Ultrasound Obstet Gynecol [JOURNAL]
Sun
200 papers
Diagnostic accuracy of ultrasound models for assessment of ovarian tumors: systematic review and meta-analysis.
Lems E, Koch AH, Delvaux EJLG … +5 more , Leemans JC, Bongers MY, Lok CAR, Ramaekers BL, Geomini PMAJ
Ultrasound Obstet Gynecol · 2026 May · PMID 41346086 · Full text
OBJECTIVE: Accurate preoperative classification of ovarian tumors is essential for guiding treatment. There is an increasing body of data evaluating ultrasound-based models for this purpose in diverse clinical settings....
OBJECTIVE: Accurate preoperative classification of ovarian tumors is essential for guiding treatment. There is an increasing body of data evaluating ultrasound-based models for this purpose in diverse clinical settings. The aim of this systematic review and meta-analysis was to generate up-to-date evidence on the diagnostic accuracy of the most relevant ultrasound-based models, including the Risk of Malignancy Index (RMI) versions 1, 2 and 3, Logistic Regression model 2 (LR2), Simple ultrasound-based Rules (SR), the Assessment of Different NEoplasias in the adneXa (ADNEX) model and subjective assessment (SA), for the differentiation between benign and malignant ovarian tumors. METHODS: Ovid/MEDLINE, EMBASE and the Cochrane Library were searched systematically from database inception until 19 June 2025. Eligible studies investigated the diagnostic accuracy of at least one of the preselected models, collected model parameters prospectively and provided sufficient data to construct 2 × 2 tables. The risk of bias of all included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 and QUADAS-C extension tools. Pooled summary estimates of sensitivity and specificity for all included models were calculated and bivariate models were fitted into hierarchical summary receiver-operating-characteristics curves. Bivariate random-effects meta-regression analysis was conducted to determine significant differences in sensitivity and specificity between models. Subgroup analyses were conducted according to menopausal status and prevalence of ovarian malignancy. RESULTS: A total of 99 studies were included, describing 42 496 ovarian tumors, of which 31 371 (74%) were benign and 11 125 (26%) were malignant. SA had both high sensitivity (90.2% (95% CI, 87.8-92.2%)) and high specificity (91.4% (95% CI, 89.3-93.2%)). SR followed by SA of inconclusive cases (SR + SA) showed similar performance to SA (sensitivity, 88.6% (95% CI, 85.7-91.0%); P = 0.397 and specificity, 91.0% (95% CI, 89.0-92.7%); P = 0.811), as did the ADNEX model with a cut-off of 20% (sensitivity, 86.7% (95% CI, 80.6-91.0%); P = 0.095; specificity, 87.9% (95% CI, 80.1-92.9%), P = 0.119). The ADNEX model with a cut-off of 10% had a similar sensitivity to SA (92.7% (95% CI, 90.8-94.2%); P = 0.130), but lower specificity (78.4% (95% CI, 71.7-83.8%); P < 0.001). Higher cut-offs of the ADNEX model led to a decrease in sensitivity, whereas lower cut-offs resulted in reduced specificity. The LR2 model with a 10% cut-off had a sensitivity of 89.5% (95% CI, 85.8-92.4%) and a specificity of 82.3% (95% CI, 75.0-87.8%). The RMI had the lowest diagnostic accuracy, with a sensitivity of 69.7% (95% CI, 67.0-72.2%) and a specificity of 90.5% (95% CI, 88.3-92.4%) for RMI version 1 with a cut-off of 200. Subgroup analyses showed that both menopausal status and prevalence of malignancy significantly affected sensitivity (P < 0.01) and specificity (P < 0.01). Postmenopausal status and higher disease prevalence were associated with lower specificity, while sensitivity was lower in premenopausal women. CONCLUSIONS: All approaches, except for the RMI, performed well and could be used to differentiate between benign and malignant ovarian tumors. Although SA with or without SR had the highest diagnostic performance, it is dependent on operator expertise. If a strategy independent of operator expertise is preferred, the ADNEX model is recommended. Because of the high sensitivity of the ADNEX model, the likelihood of missing malignancies is low. In postmenopausal women, however, the reduced specificity may warrant a higher cut-off, depending on how the impact of a false-positive test result is evaluated. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Adverse perinatal outcomes in twins: comparison of intertwin fetal size discordance vs singleton and twin fetal growth charts.
Giorgione V, Lopian M, Trapani M … +9 more , Brutto M, Ferrante MG, Bhide A, Jani JC, Badr DA, Ghi T, Bevilacqua E, Familiari A, Thilaganathan B
Ultrasound Obstet Gynecol · 2026 Jan · PMID 41346036 · Full text
OBJECTIVE: To compare the predictive performance of intertwin estimated fetal weight (EFW) discordance and EFW centile calculated according to either the Fetal Medicine Foundation (FMF) singleton or twin-specific fetal g...
OBJECTIVE: To compare the predictive performance of intertwin estimated fetal weight (EFW) discordance and EFW centile calculated according to either the Fetal Medicine Foundation (FMF) singleton or twin-specific fetal growth charts for adverse perinatal outcome in dichorionic and monochorionic twin pregnancies. METHODS: This was a retrospective multicenter cohort study of twin pregnancies managed between January 2013 and December 2023 at three tertiary fetal medicine centers in the UK, Italy and Belgium. Twin pregnancies in which an obstetric ultrasound exam was performed to obtain fetal biometry within 2 weeks before live birth or diagnosis of intrauterine fetal demise of one or both twins were included. Cases with anastomotic complications were excluded. The primary outcome was a composite adverse perinatal outcome (CAPO), defined as stillbirth (intrauterine fetal demise ≥ 22 weeks) of at least one cotwin and/or iatrogenic early preterm birth (delivery < 34 weeks) for fetal indications. The predictive performance of intertwin EFW discordance and of the EFW centile of the smaller twin, calculated using either singleton or twin-specific FMF fetal growth charts, was assessed for CAPO. Predictive models were developed using logistic regression analysis and evaluated using the area under the receiver-operating-characteristics curve (AUC); pairwise comparisons between models were performed using DeLong's test. RESULTS: The study analyzed 1294 dichorionic and 487 monochorionic twin pregnancies. For the prediction of CAPO, intertwin EFW discordance in dichorionic twins achieved an AUC of 0.93 (95% CI, 0.89-0.98), compared with 0.83 (95% CI, 0.77-0.90) (P = 0.001) and 0.87 (95% CI, 0.81-0.93) (P = 0.017) for EFW centile based on singleton and twin-specific growth charts, respectively. Likewise, intertwin EFW discordance achieved an AUC of 0.95 (95% CI, 0.92-0.97) for predicting CAPO in monochorionic twins, outperforming EFW centile based on singleton charts (AUC, 0.80 (95% CI, 0.73-0.87); P < 0.001) and twin-specific growth charts (AUC, 0.83 (95% CI, 0.76-0.90); P < 0.001). In clinical terms, at a 20% false-positive rate (FPR), the sensitivity for CAPO in dichorionic twin pregnancies was 74%, 81% and 93% using singleton charts, twin-specific charts and intertwin EFW discordance, respectively. Similarly, in monochorionic twin pregnancies, the sensitivity at a FPR of 20% was 75%, 79% and 98% using singleton charts, twin-specific charts and intertwin EFW discordance, respectively. CONCLUSIONS: Intertwin EFW discordance is a more reliable predictor of the composite outcome of stillbirth in at least one cotwin and/or iatrogenic early preterm birth in twin pregnancies than is EFW centile based on either singleton or twin-specific growth charts. This approach addresses the limitations of using different fetal growth reference charts that rely on arbitrary cut-offs. Following external validation, the use of intertwin EFW discordance prediction algorithms may potentially enhance risk stratification to improve clinical outcomes in twin pregnancies. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Association of sling location and bladder descent on ultrasound with cure, satisfaction and complications 10-20 years after midurethral sling surgery: multicenter cross-sectional study.
Solhaug BR, Nyhus MØ, Svenningsen R … +1 more , Volløyhaug I
Ultrasound Obstet Gynecol · 2026 Feb · PMID 41346009 · Publisher ↗
OBJECTIVES: The primary aim of this study was to investigate the association between sling location and cure 10-20 years after midurethral sling (MUS) surgery. The secondary aims were to explore the association of sling...
OBJECTIVES: The primary aim of this study was to investigate the association between sling location and cure 10-20 years after midurethral sling (MUS) surgery. The secondary aims were to explore the association of sling location with patient satisfaction and complications and the association of bladder descent with cure, satisfaction and complications, 10-20 years after MUS surgery. METHODS: This was a multicenter cross-sectional study of 263 women who underwent MUS surgery at Ålesund Hospital, Oslo University Hospital or Trondheim University Hospital, Norway, from 2001-2002 or 2011-2012. Inclusion periods were extended to 2001-2003 at Oslo University Hospital and 2001-2006 at Trondheim University Hospital to reach the statistical power estimate. Participants were identified from the Norwegian Female Incontinence Registry. Subjective cure (stress urinary incontinence (SUI) index < 3 (SUI index score range, 0-12)), satisfaction with MUS surgery and complications after MUS surgery (urgency urinary incontinence (UUI) index ≥ 3 (UUI index score range, 0-8), persisting pain, subjective voiding difficulties, > 1 urinary tract infection (UTI) within the last year) were assessed using validated questionnaires. Objective cure was defined as < 3 g urinary leakage on a pad-weighing cough/jump stress test conducted with a minimum bladder volume of 200 mL. Post-void residual volume ≥ 200 mL, measured by catheterization, was defined as significant objective voiding difficulty. Transperineal ultrasound was used to assess sling location (sling-to-bladder-neck distance at rest and sling-to-symphysis distance during Valsalva maneuver). Bladder neck descent and bladder descent were also measured during Valsalva maneuver. The primary null hypothesis was that subjective and objective cures are not associated with sling location. The secondary null hypothesis was that there is no difference in cure between women with vs those without significant bladder descent. RESULTS: We found no association between sling location and subjective or objective cure, satisfaction or persisting pain after MUS surgery. Women with a UUI index ≥ 3 had a significantly shorter sling-to-symphysis distance compared to women with a UUI index < 3 (adjusted mean difference (aMD), -0.13 (95% CI, -0.15 to -0.001) cm; P = 0.048). Women who had experienced > 1 UTI within the last year had a significantly shorter sling-to-symphysis distance than women who had ≤ 1 UTI within the last year (aMD, -0.14 (95% CI, -0.24 to -0.01) cm; P = 0.03). Women with bladder descent > 50 percentile had greater odds of having objective voiding difficulties compared to women with bladder descent ≤ 50 percentile (adjusted odds ratio, 3.2 (95% CI, 1.6-9.0); P = 0.03). No associations were found between bladder descent or bladder neck descent and any of the other outcomes. CONCLUSIONS: We found no differences in sling location between women who were cured vs those who were not, those who were satisfied vs those who were dissatisfied with MUS surgery, and women who did vs those who did not experience complications after MUS surgery. This indicates that other factors, such as age-related changes, repeat SUI surgery or medication, can influence long-term results. However, women with a UUI index ≥ 3 and those who had > 1 UTI within the last year had a shorter sling-to-symphysis distance compared to women with a UUI index of < 3 and those who had ≤ 1 UTI within the last year, respectively, indicating that the tension of the sling may be increased in these women. Ultrasound-measured bladder descent > 50 percentile was associated with higher odds of objective voiding difficulties at long-term follow-up, indicating that bladder descent, rather than tape location, has an impact on residual urine. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.
Fetal brain connectomics using diffusion tensor imaging: insights into prenatal brain development.
Corroenne R, Grevent D, Salomon LJ
Ultrasound Obstet Gynecol · 2026 Feb · PMID 41332140 · Publisher ↗
Abstract loading — click title to view on PubMed.
35 World Congress on Ultrasound in Obstetrics and Gynecology, 14-17 September 2025, Cancun, Mexico: presentations and awards.
Ultrasound Obstet Gynecol · 2025 Dec · PMID 41329904 · Publisher ↗
Abstract loading — click title to view on PubMed.
Cervical ripening balloon vs oral misoprostol for induction of labor in small-for-gestational age: retrospective multicenter study.
Zaccaria G, Dutemeyer V, Carlin A … +6 more , Forlani F, Maiorana A, Brodowski L, von Kaisenberg C, Jani JC, Badr DA
Ultrasound Obstet Gynecol · 2026 Jan · PMID 41305845 · Publisher ↗
OBJECTIVE: To compare the maternal and neonatal outcomes following induction of labor (IOL) using oral misoprostol vs mechanical cervical ripening using a cervical ripening balloon (CRB) in singleton pregnancies complica...
OBJECTIVE: To compare the maternal and neonatal outcomes following induction of labor (IOL) using oral misoprostol vs mechanical cervical ripening using a cervical ripening balloon (CRB) in singleton pregnancies complicated by small-for-gestational age (SGA), including those with late-onset fetal growth restriction (FGR). METHODS: This was a retrospective multicenter cohort study of women with a singleton pregnancy with estimated fetal weight < 10 percentile and a Bishop score of < 7, who underwent IOL ≥ 37 weeks' gestation for suspected SGA or late-onset FGR in one of three European tertiary centers. Participants were assigned to one of two groups depending on whether they underwent cervical ripening using a CRB without pharmacologic agents (CRB-only group) or received oral misoprostol with or without a CRB (misoprostol group). Women who had had a prior Cesarean delivery (CD), those who received vaginal misoprostol and those with early-onset FGR, fetal structural anomalies or contraindications to vaginal delivery were excluded. The primary outcome was CD. Secondary outcomes included spontaneous vaginal delivery (SVD) within 24 h after starting IOL, operative vaginal delivery (OVD), oxytocin augmentation, uterine tachysystole and neonatal outcomes. Inverse probability of treatment weighting was used to account for baseline differences and doubly robust estimation was used to adjust for confounders. RESULTS: A total of 848 women was included in the analysis, of whom 431 (50.8%) received a CRB only and 417 (49.2%) received oral misoprostol with or without a CRB. Baseline characteristics differed between the two groups, with women in the misoprostol group being older, more often nulliparous and undergoing IOL later in gestation. After adjustment, there was no significant difference in the rate of CD between the two groups (adjusted odds ratio (aOR), 1.29 (95% CI, 0.82-2.04)). Women receiving misoprostol were significantly less likely to undergo OVD (aOR, 0.33 (95% CI, 0.18-0.64)) or require oxytocin augmentation (aOR, 0.04 (95% CI, 0.03-0.07)) compared with the CRB-only group. SVD within 24 h after starting IOL was also less likely in the misoprostol group (aOR, 0.49 (95% CI, 0.33-0.74)). Uterine tachysystole occurred more frequently in the misoprostol ± CRB group, but this was not associated with higher rates of CD for fetal distress or adverse neonatal outcomes. The rate of admission to the neonatal intensive care unit was similar between the two groups. Subgroup analysis in pregnancies with confirmed late-onset FGR yielded comparable findings. CONCLUSIONS: In pregnancies complicated by late-onset FGR or SGA, oral misoprostol did not increase the risk of CD compared with mechanical cervical ripening only, and was associated with a reduced need for operative interventions and labor augmentation. These findings support the use of oral misoprostol as a safe and effective option for IOL in this high-risk population. Randomized controlled trials are needed to confirm these results. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.
Whole-genome paternal uniparental disomy identified through prenatal single-nucleotide polymorphism-based cell-free DNA screening.
Benn P, Hashimoto K, Souter V … +3 more , Dhamankar R, Xu W, Kijacic D
Ultrasound Obstet Gynecol · 2026 Jan · PMID 41299888 · Full text
OBJECTIVE: Prenatal single-nucleotide polymorphism (SNP)-based cell-free DNA (cfDNA) screening can identify genome-wide paternal uniparental disomy (GW-UPDpat), including cases with complete hydatidiform mole with a coex...
OBJECTIVE: Prenatal single-nucleotide polymorphism (SNP)-based cell-free DNA (cfDNA) screening can identify genome-wide paternal uniparental disomy (GW-UPDpat), including cases with complete hydatidiform mole with a coexisting fetus (CHMCF), those with placental mesenchymal dysplasia (PMD) and those with a mosaic/chimeric GW-UPDpat syndrome. Our objective was to review laboratory data and pregnancy outcome for SNP-based cfDNA screening tests with results compatible with GW-UPDpat and a normal cell line. METHODS: This was a retrospective study of all cfDNA screening results from a single commercial laboratory between June 2014 and November 2023 that were reported as twins or triploidy, with apparent GW-UPDpat. Two-dimensional representations of the relative ratios of SNP alleles (SNP plots) were used to identify and quantify the proportion of cfDNA from the mole ('molar fraction') and that from the coexisting non-molar pregnancy ('fetal fraction'). Test referral and follow-up information, including ultrasound findings, laboratory testing and pregnancy outcome, were reviewed. RESULTS: Of 5 699 009 tests reviewed, 89 were reported as twins or triploidy, with apparent GW-UPDpat. Retrospective review of SNP plots excluded 12 cases that were reinterpreted as triploidy with an extra set of paternal chromosomes. Of the remaining 77 cases, 24 had follow-up pregnancy information available, and of these, 21 (87.5%) had ultrasound and/or pathology findings that were consistent with CHMCF. The fetal cfDNA fraction was often very low (≤ 2% in 28 cases). The molar cfDNA fraction was in the range of 10-58%. Fetal sex was male in 35 cases, female in 40 cases and uncertain in two cases. No case showed clear evidence of a Y-chromosome in the GW-UPDpat line. All 77 cases had isodisomy; none showed clear evidence of regions of heterodisomy. CONCLUSIONS: SNP-based cfDNA screening can help to identify CHMCF and distinguish between CHMCF and triploidy. For CHMCF, early detection is important for evaluating the risk of adverse outcome and gestational trophoblastic neoplasia. Some of our test-positive cases could have included unrecognized PMD or mosaic/chimeric GW-UPDpat syndrome. These preliminary observations do not allow assessment of the sensitivity or positive predictive value of this test. © 2025 Natera, Inc. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Reproducibility of first-trimester uterine artery pulsatility index measurements and impact on preterm pre-eclampsia screening.
Ammari C, Napolitano R, Stott D … +3 more , Omer S, Nzelu D, Hillman SL
Ultrasound Obstet Gynecol · 2026 Feb · PMID 41299857 · Publisher ↗
Abstract loading — click title to view on PubMed.
Imaging in gynecological disease (30): clinical and ultrasound characteristics of usual-type and variants of leiomyoma.
Russo C, Moro F, Ciccarone F … +10 more , Biscione A, Scaglione G, Rizzi A, Robba E, Pasciuto T, Zinicola G, Sidoti G, Romualdi D, Fanfani F, Testa AC
Ultrasound Obstet Gynecol · 2026 Mar · PMID 41299835 · Publisher ↗
OBJECTIVE: To characterize the clinical and ultrasound features of usual-type leiomyoma and variants of leiomyoma. METHODS: This retrospective, single-center study included patients with a histologically confirmed diagno...
OBJECTIVE: To characterize the clinical and ultrasound features of usual-type leiomyoma and variants of leiomyoma. METHODS: This retrospective, single-center study included patients with a histologically confirmed diagnosis of benign mesenchymal uterine tumor, prospectively collected between January 2019 and December 2021 in the MYometrial Lesion UltrasouNd And mRi (MYLUNAR) study. Tumors were classified according to the Morphological Uterus Sonographic Assessment criteria and grouped according to the 2020 World Health Organization (WHO) classification of female genital tumors into usual-type and variant leiomyomas. The variants of leiomyoma were further classified into specific histological subtypes as defined in the WHO classification. Two ultrasound examiners independently reviewed all available ultrasound images to identify patterns associated with usual-type leiomyoma and variants of leiomyoma. RESULTS: A total of 1766 patients were included, of whom 1383 (78.3%) had usual-type leiomyoma and 383 (21.7%) had a variant of leiomyoma. The median age at diagnosis was 45 (range, 15-88) years, with no statistically significant difference between the two groups. Most patients were premenopausal, although the variant group had a higher proportion of postmenopausal patients compared with the usual-type group (21.5% vs 12.6%; P < 0.001). On ultrasound examination, leiomyoma variants were larger than usual-type leiomyomas (median maximum diameter, 82.5 mm vs 70.0 mm; P < 0.001) and more frequently exhibited cystic areas (33.2% vs 12.8%; P < 0.001). Acoustic shadows were present in 79.1% of variants, compared with 90.4% in usual-type leiomyomas (P < 0.001). Some variant subtypes appeared only in premenopausal women and had distinct morphological characteristics. Epithelioid leiomyomas were the largest variant, with a median diameter of 139.5 mm. Mitotically active leiomyomas showed regular margins and uniform echostructure, and lacked cystic areas in almost all cases. Lipoleiomyomas contained calcifications in some cases. After reviewing the ultrasound images, 13 patterns were identified, some of which were distinctive of specific variant subtypes. CONCLUSION: Patients with usual-type vs variant leiomyomas presented with some distinct clinical and ultrasound characteristics. Among variants of leiomyomas, some histotypes exhibited distinctive clinical and ultrasound features. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.
Antenatal ultrasound diagnosis of fetal micrognathia: validation and reproducibility of quantitative methods.
Denk MC, Bertin M, Donadono V … +5 more , Kangesu L, Yulia A, Ushakov F, Pandya PP, Napolitano R
Ultrasound Obstet Gynecol · 2026 Jan · PMID 41263617 · Full text
OBJECTIVES: The antenatal ultrasound diagnosis of fetal micrognathia can be made subjectively or objectively. We aimed to validate quantitative ultrasound methods proposed for the diagnosis of fetal micrognathia in the s...
OBJECTIVES: The antenatal ultrasound diagnosis of fetal micrognathia can be made subjectively or objectively. We aimed to validate quantitative ultrasound methods proposed for the diagnosis of fetal micrognathia in the second and third trimesters of pregnancy by evaluating their diagnostic performance, reproducibility and impact of measurement variability on diagnosis. METHODS: This was a retrospective study analyzing the objective diagnostic accuracy, reproducibility and impact of measurement variability of mandible angle measurements from facial profile images of fetuses with suspected micrognathia diagnosed antenatally using a subjective method. Fetuses were recruited at between 18 and 28 weeks' gestation, at University College London Hospital, UK, between 2000 and 2018. Four quantitative methods were compared: measurement of the inferior facial angle (IFA), the fronto-naso-mental angle (FNMA), the maxilla-nasion-mandible angle (MNMA) and the facial maxillary angle (FMA). Methods were validated by calculating the percentage of cases in which the measured angles met the diagnostic criteria for micrognathia. To assess intra- and interobserver reproducibility, two sonographers, blinded to each other's findings, measured each angle twice. Bland-Altman plots were used to calculate mean systematic differences and 95% limits of agreement (LoA). Data were expressed in degrees and as percentages to account for the increase in fetal size with advancing gestation. The impact of measurement variability was evaluated by recalculating the diagnostic accuracy adding to the angle cut-off the intraobserver 95% LoA. RESULTS: Of 132 fetuses diagnosed with suspected antenatal micrognathia, 84 cases had a known outcome (termination of pregnancy (n = 56); fetal demise (n = 11); neonatal death (n = 4); live birth (n = 13)) and 48 were lost to follow-up. Fetal facial profile ultrasound images were available for 49 cases in which reproducibility of the measurements was assessed (termination of pregnancy (n = 22); fetal demise (n = 5); neonatal death (n = 3); live birth (n = 6); lost to follow-up (n = 13)). FNMA was the most reproducible and FMA was the least reproducible measurement. Validation analysis showed that 14%, 100%, 88% and 90% of fetuses from our cohort met the criteria for the diagnosis of micrognathia using the cut-off criteria suggested in the original studies for IFA, FNMA, MNMA and FMA, respectively. The 95% LoA for intra- and interobserver reproducibility were 3.5% and 9.5% for FNMA, and 11.6% and 45.0% for FMA, respectively. When adding the intraobserver widest random error to the original study cut-offs, the percentage of fetuses meeting the criteria for diagnosis decreased to 0%, 87%, 49% and 45% for IFA, FNMA, MNMA and FMA, respectively. CONCLUSIONS: Current quantitative ultrasound methods to assess micrognathia antenatally have variable diagnostic accuracy and are not consistently reproducible, which can lead to overdiagnosis or missed diagnosis. Measurement of FNMA is the preferred method to support subjective assessment, however, further evaluation in prospective studies is warranted. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Fetal density evolution and association with ultrasonographically estimated fetal weight: prospective study.
Bouachba A, Bartin R, De Jesus Neves J … +8 more , Bussières L, Grévent D, Virfollet J, Gauchard G, Bobet L, Roux N, Salomon LJ, Gorincour G
Ultrasound Obstet Gynecol · 2026 Feb · PMID 41259892 · Publisher ↗
OBJECTIVE: To assess fetal density throughout gestation using magnetic resonance imaging (MRI) and its potential application in early fetal weight estimation. METHODS: This single-center prospective study included health...
OBJECTIVE: To assess fetal density throughout gestation using magnetic resonance imaging (MRI) and its potential application in early fetal weight estimation. METHODS: This single-center prospective study included healthy pregnant women with a singleton fetus at 16-36 weeks' gestation evaluated between December 2021 and June 2022, and was conducted as part of the 'Lumiere on the Fetus' trial. Fetal density was calculated as the ratio between ultrasound-based estimated fetal weight and the raw fetal body volume (FBV) measured using MRI. Measurements were performed from 16 to 36 weeks. Mean fetal density values were recorded across gestational age. A third-degree polynomial regression was fitted to model the non-linear relationship between gestational age and fetal density, and the results were analyzed accordingly. RESULTS: In total, 260 healthy pregnant women with a singleton fetus were recruited, of whom 196 cases with ultrasound examination performed on the same day or within 7 days before the MRI scan were included in the analysis. Fetal density declined sharply from the early to mid second trimester, decreasing from a mean of 1.42 g/cm at 16 weeks to 1.12 g/cm at 20 weeks, and then stabilizing at a mean of 1.02 g/cm after 22 weeks. A third-degree polynomial regression equation (fetal density = (-1.36 × 10 × GA) + (0.0126 × GA) - (0.390 × GA) + 5.01, where GA is gestational age in weeks) was fitted to model this non-linear relationship, highlighting a physiological transition in fetal density at approximately 22 weeks' gestation that may be linked to early changes in tissue composition. CONCLUSIONS: Fetal density exhibited a sharp decline from 16 to 20 weeks before stabilizing at a mean of 1.0 g/cm after 22 weeks, enabling FBV to approximate fetal weight in g beyond this point based on the principle that weight = volume × density. MRI-based fetal density could serve as a valuable parameter for detecting growth abnormalities in early pregnancy and refining fetal-weight prediction models. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.
Gestational-age calculation by embryonic dating: a more accurate and practical approach than using last menstrual period.
Berghella V, McLaren RA, Barnhart K
Ultrasound Obstet Gynecol · 2026 Feb · PMID 41259816 · Publisher ↗
Abstract loading — click title to view on PubMed.
Perinatal and maternal outcomes of extremely early-onset fetal growth restriction (≤ 26 weeks): systematic review and meta-analysis.
Piergianni M, Della Valle L, Khalil A … +6 more , Rizzo G, Mappa I, Villalain C, Herraiz I, Galindo A, D'Antonio F
Ultrasound Obstet Gynecol · 2026 Apr · PMID 41235926 · Publisher ↗
OBJECTIVE: To report the perinatal and maternal outcomes of singleton pregnancies complicated by extremely early-onset fetal growth restriction (FGR), defined as FGR diagnosed ≤ 26 weeks of gestation. METHODS: MEDLINE, E...
OBJECTIVE: To report the perinatal and maternal outcomes of singleton pregnancies complicated by extremely early-onset fetal growth restriction (FGR), defined as FGR diagnosed ≤ 26 weeks of gestation. METHODS: MEDLINE, EMBASE and Cochrane databases were searched for studies reporting the outcome of singleton pregnancies complicated by FGR diagnosed ≤ 26 weeks of gestation. The primary outcome was perinatal death (PND), defined as the sum of intrauterine death (IUD) and neonatal death (NND). Secondary outcomes included genetic anomaly, structural anomaly, infection, pre-eclampsia (PE), IUD, NND, termination of pregnancy, preterm birth (PTB) ≤ 32 and ≤ 28 weeks of gestation, Cesarean delivery, vaginal delivery, admission to the neonatal intensive care unit, abnormal brain imaging, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, neonatal sepsis, neurological morbidity, composite adverse perinatal outcome (CAPO) and intact survival. All outcomes were explored in the overall population of pregnancies complicated by extremely early-onset FGR. A subset of outcomes was explored in a subgroup analysis of FGR etiology: apparently isolated FGR, FGR defined according to the Delphi criteria, or FGR due to genetic or structural anomaly. Among those with apparently isolated FGR, subgroup analyses were conducted according to the gestational-age cut-off used to define extremely early onset, gestational age at diagnosis, gestational age at birth and presence of abnormal Doppler findings. Random-effects meta-analysis of proportions was used to combine the data. RESULTS: Fourteen studies (2818 pregnancies) were included in the systematic review, of which 13 (2573 pregnancies) were included in the meta-analysis. Among all fetuses with extremely early-onset FGR, PND, IUD and NND occurred in 16.0% (95% CI, 8.1-26.0%), 8.8% (95% CI, 4.0-15.2%) and 6.2% (95% CI, 3.0-10.4%) of cases, respectively. PTB ≤ 32 and ≤ 28 weeks of gestation complicated 54.6% (95% CI, 23.1-84.2%) and 23.3% (95% CI, 4.7-50.3%) of pregnancies, respectively, while 45.6% (95% CI, 32.6-58.9%) underwent Cesarean delivery. CAPO affected 30.5% (95% CI, 19.4-42.8%) of infants, while neurological morbidity was reported in 38.3% (95% CI, 9.8-72.1%). Among pregnancies complicated by apparently isolated extremely early-onset FGR, PND occurred in 14.3% (95% CI, 6.2-25.0%) of cases. PTB ≤ 32 and ≤ 28 weeks of gestation occurred in 54.8% (95% CI, 49.8-59.7%) and 23.6% (95% CI, 4.9-50.6%) of cases, respectively. CAPO occurred in 28.8% (95% CI, 20.4-38.0%) of infants, while neurological morbidity was present in 38.3% (95% CI, 9.8-72.1%). In pregnancies complicated by extremely early-onset FGR due to a genetic or structural anomaly, PND occurred in 17.6% (95% CI, 6.2-33.3%) and CAPO in 19.3% (95% CI, 7.6-34.9%). CONCLUSION: Pregnancies with extremely early-onset FGR are at high risk of genetic and structural anomalies, as well as adverse maternal and perinatal outcomes. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.
Undetected cases after implementation of first-trimester anomaly scan in low-risk population: insights from the IMITAS study.
Bronsgeest K, Lust EER, Zaaijer SCE … +9 more , Henneman L, Crombag N, Bilardo CM, Galjaard RH, Sikkel E, Teunissen AKK, Bekker MN, Haak MC, Collaborators
Ultrasound Obstet Gynecol · 2026 Jan · PMID 41235619 · Full text
OBJECTIVE: To assess the effectiveness of the first-trimester anomaly scan (FTAS) performed as part of a centrally steered national screening program in The Netherlands by investigating false-negative cases with a fetal...
OBJECTIVE: To assess the effectiveness of the first-trimester anomaly scan (FTAS) performed as part of a centrally steered national screening program in The Netherlands by investigating false-negative cases with a fetal structural anomaly that was not detected at the FTAS. METHODS: This was a secondary analysis of the IMplementation of fIrst Trimester Anomaly Scan (IMITAS) study, a national prospective cohort study conducted in a low-risk population in The Netherlands between November 2021 and November 2022. The FTAS was performed according to a predefined scanning protocol. We collected all cases with a fetal structural anomaly that was not detected at the FTAS and was diagnosed at a tertiary care center before 24 weeks' gestation following a referral based on the second-trimester anomaly scan. These anomalies were classified as: (1) 'always detectable' in the first trimester (e.g. holoprosencephaly, anencephaly), referred to as first-trimester major anomalies (FTMAs); (2) 'often detectable' in the first trimester (e.g. spina bifida, major heart defect); or (3) 'undetectable' in the first trimester (e.g. agenesis of the corpus callosum). To investigate the reasons for undetected FTMA, sonographic images from these cases and from a sample of normal controls were retrieved and scored for quality by two fetal medicine experts, who were blinded to the fetal outcome. RESULTS: Of the 127 979 cases with a normal FTAS result, 1164 (0.9%) had a fetal structural anomaly diagnosed before 24 weeks' gestation. Seven cases could not be categorized because intrauterine fetal death occurred before arrival at the tertiary care center. Among the 1157 remaining cases with an undetected anomaly, 23 (2.0%) had a FTMA, comprising mainly limb reduction defects, hydrops and megacystis, with seven cases of multiple congenital anomalies. A further 126 (10.9%) cases had an anomaly that is considered often detectable in the first trimester, which primarily comprised cardiac defects and central nervous system anomalies. Lastly, 1008 (87.1%) cases had an anomaly that is considered undetectable in the first trimester, represented mainly by urogenital and cardiac anomalies. Quality assessment of images obtained at the FTAS in 23 cases with undetected FTMA and 19 controls showed that the quality score for fetal anatomy was significantly lower in cases vs controls (P = 0.003), with mandatory planes missing more often (P = 0.039). CONCLUSIONS: Nearly 1% of pregnancies with a normal FTAS result were diagnosed with a structural anomaly in the second trimester, including 23 major anomalies amenable to detection in the first trimester (accounting for 0.02% of scans with a normal result). Missing mandatory planes and acquisition of suboptimal planes were the main reasons for the overlooked FTMA diagnoses. Improvements are expected with increasing sonographer experience, additional training and possible expansion of the protocol. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Outcome of fetal ovarian cysts following in-utero aspiration vs expectant management: multicenter cohort study.
Peyronnet V, Tudal L, Egloff C … +8 more , Veluppillai C, Noël C, Tordjeman N, Mairovitz V, Lieng C, Tassin M, Picone O, Mandelbrot L
Ultrasound Obstet Gynecol · 2026 Jan · PMID 41235588 · Full text
OBJECTIVE: The primary aim was to evaluate pre- and postnatal morphological changes in large simple fetal ovarian cysts following in-utero aspiration compared with expectant management. Secondary aims were to assess post...
OBJECTIVE: The primary aim was to evaluate pre- and postnatal morphological changes in large simple fetal ovarian cysts following in-utero aspiration compared with expectant management. Secondary aims were to assess postnatal outcome in terms of surgical intervention and to evaluate complications associated with in-utero aspiration. METHODS: This was a retrospective observational cohort study, conducted between January 2006 and May 2023 in four centers associated with a multidisciplinary prenatal diagnosis center in the Paris area, France. We included all cases with prenatally diagnosed fetal ovarian cysts measuring ≥ 30 mm at least once during prenatal ultrasound follow-up and classified as simple at referral. The primary outcome was the occurrence of pre- and/or postnatal changes in cyst morphology during ultrasound follow-up suggestive of ovarian hemorrhage or torsion. Postnatal surgery included ovarian oophorectomy or cystectomy performed via laparoscopy or laparotomy. The chi-square test or Fisher's exact test was used, as appropriate, to compare categorical variables between pregnancies that underwent in-utero aspiration vs expectant management, while Wilcoxon's rank-sum test was used to compare continuous variables. RESULTS: Sixty-five fetal ovarian cysts measuring ≥ 30 mm were included: 18 (27.7%) were managed by in-utero ultrasound-guided transabdominal aspiration and 47 (72.3%) were managed expectantly. Gestational age at diagnosis did not differ significantly between groups (median, 33.0 (interquartile range (IQR), 32.0-33.3) weeks vs 32.6 (IQR, 31.4-33.4) weeks). The maximum prenatal cyst diameter was greater in cases that underwent in-utero aspiration compared to those managed expectantly (median, 45 (IQR, 40-55) mm vs 39 (IQR, 32-45) mm; P < 0.01). The median gestational age at in-utero aspiration was 34.2 (IQR, 33.5-36.1) weeks. Pre- and/or postnatal morphological changes suggestive of ovarian hemorrhage or torsion were reported in 1/18 (5.6%) cysts that were aspirated prenatally and 21/47 (44.7%) cysts managed expectantly (P = 0.003). Postnatal surgery was performed in 1/18 (5.6%) and 5/47 (10.6%) cases, respectively (P = 0.66). One case of preterm prelabor rupture of membranes occurred following in-utero aspiration at 36.4 weeks. CONCLUSIONS: In-utero aspiration may help to prevent changes in cyst morphology and related complications in large simple fetal ovarian cysts. Larger prospective studies are needed to confirm this potential benefit; however, definitive evidence would require systematic postnatal surgical exploration in infants with an ovarian cyst, which is not warranted. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Two-dimensional speckle-tracking echocardiography in fetal medicine: what next?
Dall'Asta A, van Oostrum N, van Laar J … +1 more , Crispi F
Ultrasound Obstet Gynecol · 2025 Dec · PMID 41225736 · Publisher ↗
Abstract loading — click title to view on PubMed.
Fetal head molding diagnosis using three-dimensional transperineal ultrasound.
Youssef A, Paoli M, Bernardi V … +1 more , Brunelli E
Ultrasound Obstet Gynecol · 2025 Nov · PMID 41225716 · Publisher ↗
Abstract loading — click title to view on PubMed.
Beyond consensus: critically evaluating interpretation of Delphi study results.
Espinoza J, LeMoine FV, Backley S … +2 more , Papanna R, Johnson A
Ultrasound Obstet Gynecol · 2026 Jan · PMID 41225713 · Publisher ↗
Abstract loading — click title to view on PubMed.
Correction to 'Diagnostic fetoscopy: important resource for prenatal assessment'.
Ultrasound Obstet Gynecol · 2025 Nov · PMID 41206636 · Publisher ↗
Abstract loading — click title to view on PubMed.
Prognostic value of maternal N-terminal pro-B-type natriuretic peptide for prediction of severe maternal adverse outcome in women with pre-eclampsia.
Palmrich P, Kalafat E, Schirwani-Hartl N … +5 more , Haberl C, Dorittke T, Steinmetz L, Krepler L, Binder J
Ultrasound Obstet Gynecol · 2025 Dec · PMID 41206530 · Full text
OBJECTIVE: N-terminal pro-B-type natriuretic peptide (NT-proBNP), a marker of cardiac stress, has been proposed as a potential prognostic biomarker for maternal adverse outcome in pre-eclampsia (PE). This study aimed to...
OBJECTIVE: N-terminal pro-B-type natriuretic peptide (NT-proBNP), a marker of cardiac stress, has been proposed as a potential prognostic biomarker for maternal adverse outcome in pre-eclampsia (PE). This study aimed to evaluate the predictive value of NT-proBNP for severe maternal adverse outcome in pregnancies with an established diagnosis of PE. METHODS: This was a retrospective cohort study of singleton pregnancies diagnosed with PE ≤ 36 weeks of gestation that were assessed at the Medical University of Vienna between January 2018 and December 2023. Maternal serum levels of NT-proBNP, soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) were measured at the time of PE diagnosis. The primary outcome was the occurrence of a severe maternal adverse event, including intensive care unit admission, maternal death, pulmonary edema and severe neurological complications. Associations between severe maternal adverse outcome and Z-scores for NT-proBNP and the sFlt-1/PlGF ratio were analyzed using logistic and Cox regression models adjusted for gestational age at sampling and the Z-score of the other biomarker. The area under the receiver-operating-characteristics (ROC) curve (AUC) was used to assess the discriminative ability of the biomarkers. RESULTS: Of 130 women included in our cohort, 13 (10%) experienced severe maternal adverse outcome. NT-proBNP levels were significantly higher in this group (median, 688.0 (interquartile range (IQR), 249.6-1038.0) pg/mL vs 106.1 (IQR, 50.6-280.6) pg/mL; P < 0.001). Higher NT-proBNP Z-score was associated significantly with severe maternal adverse outcome (adjusted odds ratio, 3.24 (95% CI, 1.50-7.84); P = 0.005) and predicted shorter time-to-delivery with severe maternal adverse outcome (adjusted hazard ratio, 3.08 (95% CI, 1.47-6.44); P = 0.003) after adjusting for gestational age at sampling and sFlt-1/PlGF ratio Z-score. The sFlt-1/PlGF ratio was not associated significantly with these outcomes. ROC-curve analysis showed that NT-proBNP had superior discriminative performance compared with the sFlt-1/PlGF ratio (AUC, 0.75 (95% CI, 0.61-0.90) vs 0.67 (95% CI, 0.56-0.79)). The performance of both biomarkers improved when combined with gestational age at sampling (AUC, 0.82 (95% CI, 0.71-0.94) vs 0.76 (95% CI, 0.65-0.88)). CONCLUSION: NT-proBNP was a strong predictor of severe maternal adverse outcome and time-to-delivery in women diagnosed with PE, especially in early-onset cases. NT-proBNP may serve as a clinically accessible biomarker for risk stratification and surveillance in women with established PE. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe