quintero Stage III, but the overall survival rate was not significantly different between cases diagnosed at Quintero Stages I-II vs Stages III-IV, except when the diagnosis was made ≤ 16 weeks, in which case the survival rate was higher among cases diagnosed at Stages I-II. Revisions to the diagnostic criteria for early TTTS should be considered. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Rolnik DL, Gil-Pugliese S, Syngelaki A
… +5 more
, Bujold E, Wright D, Poon LC, Nicolaides KH, ASPRE and SPREE Collaborators
Ultrasound Obstet Gynecol
· 2026 May · PMID 41903191
·
Full text
OBJECTIVES: To evaluate the effect of aspirin on gestational age at delivery due to preterm pre-eclampsia (PE) in women with chronic hypertension (CH), to assess the predictive performance of the Fetal Medicine Foundatio...OBJECTIVES: To evaluate the effect of aspirin on gestational age at delivery due to preterm pre-eclampsia (PE) in women with chronic hypertension (CH), to assess the predictive performance of the Fetal Medicine Foundation (FMF) first-trimester competing-risks model for preterm PE in this high-risk group and to evaluate how parity, previous PE and biomarker values influence individualized risk estimates. METHODS: We analyzed data from two multicenter first-trimester PE screening studies: the Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-based Preeclampsia Prevention trial and the Screening Program for Preeclampsia trial. The effect of aspirin on gestational age at delivery due to PE was assessed using Bayesian inference. The screening performance of the FMF model was evaluated by discrimination, calibration and decision-curve analysis. The influence of parity, previous PE and biomarkers (mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI) and placental growth factor (PlGF)) on risk classification was explored using empirical data and Monte Carlo simulations with generalized additive models. RESULTS: The combined dataset included 51 024 women with a singleton pregnancy, of whom 556 (1.1%) had CH. Among the women with CH, 58 (10.4%) developed preterm PE. Bayesian analysis indicated that aspirin delayed delivery due to PE by a mean of 3.6 (95% credible interval, 0.2-6.6) weeks, with a 98% posterior probability of benefit. The FMF model demonstrated good discrimination (area under the receiver-operating-characteristics curve, 0.819 (95% CI, 0.763-0.874)), adequate calibration and higher net benefit compared with a treat-all approach. Overall, 21.8% of women with CH were classified as low risk (< 1 in 100) for preterm PE, consisting mostly of nulliparous women and parous women without previous PE. Predicted risks for preterm PE were strongly influenced by MAP and PlGF, with UtA-PI contributing to a lesser extent. CONCLUSIONS: In women with CH, aspirin can delay delivery due to preterm PE, and first-trimester risk assessment using the FMF competing-risks model reliably identifies low- and high-risk individuals. The predicted risk is driven primarily by MAP and PlGF, supporting risk stratification and individualized management in early pregnancy. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Cruz-Martínez R, Cisneros-Martínez A, Rodriguez-García JL
… +2 more
, Peláez-Jiménez A, Gil-Pugliese S
Ultrasound Obstet Gynecol
· 2026 May · PMID 41903156
·
Publisher ↗
Abstract loading — click title to view on PubMed.
Stampalija T, Forcato C, Grati FR
… +21 more
, Volpe P, De Robertis V, Izzi C, Bertucci E, Fabietti I, Novelli A, Ornaghi S, Pasquini L, Bevilacqua E, Paladini D, Ghi T, Lattuada D, Dori M, Mercatelli D, Dal Molin A, Buson G, Bolognesi C, Doffini A, Musci TJ, Ferrazzi E, Collaborators
Ultrasound Obstet Gynecol
· 2026 Apr · PMID 41883021
·
Full text
OBJECTIVE: Pathogenic or likely pathogenic copy-number variants (p/lpCNVs) are a significant cause of perinatal morbidity and mortality. Current prenatal screening based on cell-free DNA (cfDNA) fails to detect the major...OBJECTIVE: Pathogenic or likely pathogenic copy-number variants (p/lpCNVs) are a significant cause of perinatal morbidity and mortality. Current prenatal screening based on cell-free DNA (cfDNA) fails to detect the majority of microimbalances (microdeletions/microduplications), leaving a significant residual risk of undetected chromosomal abnormalities. This study evaluated the clinical performance of a novel single-cell-sequencing-based non-invasive prenatal testing (scsbNIPT) method utilizing circulating extravillous trophoblasts (cEVTs) for the detection of fetal p/lpCNVs, particularly microimbalances < 8 Mb. METHODS: This was a prospective, blinded, observational multicenter cohort study of 1390 high-risk pregnant women undergoing prenatal invasive diagnostic testing between November 2021 and December 2023. A 20-mL maternal blood sample was collected from each subject between 11 + 0 and 22 + 6 weeks' gestation prior to invasive sampling. cEVTs were isolated and subjected to whole-genome sequencing, using a proprietary workflow. scsbNIPT results were compared with standard invasive prenatal diagnostic results obtained by karyotyping and/or chromosomal microarray analysis. RESULTS: scsbNIPT showed a sensitivity of 92.9% (95% CI, 76.5-99.1%) and a specificity of 98.2% (95% CI, 97.0-99.0%) for the detection of genome-wide microimbalances measuring ≥ 300 kb to < 8 Mb. The sensitivity for p/lpCNVs ≥ 300 kb in pregnancies screened at 11 + 0 to 14 + 6 weeks was 100% (95% CI, 83.9-100%). For trisomy 21, the sensitivity of scsbNIPT was 98.0% (95% CI, 92.9-99.8%) and the specificity was 99.7% (95% CI, 99.0-99.9%). CONCLUSIONS: This study demonstrates the scientific validity and clinical utility of scsbNIPT for the non-invasive detection of genome-wide fetal p/lpCNVs, particularly microimbalances, with high sensitivity and a resolution comparable to that of chromosomal microarray analysis. scsbNIPT may offer more complete screening for genome-wide p/lpCNVs, markedly lowering the residual risk early in pregnancy compared with existing cfDNA-based methods. © 2026 Menarini Silicon Biosystems. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Fischerova D, Farsi E, Facchetti E
… +9 more
, Panizzolo E, Gambino G, Reina H, Sousa F, Kadajari MR, Tiszlavicz N, Garganese G, Nanka O, Collaborators
Ultrasound Obstet Gynecol
· 2026 Mar · PMID 41873786
·
Publisher ↗
Abstract loading — click title to view on PubMed.
Dall'Asta A, Ghi T
Ultrasound Obstet Gynecol
· 2026 Jun · PMID 41834490
·
Publisher ↗
Abstract loading — click title to view on PubMed.
Melis B, Macé P, Dawood Y
… +3 more
, de Bakker B, Ghi T, Quarello E
Ultrasound Obstet Gynecol
· 2026 Mar · PMID 41808390
·
Publisher ↗
Abstract loading — click title to view on PubMed.
Diaz L, Zambrano B, Viñals F
Ultrasound Obstet Gynecol
· 2026 Apr · PMID 41793086
·
Publisher ↗
Abstract loading — click title to view on PubMed.
Nijjar S, Jurkovic D
Ultrasound Obstet Gynecol
· 2026 Apr · PMID 41793075
·
Publisher ↗
Abstract loading — click title to view on PubMed.
Hovsepyan L, Malakyan Z, Saradyan A
… +4 more
, Asilbekyan N, Mazmanian I, Eloyan H, Valentin L
Ultrasound Obstet Gynecol
· 2026 Jun · PMID 41793047
·
Publisher ↗
Abstract loading — click title to view on PubMed.
Moro F, Pellecchia G, Perrone F
… +3 more
, D'Alessandris N, Fagotti A, Testa AC
Ultrasound Obstet Gynecol
· 2026 May · PMID 41792026
·
Publisher ↗
Abstract loading — click title to view on PubMed.
Sherer DM, Kheyman M, Dalloul M
Ultrasound Obstet Gynecol
· 2026 May · PMID 41791935
·
Publisher ↗
Abstract loading — click title to view on PubMed.
Ciccarone F, Rizzi A, Biscione A
… +21 more
, Baldassari G, Tran EH, Pasciuto T, Moro F, Zinicola G, Buonomo F, Colombin M, Ghezzi F, Casarin J, Mancari R, Borella F, Kardhashi A, Roccio M, Savelli L, Cioffi R, Fanfani F, Ferrandina G, Scambia G, Valentin L, Lorusso D, Testa AC
Ultrasound Obstet Gynecol
· 2026 Apr · PMID 41791853
·
Full text
OBJECTIVE: To develop machine-learning models that incorporate clinical information and radiomics features extracted from ultrasound images to distinguish uterine sarcomas from leiomyomas. METHODS: This retrospective, mu...OBJECTIVE: To develop machine-learning models that incorporate clinical information and radiomics features extracted from ultrasound images to distinguish uterine sarcomas from leiomyomas. METHODS: This retrospective, multicenter, pilot case-control study included 200 patients (100 with a uterine sarcoma and 100 with a usual-type leiomyoma, i.e. including no benign leiomyoma variants) who underwent preoperative ultrasound examination between January 2010 and June 2022. The patient cohort was split (70:30) into training and validation sets, with the same proportion of leiomyomas and sarcomas in each subset. We extracted radiomics features belonging to different families: intensity-based statistical features and textural features. The variables used in model building were patient age and the radiomics features that differed statistically significantly between sarcomas and leiomyomas and that were not redundant based on Spearman's correlation coefficient. Logistic regression, random forest, extreme gradient boosting (XGBoost) and support vector machine models were tested in the model development process. We evaluated the performance of the models in differentiating between sarcomas and leiomyomas using the area under the receiver-operating-characteristics curve (AUC), accuracy, sensitivity and specificity. We compared these results to those of subjective assessment by the original ultrasound examiner and to those of two independent expert ultrasound examiners who, blinded to clinical history, reviewed the same grayscale ultrasound images as those used for the radiomics analysis. RESULTS: Sixty-three radiomics features were extracted. Of these, eight differed statistically significantly between sarcomas and leiomyomas and were not correlated, so were selected for inclusion in model building. In the validation set, the model that performed best in differentiating between sarcomas and leiomyomas was an XGBoost model integrating patient age and radiomics features. In the validation set, this model had an AUC of 0.93, sensitivity of 0.93 and specificity of 0.83, at a risk-of-malignancy cut-off of 47% (the cut-off that yielded the highest number of correct classifications based on Youden's index in the training set). The corresponding results for the model integrating only the radiomics features were: AUC of 0.87, sensitivity of 0.87 and specificity of 0.83. Subjective assessment by the original ultrasound examiner had a sensitivity of 0.87 and specificity of 1 in the validation set, while retrospective review of grayscale ultrasound images by ultrasound experts had a sensitivity of 0.87 and specificity of 0.80 (same results for both reviewers). CONCLUSION: A model including eight radiomics features and patient age demonstrated reasonably good discriminative and classification performance for distinguishing uterine sarcomas from leiomyomas. Its classification ability was similar to that of subjective assessment by the original ultrasound examiner, being more sensitive but less specific. To confirm the role of radiomics for discriminating between uterine sarcomas and leiomyomas, large prospective studies including benign leiomyoma variants are needed. If good performance of radiomics models can be confirmed, integrating automated radiomics analysis into ultrasound machine software may help ultrasound examiners to discriminate between sarcomas and benign leiomyomas. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Jaeggi E, Sun L, Saito M
… +4 more
, Szabo A, Arbic N, Mueller B, Seed M
Ultrasound Obstet Gynecol
· 2026 Jul · PMID 41784038
·
Publisher ↗
OBJECTIVE: Newborns with dextro-transposition of the great arteries (TGA) without adequate intracardiac shunting of oxygenated blood are at imminent risk of severe hypoxia at birth. Using fetal echocardiography and cardi...OBJECTIVE: Newborns with dextro-transposition of the great arteries (TGA) without adequate intracardiac shunting of oxygenated blood are at imminent risk of severe hypoxia at birth. Using fetal echocardiography and cardiac magnetic resonance imaging (CMR) in room air (RA) and during acute maternal hyperoxygenation (AMH), we sought to identify predelivery imaging features predictive of neonatal hypoxia and the need for urgent balloon atrial septostomy (BAS) within the first 3 h after birth. METHODS: This was a prospective single-center cohort study of pregnancies with TGA with an intact ventricular septum (IVS) or a single ventricular septal defect (VSD) ≤ 4 mm. Fetal echocardiography and, if feasible, CMR were conducted concurrently at 34-38 weeks' gestation. Cardiac structures, including the foramen ovale (FO) and atrial septum, were examined using two-dimensional and Doppler echocardiography. CMR was used to quantify fetal weight, brain volume and vascular oxygen saturation (SaO). Both imaging modalities were used to assess fetal vascular blood flows in RA and during AMH. Postnatal data collected included preductal oxygen saturation (SpO) and the need for and timing of BAS. Univariable logistic regression analysis was used to evaluate associations between predelivery imaging features and the need for urgent neonatal BAS. RESULTS: Of 34 newborns with TGA/IVS (n = 29) or TGA/VSD (n = 5), 23 (68%) underwent neonatal BAS, including 12 cases of urgent BAS < 3 h after birth for persistent preductal SpO < 70%. A fetal echocardiogram was obtained in all cases, while 26/34 (76%) underwent CMR, including 9/12 (75%) cases that underwent urgent BAS. On univariable logistic regression analysis, abnormal atrial septal flap morphology in RA (P = 0.004), effective FO size ≤ 3.4 mm during AMH (P = 0.0024) and constricted or continuously reversed diastolic flow across the ductus arteriosus (DA) during AMH (P = 0.0006) were the most significant predictors of urgent neonatal BAS. On CMR, fetuses with an ascending aorta (AAo)/main pulmonary artery (MPA) SaO ratio > 1 during AMH were significantly more likely to undergo urgent BAS postnatally (odds ratio, 28.6 (95% CI, 1.1-620.3); P = 0.0084). CONCLUSION: In fetuses with TGA, predelivery assessment of atrial septal morphology in RA, as well as effective FO size, DA flow pattern and AAo/MPA SaO ratio > 1 during AMH, are the most useful variables for predicting the need for urgent neonatal BAS. © 2026 International Society of Ultrasound in Obstetrics and Gynecology.
Rameh G, Gallo DM, Corroenne R
… +5 more
, Helou N, Aboujaoude I, Seshadri S, Tolosa JE, Chalouhi G
Ultrasound Obstet Gynecol
· 2026 Apr · PMID 41739883
·
Publisher ↗
OBJECTIVES: The primary objective was to compare the evaluation of trainees' obstetric and gynecological (OBGYN) ultrasound skills by an in-person vs remote examiner. The secondary objectives were to compare the assessme...OBJECTIVES: The primary objective was to compare the evaluation of trainees' obstetric and gynecological (OBGYN) ultrasound skills by an in-person vs remote examiner. The secondary objectives were to compare the assessment of obstetric ultrasound skills using three types of ultrasound simulator vs traditional examination involving a pregnant volunteer, and to evaluate the perspectives of trainees and examiners on the three ultrasound simulators. METHODS: This was a prospective study of 12 physicians with minimal experience in OBGYN ultrasound. After completing a structured training course, trainees performed an ultrasound examination at four stations: one involving a mid-trimester pregnant volunteer (obstetric examination only) and three using ultrasound simulators (OBGYN examination), namely an ultrasound simulator app, a high-fidelity mannequin simulator and an optical positioning simulator. At each station, two certified maternal-fetal medicine specialists assessed the scans simultaneously, with one examiner present in the room and the other observing remotely via live video. The assessments were based on the 20-planes approach from the International Society of Ultrasound in Obstetrics and Gynecology Basic Training program and the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale. An anonymous survey was used to gauge the subjective impressions of the maternal-fetal medicine specialists and trainees on the three ultrasound simulators. RESULTS: The image scores from remote vs in-person assessment using the 20-planes approach showed moderate-to-good agreement across three of the four stations, with intraclass correlation coefficient (ICC) values ranging from 0.51 (95% CI, 0.06-0.80) to 0.89 (95% CI, 0.26-0.99). However, remote assessment of OBGYN ultrasound images obtained using the high-fidelity mannequin simulator yielded lower scores compared with in-person assessment, with an ICC of 0.28 (95% CI, -0.32 to 0.72). Additionally, scores on the OSAUS scale obtained remotely differed significantly from those obtained in person for all stations (P < 0.05 for all). Using the 20-planes approach, the obstetric image scores obtained during the traditional examination involving a pregnant volunteer were similar to those obtained using the optical positioning simulator, but not to those from the other two simulators. The OSAUS scores were similar only between the ultrasound simulator app and the high-fidelity mannequin simulator, and between the optical positioning simulator and assessment on a pregnant volunteer, when the assessment was conducted by an in-person examiner. Examiners and trainees generally agreed that ultrasound simulators offer benefit in the training and assessment of OBGYN ultrasound skills. CONCLUSIONS: Simulation-based techniques show potential for evaluating OBGYN ultrasound competence. It may be possible for evaluation to be conducted remotely by experts certified in maternal-fetal medicine. While promising as an educational and training tool, the role of simulation as a method for remotely assessing ultrasound skills warrants further investigation. © 2026 International Society of Ultrasound in Obstetrics and Gynecology.