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List of All Articles
1.  Review Article
Ultrasound in Infertility
Sonal Panchal, CB Nagori
[Year:2015] [Month:January-March] [Volume:9 ] [Number:1] [Pages:110] [Pages No:100-110] [No of Hits : 2249]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1396 | FREE

ABSTRACT

Evaluation of the complete cycle instead of only pre hCG scan is an essential for follicular monitoring. Using color Doppler in this assessment is mandatory because it allows to assess the functional status of follicle and endometrium. 3D ultrasound is useful for volume measurements, and 3D PD for assessment of global vascularity.
Baseline scan is done to predict the ovarian reserve and response and decide the stimulation protocols for ARTs. Uterus is assessed for receptivity. But baseline scan also diagnoses PCOS. This is by counting antral follicles, stromal flows and stromal and ovarian volume. Ultrasound features of ovary on baseline scan can also be correlated closely with the baseline hormonal status of ovaries-LH, FSH and Androgen. Ultrasound is a key tool to decide follicular maturity and endometrial receptivity and to decide the time of hCG and time of IUI. Doppler plays a major role in correct decision making and 3D and 3D power Doppler add to the details and also improves the success rates of different ARTs. Luteal phase also can be better explained by the use of Doppler. Ultrasound to hormonal correlation in both preovulatory and luteal phase helps plan the ART for positivity.

Keywords: Baseline scan, Preovulatory scan, Endometrial receptivity.

How to cite this article: Panchal S, Nagori CB. Ultrasound in Infertility. Donald School J Ultrasound Obstet Gynecol 2015;9(1):100-110.

Source of support: Nil

Conflict of interest: None

 
2.  Review Article
Fetal Neurology: Past, Present and Future
Asim Kurjak, Panagiotis Antsaklis, Milan Stanojevic
[Year:2015] [Month:January-March] [Volume:9 ] [Number:1] [Pages:110] [Pages No:6-29] [No of Hits : 1809]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1385 | FREE

ABSTRACT

Neurological failure is the most apprehension complication of pregnancy, labor and the neonatal period. The origin and outcome correlation is frequently doubtful. The arrival of four-dimensional ultrasonography (4D US) and its function to study fetal behavior patterns have initiated to offer insight into the structural and functional fetal brain development. Although many fetal behavioral studies have been conducted, it is still questionable whether the assessment of continuity from fetal to neonatal behavior could improve our ability of early detection of brain pathology. Neurological assessment of fetus in utero is extremely difficult even having such sophisticated equipment like 4D ultrasound. As it is well known that quantity of GMs is not so informative and predictive for neurological impairment, their quality should be assessed. Gestalt perception of premature GMs we are dealing with in utero and several weeks postnatally are not as predictive for the detection of neurologically abnormal fetuses or newborns as fidgety GMs. Therefore, some additional parameters should be added to the prenatal neurological examination in order to improve our ability to make the distinction between normal and abnormal fetuses.

Keywords: Neurobehavioral development, Fetal behavior, Four-dimensional ultrasound.

How to cite this article: Kurjak A, Antsaklis P, Stanojevic M. Fetal Neurology: Past, Present and Future. Donald School J Ultrasound Obstet Gynecol 2015;9(1):6-29.

Source of support: Nil

Conflict of interest: None

 
3.  Review Article
First Trimester Anomaly Scan-The Last Redoubt Won: Open Spina Bifida
Stefania Tudorache, Iliescu Dominic Gabriel, Adina Turcu, Maria Florea, Roxana Dragusin, Liliana Novac, Cernea Nicolae, Daniela Cernea
[Year:2015] [Month:January-March] [Volume:9 ] [Number:1] [Pages:110] [Pages No:80-90] [No of Hits : 1699]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1393 | FREE

ABSTRACT

Open spina bifida (OSB) is a non-lethal fetal anomaly, yet often leads to severe disability. Most cases of open spina bifida are detected at the second trimester fetal anomaly ultrasound scan. The 11 to 13 weeks of amenorrhea scan evolved over the last 20 years from essentially a dating scan, to a genetic scan, and recently to one which includes, in addition to the genetic markers, a basic checklist for examination of the whole fetal anatomy. The direct visualization of the spine at the first trimester (FT) scan remained difficult, despite the wider use of high-resolution ultrasound machines and the volumetric approach. Thus, indirect intracranial morphological markers for OSB were proposed to diagnose this neural tube defect.
The present review aims to describe the specific anatomical feature of the spine and the posterior brain, both on parasagittal and on axial planes, recently proposed for the early detection of OSB.
Specialists involved in the prenatal diagnosis will eventually elaborate in the future a screening protocol for OSB in the FT of pregnancy, using the most valuable and easy to obtain marker, in a single 2D plane.
The offer of an early diagnosis of possible severe anomalies, such as OSB, is a tool enhancing the autonomy of the pregnant woman.

Keywords: Open spina bifida, First trimester, Anomaly scan, Posterior brain.

How to cite this article: Tudorache S, Iliescu DG, Turcu A, Florea M, Dragusin R, Novac L, Nicolae C, Cernea D. First Trimester Anomaly Scan-The Last Redoubt Won: Open Spina Bifida. Donald School J Ultrasound Obstet Gynecol 2015;9(1):80-90.

Source of support: Nil

Conflict of interest: None declared.

 
4.  Review Article
Prenatal Development of the Human Central Nervous System, Normal and Abnormal
Kohei Shiota
[Year:2015] [Month:January-March] [Volume:9 ] [Number:1] [Pages:110] [Pages No:61-66] [No of Hits : 1352]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1390 | FREE

ABSTRACT

The organogenesis of the central nervous system (CNS) begins during the third week of development, but its maturation requires a considerably long period of time until after birth. Therefore the developing nervous system is vulnerable to the deleterious effects of environmental factors during the pre- and perinatal periods. In addition, molecular studies have revealed various gene mutations that are responsible for congenital CNS disorders. This chapter provides an overview of the prenatal development of the human brain and spinal cord.

Keywords: Neurulation, Neuroectoderm, Neural tube defect, Histogenesis, Neuronal migration, Myelination.

How to cite this article: Shiota K. Prenatal Development of the Human Central Nervous System, Normal and Abnormal. Donald School J Ultrasound Obstet Gynecol 2015;9(1):61-66.

Source of support: Nil

Conflict of interest: None declared.

 
5.  Review Article
Antenatal and Postnatal Assessment of Neurobehavior: Which One should be used?
Milan Stanojevic
[Year:2015] [Month:January-March] [Volume:9 ] [Number:1] [Pages:110] [Pages No:67-74] [No of Hits : 1227]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1391 | FREE

ABSTRACT

It is obvious that this environment is quite different from one man is experiencing after birth, but, although different, intrauterine environment is ideal at that stage of human development. There is a question of the environmental discontinuity between intrauterine conditions characterized by existence of microgravity (baby astronaut hypothesis), and extrauterine life with gravity as developmental condition sine qua non. The human brain is one of the organs which is very sensitive to environmental changes affecting its growth and development. The brain of very tiny prematurely born babies is unable to follow the genetically determined growth pattern in extrauterine environment, even when postnatal nutrition and nurturing of the babies according to our best knowledge are appropriate. Is this fact of any significance to make distinction between normal and abnormal neurodevelopment pre- and postnatally is still unclear?
Kurjak antenatal neurodevelopmental test (KANET) using four-dimensional ultrasound (4D US) has been introduced using ten parameters and after attempt of standardization only eight parameters remained for neurodevelopmental assessment of low- and high-risk fetuses. We believe that at present level of knowledge, KANET test could be considered as a good test for the detection of fetuses with high neurological risk, without the possibility to define reliable long-term neurodevelopmental outcome. This is also hardly possible based on postnatal neurological assessment with 27 different postnatal tests. They were primarily neurobehavioral or neuromotor assessments that were suitable for use with preterm infants, and were discriminative, predictive or evaluative.
There was a high willingness of clinician to find postnatal neurodevelopmental test which could be predictive for shortterm and long-term outcome of low and high-risk infants.
Although, there are many tests available for prenatal and postnatal assessment of neurodevelopment, none of them is reliable in the prediction of neurodevelopmental outcome in low-risk population, while many could be used with fairly acceptable predictivity in high-risk population. Although, many studies have been conducted in order to solve this problem, still there is a space for improvement. In postnatal period we are dealing with infant in front of the clinician with direct observation, while pretnatally we are dealing with quite different environment and less mature brain.

Keywords: Neurodevelopment, Prenatal assessment, Postnatal assessment, Four-dimensional ultrasound, Kurjak antenatal neurodevelopmental test, Gravity.

How to cite this article: Stanojevic M. Antenatal and Postnatal Assessment of Neurobehavior: Which One should be used? Donald School J Ultrasound Obstet Gynecol 2015;9(1):67-74.

Source of support: Nil

Conflict of interest: None

 
6.  Review Article
HDlive and 4D Ultrasound in the Assessment of Fetal Facial Expressions
Toshiyuki Hata, Kenji Kanenishi, Uiko Hanaoka, Genzo Marumo
[Year:2015] [Month:January-March] [Volume:9 ] [Number:1] [Pages:110] [Pages No:44-50] [No of Hits : 1212]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1388 | FREE

ABSTRACT

Four-dimensional (4D) sonographic assessment of fetal facial expressions is considered to reflect normal and abnormal fetal neurological developments, and may be an important clue to predict the fetal brain function and well-being before and after birth. HDlive is a new surface-rendering mode, which uses an adjustable light source that facilitates the ability to create lighting and shadowing effects, thereby increasing depth perception. This technique facilitates extraordinarily realistic imaging of the fetal face, making it almost impossible to differentiate between actual photographs and HDlive images. In this article, we discuss recent topics regarding fetal facial expressions assessed by 4D ultrasound and HDlive, focusing on mouthing, sucking, yawning, blinking, tongue expulsion, scowling (pain/distress), and smiling. Moreover, we consider possibility of the existence of fetal emotion or awareness.

Keywords: HDlive, Four-dimensional ultrasound, Fetal facial expression, Fetal emotion, Fetal awareness.

How to cite this article: Hata T, Kanenishi K, Hanaoka U, Marumo G. HDlive and 4D Ultrasound in the Assessment of Fetal Facial Expressions. Donald School J Ultrasound Obstet Gynecol 2015;9(1):44-50.

Source of support: Nil

Conflict of interest: None

 
7.  Review Article
Fetal Neurology: The Role of Fetal Stress
Aida Salihagic Kadic
[Year:2015] [Month:January-March] [Volume:9 ] [Number:1] [Pages:110] [Pages No:30-39] [No of Hits : 1211]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1386 | FREE

ABSTRACT

Fetal development and growth, as well as the timing of birth is influenced by the intrauterine environment. Many environmental factors causing the fetal stress can interfere with fetal development and leave long-term and profound consequences on health. Fetal glucocorticoid overexposure has primarily significant consequences for the development of the central nervous system. In response to an adverse intrauterine conditions, the fetus is able to adapt its physiology to promote survival. However, these adaptations can result in permanent changes in tissue and organ structure and function that directly ‘program’ predisposition to disease. Cardiometabolic disorders, behavioral alterations and neuropsychiatric impairments in adulthood and/ or childhood may have their roots in the fetal period of life. Fetal response to stress and its prenatal and lifelong consequences are discussed in this review.

Keywords: F etal n eurology, F etal s tress, F etal b ehavior, Consequences of fetal stress.

How to cite this article: Kadiæ AS. Fetal Neurology: The Role of Fetal Stress. Donald School J Ultrasound Obstet Gynecol 2015;9(1):30-39.

Source of support: This work was supported by a grant from University of Zagreb.

Conflict of interest: None declared.

 
8.  Review Article
Fetal Isolated Ventriculomegaly: Is There any Neonatal Consequences?
Simona Vladareanu, Vlad Andrei Traistaru, Radu Vladareanu
[Year:2015] [Month:January-March] [Volume:9 ] [Number:1] [Pages:110] [Pages No:75-79] [No of Hits : 1202]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1392 | FREE

ABSTRACT

Isolated fetal ventriculomegaly is the most common cerebral anomaly encountered in utero during a routine pregnancy scan. Ultrasonography remains the most easy to access tool in the examination of the fetal brain, although fetal MRI is a more accurate method of evaluating fetal ventriculomegaly- associated brain anomalies are found in 17% of the cases after performing fetal MRI. Amniocentesis with chromosomal evaluation must be performed, because kariotype anomalies are more frequently encountered in fetuses with enlargement of the ventricular atrium, but the ventriculomegaly can be a cosequence of congenital infection with CMV, Toxoplasma or Rubella. Fetal isolated ventriculomegaly is a significant risk factor for developmental delay in children.

Keywords: Isolated ventriculomegaly, Neurodevelopmental delay, Fetal MRI, Associated anomalies.

How to cite this article: Vladareanu S, Traistaru VA, Vladareanu R. Fetal Isolated Ventriculomegaly: Is There any Neonatal Consequences? Donald School J Ultrasound Obstet Gynecol 2015;9(1):75-79.

Source of support: Nil

Conflict of interest: None

 
9.  Review Article
First Experience in Clinical Application of KANET
Ana Tikvica Luetic
[Year:2015] [Month:January-March] [Volume:9 ] [Number:1] [Pages:110] [Pages No:96-99] [No of Hits : 1102]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1395 | FREE

ABSTRACT

Introduction of three- and four-dimensional ultrasound into clinical practice enabled qualitative and quantitative assessment of fetal movements, including the analysis of fetal face expression which is considered to be the mirror of the maturational processes of upper motor neuron. Since, prenatal fetal behavioral patterns are reflections of developmental and maturational processes within the fetal central nervous system, the findings about changes in fetal movements and behavior could leed to the prenatal diagnosis of neurological impairment. Kurjak’s antenatal neurodevelopment test (KANET) is the first prenatal test based on the three- and four-dimensional ultrasound examination of the fetus that could be used for the evaluation and prediction of the fetal neurologic status.

Keywords: Fetal behavior, Three/four-dimensional ultrasound, KANET.

How to cite this article: Luetic AT. First Experience in Clinical Application of KANET. Donald School J Ultrasound Obstet Gynecol 2015;9(1):96-99.

Source of support: Nil

Conflict of interest: None declared.

 
10.  Original Article
KANET in Brazil: First Experience
Raul Moreira Neto
[Year:2015] [Month:January-March] [Volume:9 ] [Number:1] [Pages:110] [Pages No:1-5] [No of Hits : 1091]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1384 | FREE

ABSTRACT

Objective: The goal of this pilot test is to compare Kurjak’s antenatal neurological test (KANET) results between high and low-risk pregnancies and see the feasibility of using this test on a larger scale in Brazil.

Methods: We applied KANET test in high-risk (n = 17) and low-risk (n = 34) pregnancies and compared the results.

Results: There was a significant difference between groups of high-risk and low-risk pregnancies for all parameters in KANET score 2. For KANET score 0, 5 out of 8 parameters where significant different: isolated head anteflexion, cranial sutures and head circumference, isolated hand movement or hand to face movements, isolated leg movement and fingers movements. All abnormal KANET result came from high-risk pregnancies (17.6%). No low-risk pregnancies presented KANET score 0. Efficacy and effectiveness were not evaluated due to the imprecision inherent in data from small samples.

Conclusion: This successful preliminary study of KANET in Brazil showed important differences in fetal behavior between the low and high-risk pregnancies, and can be used as information of feasibility and identify modifications needed in the design of a larger testing study.

Keywords: Fetal behavior, Four-dimensional ultrasound, KANET, Neurodevelopment prenatal assessment, Fetal central nervous system.

How to cite this article: Neto RM. KANET in Brazil: First Experience. Donald School J Ultrasound Obstet Gynecol 2015;9(1):1-5.

Source of support: Nil

Conflict of interest: None declared.

 
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