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Fetal Abdominal Circumference

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281. Obesity and reproduction: a committee opinion

). Speci?cally, increased abdominal circumference is a component of the metabolic syndrome (MBS), which also includes hypertension, elevated fasting glucose levels, hypertriglyceridemia, and decreased high-density lipoprotein (HDL)-choles- terol levels. Nevertheless, considerable variability in metabolic dysfunction remainsamongpeople,evenwhencon- trolling for BMI and MBS, which likely results from ectopic lipid accumulation in non-adipose cells (i.e., lipotoxicity) (16). With lipotoxicity, when energy (...) anovulatory women have a greater waist circumference and more abdominal fat than ovulatory women of similar BMI (35). A case-control study of 2,527 women with anovulatory infertility versus 46,718 control subjects (mostly married parous nurses without infertility) noted a relationship between BMI at 18 years of age and the RR of subsequent anovulatory infertility (1.0, BMI 20.0–21.9; 1.3, BMI 24–25.9; 1.7, BMI 26–27.9; 2.4, BMI 28–29.9; 2.7, BMI 30–31.9; and 2.7, BMI >32 kg/m 2 ) (33). Conversely

2015 Society for Assisted Reproductive Technology

282. Paediatric Urology

after completion of the second year of life. Alternatively, the Shang Ring may be used especially in developing countries [12]. Plastic circumcision has the objective of achieving a wide foreskin circumference with full retractability, while the foreskin is preserved (dorsal incision, partial circumcision). However, this procedure carries the potential for recurrence of the phimosis [13]. In the same session, adhesions are released and an associated fraenulum breve is corrected by fraenulotomy (...) laparoscopy is the only examination that can reliably confirm or exclude an intra-abdominal, inguinal and absent/vanishing testis (non-palpable testis) [37]. Before carrying out laparoscopic assessment, examination under general anaesthesia is recommended because some, originally non-palpable, testes become palpable under anaesthetic conditions. 3B.4 Disease management Treatment should be done as early as possible around one year of age, starting after six months and finishing preferably at 12 months

2015 European Association of Urology

285. Management of Cervical Cancer

) MoH, Putrajaya Dr. Azura Deniel Consultant Oncologist Hospital Kuala Lumpur, Kuala Lumpur Dr. Carol Lim Consultant Maternal Fetal Medicine Hospital Sultan Haji Ahmad Shah, Pahang Ms. Chan Pek Har Clinical Psychologist Hospital Kuala Lumpur, Kuala Lumpur Dr. Cindy Teoh Cy Oun Fellow in Palliative Medicine Hospital Selayang, Selangor Dr. Faizatuddarain Mahmood Consultant Radiologist Hospital Kajang, Selangor Dr. Fuziah Paimin Family Medicine Specialist Klinik Kesihatan Salak, Selangor Ms. Gillian (...) are postmenopausal bleeding (84.0%), vaginal discharge (72.0%), postcoital bleeding (PCB) (64.0%) and abdominal pain (56.0%). 9, level III The prevalence of PCB in cervical cancer ranges between 0.7% to 39%. 10, level III In patients with PCB, cervical cancer is found in 3.6% of women with no record of smear or with normal smear and 5% of women with abnormal smear. 11, level III • Most patients are asymptomatic. However, common presenting symptoms that may suggest cervical cancer are: ? postmenopausal bleeding

2015 Ministry of Health, Malaysia

286. Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus Full Text available with Trip Pro

are at greater risk for renal injury than women (perhaps because of sex hormone differences) Cardiovascular risk profile More adverse in women with DM: impaired endothelium-dependent vasodilation, worse atherogenic dyslipidemia, prothrombotic coagulation profile, higher metabolic syndrome prevalence Compared with men, women have worse HbA 1c and blood pressure control CHD predictors in T1DM (Pittsburgh Epidemiology of Diabetes Complications Study) Women only: abdominal adiposity, insulin resistance, HbA 1c (...) Men and women: inflammatory markers (fibrinogen, white blood cell count), microalbuminuria Adiposity Abdominal adiposity was more strongly associated with cardiovascular mortality in women compared with men with DM in a Finnish population Outcome CHD Women with DM have a 2-fold excess CHD risk compared with men Myocardial infarction occurs earlier and has higher mortality in women with DM compared with men Revascularization rates (angioplasty, coronary artery bypass grafting) are lower in women

2015 American Heart Association

287. Development and validation of a machine learning model for prediction of shoulder dystocia. (Abstract)

beta > 0.02 increasing the risk of ShD: aEFW (0.164), pregestational diabetes (0.047), prior ShD (0.04), female fetal sex (0.04) and adjusted abdominal circumference (0.03). The following risk modifiers had a negative beta < -0.02 protective of ShD: adjusted biparietal diameter (-0.08) and maternal height (-0.03). In the validation cohort the model outperformed aEFW and diabetes (AUC = 0.866 vs. 0.784, p-value = 0.00007). Additionally, in the validation cohort, among the subgroup of 273 women (...) . Biometric measurements and their derived estimated fetal weight were adjusted (aEFW) to the date of the delivery. A ML pipeline was utilized to develop the model.In the derivation cohort, the ML model provided significantly better prediction than the current paradigm: using nested cross validation the area under the receiver operator characteristics curve (AUC) of the model was 0.793 ± 0.041, outperforming aEFW and diabetes (0.745 ± 0.044, p-value = 1e-16). The following risk modifiers had a positive

2019 Ultrasound in Obstetrics and Gynecology

288. Diagnostic accuracy of Doppler ultrasound in predicting perinatal outcome in pregnancies at term: A prospective longitudinal study. Full Text available with Trip Pro

1.2-1.6, P = 0.001), abdominal circumference centile (OR 1.12, 95% CI 1.1-1.4, P = 0.001) and gestational age at birth (OR 1.6, 95% CI 1.2-2.1, P = 0.004) were independently associated with composite adverse outcome. Despite this, the diagnostic accuracy of Doppler in predicting adverse pregnancy outcome at term was poor.MCA PI and cerebroplacental ratio are associated with adverse perinatal outcome at term. However, their predictive accuracy for perinatal compromise is poor, and thus their use (...) arteries PI (0.8 ±0.2 vs 0.7 ±0.3, P = 0.001) was higher in pregnancies experiencing than in those not experiencing composite adverse outcome. Conversely, there was no difference in either UA PI (P = 0.399) or estimated fetal weight centile (P = 0.712) between the two groups, but AC centile was lower in fetuses experiencing composite adverse outcome (45.4 vs 53.2, P = 0.040). At logistic regression analysis, MCA PI (odds ratio [OR] 0.1, 95% CI 0.01-.2, P = 0.001), uterine arteries PI (OR 1.4, 95% CI

2019 Acta Obstetricia et Gynecologica Scandinavica

289. Heparin therapy in placental insufficiency: Systematic review and meta-analysis. (Abstract)

, and PROSPERO database for meta-analysis. Suspected placental insufficiency was defined as either an estimated fetal weight or abdominal circumference below the 10th centile or when at least 2 of the following criteria were met: (1) abnormal biochemical markers, (2) sonographic evidence of abnormal placental morphology, or (3) abnormal uterine artery Doppler. Heparin in any commercial presentation was defined as the intervention. Mean difference (MD) by random effects model was used. Heterogeneity between (...) with very high suspicion of placental insufficiency, heparin may increase fetal growth and prolong pregnancy. There is no evidence for a beneficial effect of heparin in reducing neonatal adverse outcomes.© 2019 Nordic Federation of Societies of Obstetrics and Gynecology.

2019 Acta Obstetricia et Gynecologica Scandinavica

290. Routine ultrasound at 32 vs 36 weeks' gestation: prediction of small-for-gestational-age neonates. Full Text available with Trip Pro

Routine ultrasound at 32 vs 36 weeks' gestation: prediction of small-for-gestational-age neonates. To evaluate and compare the performance of routine ultrasonographic estimated fetal weight (EFW) and fetal abdominal circumference (AC) at 31 + 0 to 33 + 6 and 35 + 0 to 36 + 6 weeks' gestation in the prediction of a small-for-gestational-age (SGA) neonate.This was a prospective study of 21 989 singleton pregnancies undergoing routine ultrasound examination at 31 + 0 to 33 + 6 weeks' gestation (...) and 45 847 undergoing routine ultrasound examination at 35 + 0 to 36 + 6 weeks' gestation. In each case, the estimated fetal weight (EFW) from measurements of fetal head circumference, AC and femur length was calculated using the Hadlock formula and expressed as a percentile according to The Fetal Medicine Foundation fetal and neonatal population weight charts. The same charts were used for defining a SGA neonate with birth weight < 10th and < 3rd percentiles. For each gestational-age window

2019 Ultrasound in Obstetrics and Gynecology

291. Prediction of small-for-gestational-age neonates at 35-37 weeks' gestation: contribution of maternal factors and growth velocity between 20 and 36 weeks. (Abstract)

was a prospective study of 44,043 singleton pregnancies that had undergone routine ultrasound examination at 19+0 - 23+6 and at 35+0 - 36+6 weeks' gestation. Multivariable logistic regression analysis was used to determine whether addition of maternal risk factors and growth velocity, defined by a difference in EFW Z-scores or fetal abdominal circumference (AC) Z-scores between the third and second trimester scans divided by the time interval between them, improved the performance of EFW at 35+0 - 36+6 weeks (...) Prediction of small-for-gestational-age neonates at 35-37 weeks' gestation: contribution of maternal factors and growth velocity between 20 and 36 weeks. To evaluate the performance of ultrasonographic estimated fetal weight (EFW) at 35+0 - 36+6 weeks' gestation in the prediction of small for gestational age (SGA) neonates and assess the additive value of first, maternal risk factors and second, fetal growth velocity between 20 and 36 weeks' gestation in improving such prediction.This

2019 Ultrasound in Obstetrics and Gynecology

292. Prediction of small-for-gestational-age neonates at 35-37 weeks' gestation: contribution of maternal factors and growth velocity between 32 and 36 weeks. (Abstract)

pregnancies undergoing routine ultrasound examination at 30 + 0 to 34 + 6 and at 35 + 0 to 36 + 6 weeks' gestation. Multivariable logistic regression analysis was used to determine whether addition of growth velocity, defined as the difference in EFW Z-score or abdominal circumference (AC) Z-score between the early and late third-trimester scans divided by the time interval between the scans, improved the performance of EFW Z-score at 35 + 0 to 36 + 6 weeks in the prediction of, first, delivery of a SGA (...) Prediction of small-for-gestational-age neonates at 35-37 weeks' gestation: contribution of maternal factors and growth velocity between 32 and 36 weeks. To assess the additive value of fetal growth velocity between 32 and 36 weeks' gestation to the performance of ultrasonographic estimated fetal weight (EFW) at 35 + 0 to 36 + 6 weeks' gestation for prediction of delivery of a small-for-gestational-age (SGA) neonate and adverse perinatal outcome.This was a prospective study of 14 497 singleton

2019 Ultrasound in Obstetrics and Gynecology

293. Prediction of large for gestational age neonates by routine third trimester ultrasound. (Abstract)

Prediction of large for gestational age neonates by routine third trimester ultrasound. First, to evaluate and compare the performance of routine ultrasonographic estimated fetal weight (EFW) and fetal abdominal circumference (AC) at 31+0 - 33+6 and 35+0 - 36+6 weeks' gestation in the prediction of large for gestational age (LGA) neonates born at ≥37 weeks' gestation. Second, to assess the additive value of fetal growth velocity between 32 and 36 weeks' gestation on the performance of EFW at 35 (...) percentiles, respectively, at screen positive rate of 11%). Fourth, screening by EFW >70th percentile at 35+0 - 36+6 weeks' gestation predicted 91% and 82% of LGA neonates with birthweight >97th and >90th percentiles born at ≥37 weeks' gestation, at screen positive rate of 32%, and the respective values of screening by EFW >85th percentile for prediction of LGA neonates born at ≤10 days from the scan were 88%, 81% and 15%. On the basis of these results it was proposed that routine fetal biometry at 36

2019 Ultrasound in Obstetrics and Gynecology

294. Spontaneous triplet pregnancy and trap sequence, case report. Full Text available with Trip Pro

visualization of cranium, thoracic organs or extremities, but abdominal circumference consistent with 28 weeks. Pregnancy was followed conservatively and evaluated regularly by ultrasonography twice a week. When prolonged bradycardia was detected in fetus B at 35 4/7 weeks, emergency cesarean section was performed. Two healthy fetuses weighing 2 kg were delivered each with an 8/10 APGAR score (Appearance, Pulse, Eye Insertion, Activity, Respiration).This case was managed without any invasive procedures (...) triplet pregnancy was detected by ultrasonographic examination. First amniotic sac had one foetus (Foetus A). Ultrasonographic evaluation of Foetus A revealed gestational age of 31 weeks, adequate amniotic fluid and no fetal structural anomalies. The second amniotic sac contained 2 foetuses and polyhydromnios. Ultrasonic measurements of Foetus B were consistent with 32 weeks gestational age. Color flow doppler indicated Foetus B was the pump foetus. Foetus C was an acardiac foetus with no sonographic

2019 BMC Pregnancy and Childbirth

295. Investigation and Management Small-for-Gestational-Age Fetus

plots below the 10 th centile or serial measurements which demonstrate slow or static growth by crossing centiles should be referred for ultrasound measurement of fetal size. Women in whom measurement of SFH is inaccurate (for example: BMI > 35, large fibroids, hydramnios) should be referred for serial assessment of fetal size using ultrasound. Optimum method of diagnosing a SGA fetus and FGR Fetal abdominal circumference (AC) or estimated fetal weight (EFW) +2 SDs above mean for gestational age (...) of fetal size is valuable in predicting birthweight and determining size-for-gestational age 2 If two AC/EFW measurements are used to estimate growth, they should be at least 3 weeks apart 3 Use cCTG when DV Doppler is unavailable or results are inconsistent – recommend delivery if STV 2 SDs, EDV present AREDV Normal AC & EFW 1,2 UA Doppler MCA Doppler after 32 weeks APPENDIX III: The Management of the Small–for–Gestational–Age (SGA) FetusAPPENDIX IV: Glossary AC Abdominal circumference AFI Amniotic

2013 Royal College of Obstetricians and Gynaecologists

296. Continuous independent quality control for fetal ultrasound biometry provided by the cumulative summation technique. fetal weight and size CUSUM for prenatal ultrasound diagnostics. Full Text available with Trip Pro

for systematic error detection based on absolute and signed mean percentage error were generated to retrospectively estimate the longitudinal accuracy of sonographic fetal weight estimation conducted by three trainees and one experienced examiner. For LC-CUSUM analysis an examination was considered to be a failure when there was an absolute error in birth weight estimation >/= 15%. Fetal biometry measurements (head circumference, abdominal circumference (AC) and femur length (FL)) from 227 routine ultrasound (...) Continuous independent quality control for fetal ultrasound biometry provided by the cumulative summation technique. fetal weight and size CUSUM for prenatal ultrasound diagnostics. To apply the cumulative summation (CUSUM) technique for an evaluation of the learning process of sonographic fetal weight estimation at term in combination with the z-scores of biometry determinants and to assess the time of appearance and sources of errors.Learning curve (LC-CUSUM) and double CUSUM charts

2010 Ultrasound in Obstetrics and Gynecology

297. New aids for the non-invasive prenatal diagnosis of achondroplasia: dysmorphic features, charts of fetal size and molecular confirmation using cell free fetal DNA in maternal plasma. Full Text available with Trip Pro

by 25 weeks' gestation, and always below the 3(rd) by 30 weeks. Head circumference was above the 50(th) centile, increasing to above the 95(th) when compared with normal for the majority of fetuses. The abdominal circumference was also increased but to a lesser extent. Commonly reported sonographic features were bowing of the femora, frontal bossing, short fingers, a small chest and polyhydramnios. Analysis of cell-free fetal DNA in six pregnancies confirmed the presence of the c.1138G > A mutation (...) New aids for the non-invasive prenatal diagnosis of achondroplasia: dysmorphic features, charts of fetal size and molecular confirmation using cell free fetal DNA in maternal plasma. To improve the prenatal diagnosis of achondroplasia by constructing charts of fetal size, defining frequency of sonographic features and exploring the role of non-invasive molecular diagnosis based on cell-free fetal deoxyribonucleic acid (DNA) in maternal plasma.Data on fetuses with a confirmed diagnosis

2010 Ultrasound in Obstetrics and Gynecology

298. Forceps vs Vacuum. Rate of Levator Ani Muscle Avulsion: Clinical Trial.

, type of instrumentation, duration of second stage of labor, episiotomy and perineal tears. Fetal parameters studied after birth were: fetal sex, weight, head circumference, umbilical artery pH at birth, Apgar test result (at 1 and 5 min), presence of neonatal morbidity (cephalohaematoma, brachial plexus palsy, etc.), admission to neonatology department and neonatal mortality. The sonographic evaluation was performed six months after delivery and was carried out by a single examiner, with more than (...) instrumentation were performed by obstetricians with a minimum of five years' experience in obstetric practice. In terms of analgesia, epidural analgesia was used for intrapartum analgesia. The forceps used for the instrumentation was the forceps of Kielland and the vacuum was a metal vacuum (Bird's cup 50 mm, 80 kPa) was used to perform fetal extraction. A suction cup was carefully placed over the flexion point, avoiding caput succedaneum, and rapid negative pressure was applied (over 2 min, until 0.6-0.8 kg

2018 Clinical Trials

299. Fetoscopic Endoluminal Tracheal Occlusion (FETO)

the use ECMO. Immediate morbidity/mortality is related to the severity of the pulmonary hypoplasia caused by the mass effect of the herniated abdominal contents on the developing lungs. Quantifying the severity of pulmonary hypoplasia has been performed using the observed/expected lung to head circumference ratio (O/E LHR). It is a tool validated in 354 fetuses with unilateral isolated CDH evaluated between 18 and 38 weeks gestation. For O/E LHR < 25%, survival was dismal at 1/9 or 11% (CHOP (...) experience, not published). Published data from an interdisciplinary follow-up program at CHOP shows striking morbidities in neuromuscular tone and neurodevelopmental status. The rationale for fetal therapy in severe CDH is to improve fetal lung growth and therefore neonatal survival. Prenatal tracheal occlusion obstructs the normal egress of lung fluid during pulmonary development leading to increased lung tissue stretch, increased cell proliferation, and accelerated lung growth. European colleagues

2018 Clinical Trials

300. Birth Cohort Study of China Medical University

Outcome Measures : Change of biometric parameter in centimeter of fetuses at the thirteenth week of gestational age [ Time Frame: At every week from the thirteenth week of gestational age to delivery of babies ] Including head circumference, abdominal circumference, biparietal diameter, femur length Weight in kilogram of neonate [ Time Frame: At birth of neonate ] Measured by nurses Gene expression of husbands of pregnancy women [ Time Frame: At 13 weeks of gestational age ] DNA methylation, histone (...) are also collected from the children and their parents. Condition or disease Twin; Complicating Pregnancy Advanced Maternal Age Pregnancy Scarred Uterus Overweight and Obesity Detailed Description: Early life phase (fetal and infant) is a critical period for the development of health and disease in a person's life. Many adult chronic diseases, such as diabetes, cardiovascular and cerebrovascular diseases, all come from the exposure of negative environmental and behavioral factors during this period

2018 Clinical Trials

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