Diagnosis of fetal pulmonary hypoplasia by measurement of blood flow velocity waveforms of pulmonary arteries with Doppler ultrasonography

Yoshimura, Shuichiro; Masuzaki, Hiroaki; Miura, Kiyonori; Muta, Kunio; Gotoh, Hiroki; Ishimaru, Tadayuki

doi:10.1016/s0002-9378(99)70229-2

Cited by 54 publications

(26 citation statements)

References 16 publications

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“…However, there are insufficient data from which to draw conclusions and results obtained in trials involving all fetuses at risk for PH should be reconsidered. Several studies have shown increased impedance to flow in the branches of the pulmonary arteries, consistent with high peripheral pulmonary vascular resistance, in fetuses with subsequent PH9, 21–24. Ductus arteriosus blood flow was reduced by breathing movements in a case series with PH25.…”

Section: Ultrasound and Doppler Measurementsmentioning

confidence: 77%

5‐Year mammography rates and associated factors for older women

Harrison¹,

Janz²,

Wolfe³

et al. 2003

Cancer

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BACKGROUNDMajor national interventions occurred in the early and mid‐1990s to increase mammography screening rates among older women. The current study examined mammography utilization by older women during this period. Relation between mammography utilization and demographic measures and health care‐related factors also were examined.METHODSA cross‐sectional design examined variations in mammography during the 5 years between 1993 to 1997 in a representative sample of 10,000 female Medicare beneficiaries in Michigan age ≥ 65 years in 1993. Medicare and census data were used. Separate analyses were performed for having undergone any mammogram and, for the 5680 women who had undergone a mammogram, the number of mammograms. Relations were examined between mammography utilization and 15 demographic variables (e.g., age and African‐American race) and health care‐related variables (e.g., inpatient admissions and number of physicians involved in care).RESULTSIn the 5 years 43% of older women had no evidence of having undergone a mammogram. Those with any mammogram averaged 2.8 mammograms. Meaningful independent predictors of both having undergone a mammogram and having more than one mammogram were more physicians involved in care, fewer inpatient admissions, and younger age. Having undergone a mammogram also was found to be associated with seeing an obstetrician/gynecologist.CONCLUSIONSEven with screening mammography as a covered benefit and after several national informational campaigns, the current study found that in 5 years, 60% of older women either had not undergone a mammogram or had undergone only 1. Intervention efforts should emphasize screening based on functional status, not age. This message should be targeted to physicians as well as to older women without claims for recent mammograms and who are likely to be in good health. Cancer 2003;97:1147–55. © 2003 American Cancer Society.DOI 10.1002/cncr.11172

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Section: Ultrasound and Doppler Measurementsmentioning

confidence: 77%

5‐Year mammography rates and associated factors for older women

Harrison¹,

Janz²,

Wolfe³

et al. 2003

Cancer

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“…To evaluate the degree of pulmonary hypoplasia, the lung-thoracic transverse area ratio [11,12] and lung-head ratio [13][14][15] have been measured in patients with CDH, and the thoracic circumference/abdominal circumference ratio has been used in patients with premature rupture of membrane [16,17] . Recently there have been some reports that pulmonary hypoplasia is related to the PA Doppler waveform [7,9,[17][18][19][20] . However, it is so difficult to measure PA at a particular interrogation angle while, in addition, there is also a low reproducibility when using this method.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Normal Fetal Branch Pulmonary Artery Diameters Measured by Ultrasonography: A Comparison with Congenital Diaphragmatic Hernia

Katayama

Tada²,

Nakanishi³

et al. 2008

Fetal Diagn Ther

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Objective: The aim of this study was to examine the size of fetal branch pulmonary artery (PA) diameters in normal growth fetuses. Method: Fetal PA diameters were measured in 175 normal fetuses between 18 and 40 weeks of gestation from 2005 to 2006. In addition, 4 fetuses with left-sided congenital diaphragmatic hernia (CDH) from 2001 to 2006 were retrospectively reviewed. Branch PA diameters were measured from a cross-sectional image at the level of the three-vessel view (main PA, ascending aorta and superior vena cava) to demonstrate the long axis of both branch PAs whenever possible. Results: Both the left and right PA diameters were found to correlate strongly with the advancing gestational age (r = 0.78, p < 0.01, respectively). Left pulmonary artery to main pulmonary artery (LPA/MPA) ratio and right pulmonary artery to main pulmonary artery (RPA/MPA) ratio were calculated. These two parameters were almost constant throughout gestation. LPA in fetal left CDH was smaller than control. Both LPA/MPA and RPA/MPA were within the normal range in most cases. Conclusions: It is important to establish the normal range of branch PA diameters and it appears to be useful to compare the branch PA diameters in normal fetuses with that in cases of pulmonary hypoplasia.

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“…30,31 None of these was found to predict mortality rates for live-born infants in our study. Recently described techniques for assessment of pulmonary hypoplasia, such as MRI lung volumetry, 38 determination of fetal lung-head ratios, 39,40 measurement of pulmonary artery diameters, 41 and fetal pulmonary artery Doppler ultrasonography, 42 were not used regularly in our cases and have not yet been validated for widespread use.…”

Section: Prenatal Diagnosismentioning

confidence: 98%

Outcomes of Congenital Diaphragmatic Hernia: A Population-Based Study in Western Australia

Colvin¹,

et al. 2005

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ABSTRACT.Objectives. There have been many recent reports of improved survival rates for congenital diaphragmatic hernia (CDH), largely derived from institution-based data. These are often flawed by case selection bias. The objectives of this study were to document the true incidence, management, and outcomes of CDH in a geographically defined population over a 12-year period and to determine the changing trends in these over time. We also sought to ascertain the prenatal and postnatal factors associated with morbidity and death among these infants.Methods. A retrospective study of all cases of CDH in Western Australia from 1991 to 2002 was conducted. Cases were identified from 5 independent databases within the Western Australian health network, including the Western Australian Birth Defects Registry. All fetuses and neonates diagnosed with CDH in Western Australia during this period were identified, including miscarriages, stillbirths, and terminations of pregnancies in which a diagnosis of fetal CDH had been made, as well as those diagnosed postnatally. Cases not known to involve CDH until diagnosis at autopsy were also included. Infants with diaphragmatic eventration were excluded from the study. Detailed information was obtained from review of maternal and infant medical records.Results. One hundred sixteen cases of CDH were identified. Of these, 71 (61%) infants were born alive and 37 survived beyond 1 year of age (52% of live-born infants, 32% of all cases of CDH). Pregnancies involving 38 (33%) fetuses were terminated electively, 4 (3%) fetuses were aborted spontaneously, and 3 (3%) fetuses were stillborn. Another major congenital anomaly was present in 54 (47%) cases. Twenty-one (18%) cases had other anomalies that were likely to be fatal. Of all cases with an additional major anomaly, 42 (78%) died. Twenty-seven (71%) of 38 fetuses for whom the pregnancy was terminated had another major anomaly. Twenty-three (32%) live-born infants had another major anomaly (4 of which were considered fatal conditions); however, this did not affect their survival rates. Fifty-three percent of cases were diagnosed prenatally, and 49% of these pregnancies were then terminated. Of live-born infants with prenatally diagnosed CDH, 10 (33%) survived beyond 1 year of age. The gestational age at diagnosis did not affect the survival rate for live-born infants. Postnatal diagnosis occurred in 55 (47%) cases. Of these, 41 (74%) case subjects were born alive and diagnosed on clinical grounds after birth. In the remaining 14 cases, the diagnosis was made in postmortem examinations of fetuses from pregnancies that were terminated for other reasons (8 cases) or after spontaneous abortion or stillbirth (5 cases). Significant differences were found between prenatally and postnatally diagnosed live-born infants. Among liveborn infants, prenatal diagnosis was associated with a significantly reduced survival rate (33%, compared with 66% for postnatally diagnosed infants). Prenatally diagnosed live-born infants were of lower birth weight a...

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Diagnosis of fetal pulmonary hypoplasia by measurement of blood flow velocity waveforms of pulmonary arteries with Doppler ultrasonography

Cited by 54 publications

References 16 publications

5‐Year mammography rates and associated factors for older women

5‐Year mammography rates and associated factors for older women

Evaluation of Normal Fetal Branch Pulmonary Artery Diameters Measured by Ultrasonography: A Comparison with Congenital Diaphragmatic Hernia

Outcomes of Congenital Diaphragmatic Hernia: A Population-Based Study in Western Australia

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