1
|
Carvalho JS, Axt-Fliedner R, Chaoui R, Copel JA, Cuneo BF, Goff D, Gordin Kopylov L, Hecher K, Lee W, Moon-Grady AJ, Mousa HA, Munoz H, Paladini D, Prefumo F, Quarello E, Rychik J, Tutschek B, Wiechec M, Yagel S. ISUOG Practice Guidelines (updated): fetal cardiac screening. Ultrasound Obstet Gynecol 2023; 61:788-803. [PMID: 37267096 DOI: 10.1002/uog.26224] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 06/04/2023]
Affiliation(s)
- J S Carvalho
- Royal Brompton Hospital, Guy's & St Thomas' NHS Foundation Trust; and Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust and Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK
| | - R Axt-Fliedner
- Division of Prenatal Medicine & Fetal Therapy, Department of Obstetrics & Gynecology, Justus-Liebig-University Giessen, University Hospital Giessen & Marburg, Giessen, Germany
| | - R Chaoui
- Center of Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - J A Copel
- Departments of Obstetrics, Gynecology & Reproductive Sciences, and Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - B F Cuneo
- Children's Hospital Colorado, The Heart Institute, Aurora, CO, USA
| | - D Goff
- Pediatrix Cardiology of Houston and Loma Linda University School of Medicine, Houston, TX, USA
| | - L Gordin Kopylov
- Obstetrical Unit, Shamir Medical Center (formerly Assaf Harofeh Medical Center), Zerifin, Israel; and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - K Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - W Lee
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - A J Moon-Grady
- Clinical Pediatrics, UC San Francisco, San Francisco, CA, USA
| | - H A Mousa
- Fetal Medicine Unit, University of Leicester, Leicester, UK
| | - H Munoz
- Obstetrics and Gynecology, Universidad de Chile and Clinica Las Condes, Santiago, Chile
| | - D Paladini
- Fetal Medicine and Surgery Unit, IRCCS Istituto G. Gaslini, Genoa, Italy
| | - F Prefumo
- Obstetrics and Gynecology Unit, IRCCS Istituto G. Gaslini, Genoa, Italy
| | - E Quarello
- Image 2 Center, Obstetrics and Gynecologic Department, St Joseph Hospital, Marseille, France
| | - J Rychik
- Fetal Heart Program at Children's Hospital of Philadelphia, and Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA
| | - B Tutschek
- Pränatal Zürich, Zürich, Switzerland; and Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - M Wiechec
- Department of Gynecology and Obstetrics, Jagiellonian University in Krakow, Krakow, Poland
| | - S Yagel
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Mt. Scopus and the Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
2
|
Prayer D, Malinger G, De Catte L, De Keersmaecker B, Gonçalves LF, Kasprian G, Laifer-Narin S, Lee W, Millischer AE, Platt L, Prayer F, Pugash D, Salomon LJ, Sanz Cortes M, Stuhr F, Timor-Tritsch IE, Tutschek B, Twickler D, Raine-Fenning N. ISUOG Practice Guidelines (updated): performance of fetal magnetic resonance imaging. Ultrasound Obstet Gynecol 2023; 61:278-287. [PMID: 36722431 PMCID: PMC10107509 DOI: 10.1002/uog.26129] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 05/03/2023]
Affiliation(s)
- D Prayer
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - G Malinger
- Division of Ultrasound in Obstetrics & Gynecology, Lis Maternity Hospital, Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L De Catte
- Department of Obstetrics & Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - B De Keersmaecker
- Department of Obstetrics & Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - L F Gonçalves
- Fetal Imaging, William Beaumont Hospital, Royal Oak and Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - G Kasprian
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - S Laifer-Narin
- Division of Ultrasound and Fetal MRI, Columbia University Medical Center - New York Presbyterian Hospital, New York, NY, USA
| | - W Lee
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Pavilion for Women, Houston, TX, USA
| | - A-E Millischer
- Radiodiagnostics Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France
| | - L Platt
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - F Prayer
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - D Pugash
- Department of Radiology, University of British Columbia, Vancouver, Canada; Department of Obstetrics and Gynecology, BC Women's Hospital, Vancouver, Canada
| | - L J Salomon
- Department of Obstetrics, Hôpital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Université Paris Descartes, Paris, France
| | - M Sanz Cortes
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Pavilion for Women, Houston, TX, USA
| | - F Stuhr
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - I E Timor-Tritsch
- Division of Obstetrical & Gynecological Ultrasound, NYU Grossmann School of Medicine, New York, NY, USA
| | - B Tutschek
- Department of Obstetrics & Gynecology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Prenatal Zurich, Zürich, Switzerland
| | - D Twickler
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - N Raine-Fenning
- Department of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK; Nurture Fertility, The Fertility Partnership, Nottingham, UK
| |
Collapse
|
3
|
Tutschek B, Sinkovskaya E. Short corpus callosum in fetal Down syndrome. Ultrasound Obstet Gynecol 2020; 56:464-465. [PMID: 31674081 DOI: 10.1002/uog.21908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 10/06/2019] [Accepted: 10/11/2019] [Indexed: 06/10/2023]
Affiliation(s)
- B Tutschek
- Prenatal Zurich, Gladbachstrasse, Zurich, Switzerland
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - E Sinkovskaya
- Eastern Virginia Medical School, Maternal Fetal Medicine, Norfolk, VA, USA
| |
Collapse
|
4
|
Tutschek B, Mayer K, Rauch A. Fetal tuberous sclerosis and diagnosis of paternal gonadal mosaicism. Ultrasound Obstet Gynecol 2020; 55:691-692. [PMID: 31587404 DOI: 10.1002/uog.21880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 09/15/2019] [Indexed: 06/10/2023]
Affiliation(s)
- B Tutschek
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - K Mayer
- Center of Human Genetics and Laboratory Diagnostics, Martinsried, Germany
| | - A Rauch
- Institute of Medical Genetics, University of Zurich, Schlieren-Zürich, Switzerland
| |
Collapse
|
5
|
Ebert J, Tutschek B. Virtual reality objects improve learning efficiency and retention of diagnostic ability in fetal ultrasound. Ultrasound Obstet Gynecol 2019; 53:525-528. [PMID: 30014541 DOI: 10.1002/uog.19177] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/10/2018] [Accepted: 07/09/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Virtual reality (VR) objects of fetal ultrasound volumes have been proposed for teaching and learning diagnostic ultrasound. The aim of this study was to determine if VR objects improve learning efficiency and retention of diagnostic ability in fetal ultrasound. METHODS Medical students and junior doctors were taught normal and abnormal sonographic fetal brain anatomy using conventional means (video lectures and review articles; control group) or additionally with selected VR objects from a novel fetal brain atlas (Pocket Brain, http://pb.fetal.ch; study group). Knowledge, speed of recognition and retention of diagnostic ability were tested in multiple-choice questionnaires 1 and 4 months after teaching, and the results were compared between those taught using conventional means only and those taught using VR objects. RESULTS Participants taught using VR objects answered significantly more questions correctly and solved the tests quicker than those taught using conventional methods only, both 1 and 4 months after teaching. CONCLUSION The use of VR objects in teaching fetal ultrasound significantly improves learning efficiency and knowledge retention. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- J Ebert
- Medical School, Zürich University, Zürich, Switzerland
| | - B Tutschek
- Prenatal Zürich, Zürich, Switzerland
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| |
Collapse
|
6
|
Tutschek B. 3D prints from ultrasound volumes. Ultrasound Obstet Gynecol 2018; 52:691-698. [PMID: 30151964 DOI: 10.1002/uog.20108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 08/18/2018] [Accepted: 08/22/2018] [Indexed: 06/08/2023]
Affiliation(s)
- B Tutschek
- Prenatal Zurich, Zürich, Switzerland; Heinrich Heine University, Düsseldorf, Germany
| |
Collapse
|
7
|
Tutschek B, Blaas HGK. Artifacts in 3D rendering: secondary palate concealed in acoustic shadow and use of edge-detection filters. Ultrasound Obstet Gynecol 2018; 52:407-408. [PMID: 30182402 DOI: 10.1002/uog.19175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 06/05/2018] [Indexed: 06/08/2023]
Affiliation(s)
- B Tutschek
- Prenatal Medicine Zurich, Zürich, Switzerland
- Heinrich Heine University, Düsseldorf, Germany
| | - H-G K Blaas
- Institute of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
8
|
Ghi T, Eggebø T, Lees C, Kalache K, Rozenberg P, Youssef A, Salomon LJ, Tutschek B. ISUOG Practice Guidelines: intrapartum ultrasound. Ultrasound Obstet Gynecol 2018; 52:128-139. [PMID: 29974596 DOI: 10.1002/uog.19072] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/08/2018] [Accepted: 03/16/2018] [Indexed: 06/08/2023]
Abstract
The purpose of these Guidelines is to review the published techniques of ultrasound in labor and their practical applications, to summarize the level of evidence regarding the use of ultrasound in labor and to provide guidance to practitioners on when ultrasound in labor is clinically indicated and how the sonographic findings may affect labor management. We do not imply or suggest that ultrasound in labor is a necessary standard of care.
Collapse
Affiliation(s)
- T Ghi
- Obstetrics and Gynecology, University of Parma, Parma, Italy
| | - T Eggebø
- National Center for Fetal Medicine, Trondheim University Hospital (St Olavs Hospital), Trondheim, Norway
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
| | - C Lees
- Centre for Fetal Care, Queen Charlottes and Chelsea Hospital, London, UK
| | - K Kalache
- Sidra Medical and Research Center, Doha, Qatar
| | - P Rozenberg
- Centre Hospitalier Poissy Saint Germain, Obstetrics & Gynaecology, Paris, France
| | - A Youssef
- Obstetrics and Gynecology, S. Orsola Malpighi Hospital, Bologna, Italy
| | - L J Salomon
- Hôpital Universitaire Necker-Enfants Malades, AP-HP, Université Paris Descartes, Maternité, Paris, France
- Société Française pour l'Amélioration des Pratiques Echographiques, SFAPE
| | - B Tutschek
- Prenatal Zurich, Heinrich-Heine-University, Medical Faculty, Zürich, Switzerland
| |
Collapse
|
9
|
Ghi T, Dall'Asta A, Conturso R, Volpe N, Schivardi N, Monopoli V, Preziosa A, Tutschek B. Fetal Brain Tutor 4us: an app for interactive multiplanar navigation through the normal fetal brain. Ultrasound Obstet Gynecol 2018; 51:711-713. [PMID: 29148609 DOI: 10.1002/uog.18957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/15/2017] [Accepted: 10/24/2017] [Indexed: 06/07/2023]
Affiliation(s)
- T Ghi
- Obstetrics and Gynecology Unit, University of Parma, Parma, Italy
| | - A Dall'Asta
- Obstetrics and Gynecology Unit, University of Parma, Parma, Italy
| | - R Conturso
- Obstetrics and Gynecology Unit, Hospital Valduce Como, Como, Italy
| | - N Volpe
- Obstetrics and Gynecology Unit, University of Parma, Parma, Italy
| | | | - V Monopoli
- Ultrasound Application Health & Medical Equipment, Samsung Electronics Italy, Rome, Italy
| | - A Preziosa
- Medical Engineering, Samsung Electronics Italy, Rome, Italy
| | - B Tutschek
- Prenatal Zurich, Zürich, Switzerland
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| |
Collapse
|
10
|
Tutschek B, Blaas HGK. 3D to boldly go where no 2D has gone before? Pitfalls in 3D reconstruction of the fetal palate. Ultrasound Obstet Gynecol 2018; 51:414-416. [PMID: 29512272 DOI: 10.1002/uog.18983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 10/18/2017] [Indexed: 06/08/2023]
Affiliation(s)
- B Tutschek
- Prenatal Zurich, Gladbachstrasse 95, Zürich, 8044, Switzerland
| | - H-G K Blaas
- Institute of Clinical and Molecular Medicine, Norwegian University of Science and Technology, NTNU, National Center for Fetal Medicine, St Olavs Hospital, Trondheim, Norway
| |
Collapse
|
11
|
Tutschek B, Blaas HGK. A human embryo in the palm of your hand. Ultrasound Obstet Gynecol 2017; 50:539-540. [PMID: 28233408 DOI: 10.1002/uog.17438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 01/29/2017] [Accepted: 02/08/2017] [Indexed: 06/06/2023]
Affiliation(s)
- B Tutschek
- Prenatal Zurich, Gladbachstrasse 95, 8044 Zürich, Switzerland
- Heinrich Heine University, Düsseldorf, Germany
| | - H-G K Blaas
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, National Center for Fetal Medicine, St Olavs Hospital, Trondheim, Norway
| |
Collapse
|
12
|
Tutschek B, Blaas HGK. 3D ultrasound and the fetal palate. Re: Qualitative evaluation of Crystal Vue rendering technology in assessment of fetal lip and palate. Ultrasound Obstet Gynecol 2017; 50:274-276. [PMID: 28782232 DOI: 10.1002/uog.17539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 05/30/2017] [Indexed: 06/07/2023]
Affiliation(s)
- B Tutschek
- Prenatal Zurich, Gladbachstrasse 95, 8044 Zürich, Switzerland
- Heinrich Heine University, Düsseldorf, Germany
| | - H-G K Blaas
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, National Center for Fetal Medicine, St Olavs Hospital, Trondheim, Norway
| |
Collapse
|
13
|
Tutschek B, Blaas HGK, Abramowicz J, Baba K, Deng J, Lee W, Merz E, Platt L, Pretorius D, Timor-Tritsch IE, Gindes L. Three-dimensional ultrasound imaging of the fetal skull and face. Ultrasound Obstet Gynecol 2017; 50:7-16. [PMID: 28229509 DOI: 10.1002/uog.17436] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 02/06/2017] [Accepted: 02/14/2017] [Indexed: 06/06/2023]
Affiliation(s)
- B Tutschek
- Prenatal Zurich, Zürich, Switzerland
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - H-G K Blaas
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, National Center for Fetal Medicine, St Olavs Hospital, Trondheim, Norway
| | - J Abramowicz
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA
| | - K Baba
- Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - J Deng
- University College London, London, UK
| | - W Lee
- Baylor College of Medicine, Obstetrics & Gynecology, Houston, TX, USA
| | - E Merz
- Krankenhaus Nordwest - Centre for Prenatal Diagnosis and Therapy, Frankfurt, Germany
| | - L Platt
- Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - D Pretorius
- Department of Radiology, University of California San Diego, CA, USA
| | - I E Timor-Tritsch
- Department of Obstetrics and Gynecology, NYU School of Medicine, New York, NY, USA
| | - L Gindes
- Department of Obstetrics and Gynecology, Wolfson Medical Center, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
14
|
Prayer D, Malinger G, Brugger PC, Cassady C, De Catte L, De Keersmaecker B, Fernandes GL, Glanc P, Gonçalves LF, Gruber GM, Laifer-Narin S, Lee W, Millischer AE, Molho M, Neelavalli J, Platt L, Pugash D, Ramaekers P, Salomon LJ, Sanz M, Timor-Tritsch IE, Tutschek B, Twickler D, Weber M, Ximenes R, Raine-Fenning N. ISUOG Practice Guidelines: performance of fetal magnetic resonance imaging. Ultrasound Obstet Gynecol 2017; 49:671-680. [PMID: 28386907 DOI: 10.1002/uog.17412] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/07/2017] [Accepted: 01/13/2017] [Indexed: 06/07/2023]
Affiliation(s)
- D Prayer
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - G Malinger
- Division of Ultrasound in Obstetrics & Gynecology, Lis Maternity Hospital, Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - P C Brugger
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - C Cassady
- Texas Children's Hospital and Fetal Center, Houston, TX, USA
| | - L De Catte
- Department of Obstetrics & Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - B De Keersmaecker
- Department of Obstetrics & Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - G L Fernandes
- Fetal Medicine Unit, Department of Obstetrics, ABC Medicine University, Santo Andre, Brazil
| | - P Glanc
- Departments of Radiology and Obstetrics & Gynecology, University of Toronto and Sunnybrook Research Institute, Obstetrical Ultrasound Center, Department of Medical Imaging, Body Division, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - L F Gonçalves
- Fetal Imaging, William Beaumont Hospital, Royal Oak and Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - G M Gruber
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - S Laifer-Narin
- Division of Ultrasound and Fetal MRI, Columbia University Medical Center - New York Presbyterian Hospital, New York, NY, USA
| | - W Lee
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Pavilion for Women, Houston, TX, USA
| | - A-E Millischer
- Radiodiagnostics Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France
| | - M Molho
- Diagnostique Ante Natal, Service de Neuroradiologie, CHU Sud Réunion, St Pierre, La Réunion, France
| | - J Neelavalli
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - L Platt
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - D Pugash
- Department of Radiology, University of British Columbia, Vancouver, Canada
- Department of Obstetrics and Gynecology, BC Women's Hospital, Vancouver, Canada
| | - P Ramaekers
- Prenatal Diagnosis, Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium
| | - L J Salomon
- Department of Obstetrics, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France
| | - M Sanz
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Pavilion for Women, Houston, TX, USA
| | - I E Timor-Tritsch
- Division of Obstetrical & Gynecological Ultrasound, NYU School of Medicine, New York, NY, USA
| | - B Tutschek
- Department of Obstetrics & Gynecology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany and Prenatal Zurich, Zürich, Switzerland
| | - D Twickler
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - M Weber
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - R Ximenes
- Fetal Medicine Foundation Latin America, Centrus, Campinas, Brazil
| | - N Raine-Fenning
- Department of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham and Nurture Fertility, The Fertility Partnership, Nottingham, UK
| |
Collapse
|
15
|
Tutschek B, Braun T, Chantraine F, Henrich W. Re: Prediction of delivery time in second stage of labor using transperineal ultrasound. Ultrasound Obstet Gynecol 2017; 49:663-664. [PMID: 28471029 DOI: 10.1002/uog.17424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/20/2016] [Indexed: 06/07/2023]
Affiliation(s)
- B Tutschek
- Center for Fetal Medicine, Gladbachstrasse 95, 8044, Zürich, Switzerland
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - T Braun
- Charité, Campus Virchow, University Hospital, Berlin, Germany
| | - F Chantraine
- Obstetrics and Gynecology, University Hospital, Liège, Belgium
| | - W Henrich
- Charité, Campus Virchow, University Hospital, Berlin, Germany
| |
Collapse
|
16
|
Tutschek B, Pilu G. Pocket Brain, an interactive, web-based ultrasound atlas of normal and abnormal fetal brain development. Ultrasound Obstet Gynecol 2017; 49:431-432. [PMID: 27071832 DOI: 10.1002/uog.15937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/04/2016] [Accepted: 04/07/2016] [Indexed: 06/05/2023]
Affiliation(s)
- B Tutschek
- Prenatal Zurich, Gladbachstr. 95, 8044, Zürich, Switzerland
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - G Pilu
- Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy
| |
Collapse
|
17
|
Tutschek B, Braun T, Chantraine F, Henrich W. Computed tomography and ultrasound to determine fetal head station. Ultrasound Obstet Gynecol 2017; 49:279-280. [PMID: 28169500 DOI: 10.1002/uog.17291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 04/15/2016] [Indexed: 06/06/2023]
Affiliation(s)
- B Tutschek
- Fetal Medicine and Gynecological Ultrasound, Gladbachstrasse 95, 8044, Zürich, Switzerland
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - T Braun
- Charité, Universitätsmedizin Berlin, Department of Obstetrics, Berlin, Germany
| | - F Chantraine
- Obstetrics and Gynecology, University Hospital, Liège, Belgium
| | - W Henrich
- Charité, Universitätsmedizin Berlin, Department of Obstetrics, Berlin, Germany
| |
Collapse
|
18
|
Tutschek B, Braun T, Chantraine F, Henrich W. Re: Angle of fetal head progression measured using transperineal ultrasound as a predictive factor of vacuum extraction failure. Ultrasound Obstet Gynecol 2016; 48:668-669. [PMID: 27854391 DOI: 10.1002/uog.17313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 09/03/2016] [Indexed: 06/06/2023]
Affiliation(s)
- B Tutschek
- Prenatal Zurich, Center for Fetal Medicine, Gladbachstrasse 95, 8044 Zürich, Switzerland
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - T Braun
- Charité, Campus Virchow, University Hospital, Berlin, Germany
| | - F Chantraine
- Obstetrics and Gynecology, University Hospital, Liège, Belgium
| | - W Henrich
- Charité, Campus Virchow, University Hospital, Berlin, Germany
| |
Collapse
|
19
|
Bronz C, Krähenmann F, Valsangiacomo E, Tutschek B, Zimmermann R, Ochsenbein N. Pentalogy of Cantrell: a case report. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
20
|
Tutschek B. A 28-mm crown-rump length embryo. Ultrasound Obstet Gynecol 2016; 48:255. [PMID: 27300497 DOI: 10.1002/uog.15996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 06/07/2016] [Accepted: 06/07/2016] [Indexed: 06/06/2023]
Affiliation(s)
- B Tutschek
- Prenatal Zurich, Zürich, Switzerland; Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| |
Collapse
|
21
|
Collins SL, Ashcroft A, Braun T, Calda P, Langhoff-Roos J, Morel O, Stefanovic V, Tutschek B, Chantraine F. Proposal for standardized ultrasound descriptors of abnormally invasive placenta (AIP). Ultrasound Obstet Gynecol 2016; 47:271-275. [PMID: 26205041 DOI: 10.1002/uog.14952] [Citation(s) in RCA: 185] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 06/30/2015] [Accepted: 07/12/2015] [Indexed: 05/26/2023]
Affiliation(s)
- S L Collins
- The Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford, UK
- The Fetal Medicine Unit, John Radcliffe Hospital, Oxford, UK
| | - A Ashcroft
- The Fetal Medicine Unit, John Radcliffe Hospital, Oxford, UK
| | - T Braun
- Department of Obstetrics and Division of Experimental Obstetrics, Study Group Perinatal Programming, Charité Campus Virchow, Berlin, Germany
| | - P Calda
- Department of Obstetrics and Gynecology, General Faculty Hospital, Charles University, Prague, Czech Republic
| | - J Langhoff-Roos
- Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - O Morel
- Centre Hospitalier Régional Universitaire de Nancy, Université de Lorraine, Nancy, France
| | - V Stefanovic
- Fetomaternal Medical Center, Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - F Chantraine
- Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- University of Liège, CHR de la Citadelle, Liège, Belgium
| |
Collapse
|
22
|
Imboden S, Müller M, Raio L, Mueller MD, Tutschek B. Clinical significance of 3D ultrasound compared to MRI in uterine malformations. Ultraschall Med 2014; 35:440-444. [PMID: 24557634 DOI: 10.1055/s-0033-1335664] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Congenital uterine anomalies often remain asymptomatic until they cause problems, for example during pregnancy. We studied the diagnostic aspects of two- and three-dimensional ultrasound and MRI. MATERIALS AND METHODS 63 women referred for suspected uterine anomalies were studied: In the first group (until July 2008) with 2 D-US and MRI, in the second group (from August 2008) additionally with 3 D-US; these women also had diagnostic or therapeutic operative confirmation. In the third group, only 3D-US was used. RESULTS In all women 3D-US was possible and successful. The most common anomaly was a subseptate uterus, while a septate uterus was less frequent, and uterus bicornis (unicollis) and uterus didelphys (bicornis bicollis) were rare. The women in the first two groups all underwent at least diagnostic hysteroscopy, and some (subseptate or septate uterus) underwent operative hysteroscopy. After preoperative volume imaging, laparoscopies were required less often. 3D-US diagnoses as judged by intraoperative findings were correct in 100 % of cases, while the MRI diagnoses in the same group were correct in only 7/13 cases. CONCLUSION Since the introduction of volume imaging (MRI, later 3 D-US), laparoscopy during hysteroscopic septum resection was not necessary in the majority of cases. 3D-US brings the diagnostics of uterine anomalies back into the hands of the gynecologist and can provide the gynecological surgeon with a higher subjective degree of certainty during operative hysteroscopy.
Collapse
Affiliation(s)
- S Imboden
- Universitäts-Frauenklinik, Inselspital, Bern
| | - M Müller
- Universitäts-Frauenklinik, Inselspital, Bern
| | - L Raio
- Universitäts-Frauenklinik, Inselspital, Bern
| | - M D Mueller
- Universitäts-Frauenklinik, Inselspital, Bern
| | - B Tutschek
- Pränatalmedizin und gyn. Ultraschall, Basel, und Medizinische Fakultät der Heinrich-Heine-Universität Düsseldorf
| |
Collapse
|
23
|
Gil H, Harder T, Tutschek B, Sloboda DM, Plagemann A, Henrich W, Braun T. Dosisabhängige Beeinträchtigung des Fetalwachstums nach antenataler Lungenreifeinduktion mit Betamethason bei Zwillingen. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
24
|
Tutschek B, Torkildsen EA, Eggebø TM. Comparison between ultrasound parameters and clinical examination to assess fetal head station in labor. Ultrasound Obstet Gynecol 2013; 41:425-429. [PMID: 23371409 DOI: 10.1002/uog.12422] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/24/2013] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Several ultrasound parameters, including intrapartum transperineal ultrasound (ITU) head station, angle of progression (AOP), head-perineum distance (HPD) and head-symphysis distance (HSD), have been suggested to assess fetal head station during labor. The aim of this study was to analyze the relationship between these ultrasound parameters and to compare them with digital palpation. METHODS We analyzed 106 stored volume dataset pairs that had been acquired at Stavanger University Hospital, Norway, from nulliparous women at term with prolonged first stage of labor. The volumes were acquired using a three-dimensional transducer applied between the labia majora in a mid-sagittal plane and perineally in a transverse plane. Digitally palpated head station and cervical dilatation were also noted. The results were compared using regression and correlation coefficients. RESULTS There were good correlations between ITU head station and HPD (r = 0.71), between ITU head station and HSD (r = 0.74) and between HSD and HPD (r = 0.75). Palpated head station showed only moderate correlation with ITU head station (r = 0.52). Cervical dilatation showed a weak correlation with ITU head station (r = 0.30). CONCLUSION The ultrasound parameters showed a high degree of correlation with each other, but only moderate correlation to vaginally palpated fetal head station.
Collapse
Affiliation(s)
- B Tutschek
- Heinrich Heine University, Düsseldorf, Germany.
| | | | | |
Collapse
|
25
|
Carvalho JS, Allan LD, Chaoui R, Copel JA, DeVore GR, Hecher K, Lee W, Munoz H, Paladini D, Tutschek B, Yagel S. ISUOG Practice Guidelines (updated): sonographic screening examination of the fetal heart. Ultrasound Obstet Gynecol 2013; 41:348-359. [PMID: 23460196 DOI: 10.1002/uog.12403] [Citation(s) in RCA: 423] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
26
|
Tutschek B, Braun T, Chantraine F, Henrich W. Quantification of fetal head direction and descent. Ultrasound Obstet Gynecol 2013; 41:99-100. [PMID: 23280737 DOI: 10.1002/uog.12351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
27
|
Tutschek B, Schmidt KG. Sonographic assessment of fetal cardiac function: indirect measurements of fetal cardiac function, newer techniques and clinical applications. Ultraschall Med 2012; 33:E16-E24. [PMID: 22161615 DOI: 10.1055/s-0029-1246106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Noninvasive blood flow measurements based on Doppler ultrasound studies are the main clinical tool for studying the cardiovascular status of fetuses at risk for circulatory compromise. Usually, qualitative analysis of peripheral arteries and in particular clinical situations such as severe growth restriction or volume overload also of venous vessels close to the heart or of flow patterns in the heart is being used to gauge the level of compensation in a fetus. However, quantitative assessment of the driving force of the fetal circulation, the cardiac output remains an elusive goal in fetal medicine. This article reviews the methods for direct and indirect assessment of cardiac function and explains new clinical applications. Part 1 of this review describes the concept of cardiac function and cardiac output and the techniques that have been used to quantify output. Part 2 summarizes the use of arterial and venous Doppler studies in the fetus and gives a detailed description of indirect measurements of cardiac function (like indices derived from the duration of segments of the cardiac cycle) with current examples of their application.
Collapse
MESH Headings
- Blood Flow Velocity/physiology
- Brain/blood supply
- Cardiac Output/physiology
- Echocardiography, Doppler/methods
- Female
- Fetal Growth Retardation/diagnostic imaging
- Fetal Growth Retardation/physiopathology
- Fetofetal Transfusion/diagnostic imaging
- Fetofetal Transfusion/physiopathology
- Heart Defects, Congenital/diagnostic imaging
- Heart Defects, Congenital/physiopathology
- Heart Failure/congenital
- Heart Failure/diagnostic imaging
- Heart Failure/physiopathology
- Hernia, Diaphragmatic/diagnostic imaging
- Hernia, Diaphragmatic/physiopathology
- Hernias, Diaphragmatic, Congenital
- Humans
- Infant, Newborn
- Infant, Premature, Diseases/diagnostic imaging
- Infant, Premature, Diseases/physiopathology
- Myocardial Contraction/physiology
- Placenta/blood supply
- Placental Insufficiency/diagnostic imaging
- Placental Insufficiency/physiopathology
- Pregnancy
- Regional Blood Flow/physiology
- Ultrasonography, Prenatal/methods
- Umbilical Arteries/diagnostic imaging
- Umbilical Arteries/physiopathology
- Umbilical Veins/diagnostic imaging
- Umbilical Veins/physiopathology
Collapse
Affiliation(s)
- B Tutschek
- Obstetrics and Gynecology, University Hospital
| | | |
Collapse
|
28
|
Tutschek B, Tercanli S. [Current aspects of obstetric ultrasound in the screening setting]. Praxis (Bern 1994) 2012; 101:1473-1480. [PMID: 23147603 DOI: 10.1024/1661-8157/a001108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Screening ultrasound during pregnancy has an established role and a defined scope that has increased over the years. Diagnostic possibilities with newer ultrasound systems can help in particular in referral settings and for a more detailed analysis of various fetal organ systems. In particular for the fetal heart there is a clear benefit with regard to neonatal morbidity and mortality.
Collapse
Affiliation(s)
- B Tutschek
- Ultraschall Freie Strasse, Pränatalmedizin und gynäkologischer Ultraschall, Basel.
| | | |
Collapse
|
29
|
Abstract
Proteases are involved in the invasion and metastasis of tumours by destruction of the basal membrane and connective tissue. As levels in malignant tissue have both prognostic and therapeutic implications, we examined 318 frozen samples from malignant tumours and comparable non-malignant tissue looking for urokinase plasminogen activator (uPA), tissue plasminogen activator (tPA), and plasminogen activator inhibitor-1 (PAI-1) levels with ELISA, as well as cathepsin D with RIA. Oestrogen receptor (ER) levels, progesterone receptor (PrgR) levels and epidermal growth factor receptors (EGFR) were measured by biochemical methods at the same time. Significantly raised levels of uPA, PAI-1 and cathepsin D were found in malignant tissue, with PAI-1 particularly high in carcinoma of the cervix. Significantly raised tPA levels were found in breast cancer tissue with a more favourable clinical prognosis, with a positive correlation between tPA and ER. No correlation could be shown between uPA, PAI-1 and cathepsin D with other prognostic factors for breast cancer. It could be that routine, uncomplicated estimation of tumour-associated proteases such as uPA, tPA, PAI-1 and cathepsin D will provide an independent prognostic marker for therapeutic decisions with regard to gynaecological tumours and breast cancer.
Collapse
Affiliation(s)
- C Ruppert
- UNIV FRANKFURT,CTR INTERNAL MED,DEPT ANGIOL,D-60596 FRANKFURT,GERMANY
| | | | | | | | | | | | | |
Collapse
|
30
|
Beckmann M, Tutschek B, Kruger K, Niederacher D, Risse B, Ruppert C, Schnurch H, Bender H. Biochemical and immunohistochemical detection of the epidermal growth-factor receptor (EGF-R) in breast-tumor specimens. Int J Oncol 2012; 3:389-97. [PMID: 21573379 DOI: 10.3892/ijo.3.2.389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Analyses of the level of expression of the epidermal growth factor receptor (EGF-R) of breast cancer tumors may add independent information about the prognosis of individual patients. Furthermore, the use of monoclonal antibodies directed against EGF-R as therapeutic tools (e.g., Mab 425) requires a reliable evaluation of the individual EGF-R content. Various analytical methods have been published, including (Scarff RW and Torloni H: World Health Organization, Geneva, 1968), biochemical detection of EGF-R by a radiolabeled physiologic ligand [I-125]EGF, (Early Breast Cancer Trialists' Collaborative Group: Lancet 329: 1-15, 1992) biochemical analyses of EGF-R content with a monoclonal antibody, and (McGuire WL and Clark GM: N Engl J Med 326: 1756-1761, 1992) immunohistochemical EGF-R detection. We measured the EGF-R content in membrane pellets derived from routine processing for evaluation of estrogen (ER, ER-EIA) and progesterone receptor (PgR; PgR-EIA) in 185 breast cancers and 18 benign breast samples, using a single-point saturation assay (RBA). Simultaneously, ER (ER-ICA), PgR (PgR-ICA), and EGF-R immunohistochemistry was performed on frozen sections of the same tumors. Various cell lines and normal skin tissue samples served as EGF-R positive or negative controls. The results of the two different EGF-R analyzing methods were compared with other biological characteristics of the tumors. 37% of the tumors were EGF-R positive. There was an inverse correlation between the ER or PgR and the EGF-R content. EGF-R overexpression correlated with high tumor grade. Analyses of EGF-R content in membrane pellets of breast cancer samples by single point saturation assay as well as the evaluation of tumor sections by immunohistochemistry can be performed routinely. The results obtained with both analytical methods did not differ significantly. but the immunohistochemistry proved to be more difficult to perform and to interpret. Thus, we prefer to perform both analytical methods simultaneously to provide information potentially useful for clinical management of individual cancer patients.
Collapse
Affiliation(s)
- M Beckmann
- UNIV FRANKFURT,DEPT GYNECOL & ONCOL,FRAUENKLIN,W-6000 FRANKFURT 1,GERMANY
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Tutschek B, Schmidt KG. Sonographic assessment of fetal cardiac function: introduction and direct measurement of cardiac function. Ultraschall Med 2012; 33:236-244. [PMID: 21614744 DOI: 10.1055/s-0029-1246087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Noninvasive blood flow measurements based on Doppler ultrasound studies are the main clinical tool for studying the cardiovascular status in fetuses at risk for circulatory compromise. Usually, qualitative analysis of peripheral arteries and, in particular clinical situations such as severe growth restriction or volume overload, also of venous vessels close to the heart or of flow patterns in the heart are being used to gauge the level of compensation in a fetus. Quantitative assessment of the driving force of the fetal circulation, the cardiac output, however, remains an elusive goal in fetal medicine. This article reviews the methods for direct and indirect assessment of cardiac function and explains new clinical applications. Part 1 of this review describes the concept of cardiac function and cardiac output and the techniques that have been used to quantify output. Part 2 summarizes the use of arterial and venous Doppler studies in the fetus and gives a detailed description of indirect measures of cardiac function (like indices derived from the duration of segments of the cardiac cycle) with current examples of their application.
Collapse
Affiliation(s)
- B Tutschek
- Obstetrics and Gynecology, University Hospital, 3010 Bern, Switzerland.
| | | |
Collapse
|
32
|
Tutschek B, Tercanli S, Chantraine F. Teaching and learning normal gynecological ultrasonography using simple virtual reality objects: a proposal for a standardized approach. Ultrasound Obstet Gynecol 2012; 39:595-596. [PMID: 22492592 DOI: 10.1002/uog.11090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
|
33
|
Tutschek B, Schmidt KG. Pulsed-wave tissue Doppler echocardiography for the analysis of fetal cardiac arrhythmias. Ultrasound Obstet Gynecol 2011; 38:406-412. [PMID: 21656866 DOI: 10.1002/uog.9070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Rhythm analysis of the fetal heart is hampered by the inability to routinely obtain electrocardiographic recordings of the fetus. Doppler studies of fetal cardiac tissue movements, assessing cardiac movements both qualitatively and quantitatively, have recently been described. We used a conventional high-resolution ultrasound system to obtain rhythm data from pulsed-wave tissue Doppler signals of the fetal heart in normal cardiac rhythm and in a variety of fetal cardiac arrhythmias. METHODS Fifty-five fetuses with normal (sinus) rhythm, 45 fetuses with rhythm disturbances and two neonates (one with arrhythmia and one with normal sinus rhythm) were studied. Using a conventional high-resolution ultrasound system equipped for fetal studies, but without specific tissue Doppler hardware or software, we performed pulsed-wave tissue Doppler echocardiography (PW-TDE) of atrioventricular valve ring excursions to study the atrial and ventricular mechanical actions. In the neonates, electrocardiograms were also recorded. RESULTS PW-TDE in normal fetuses shows a typical pattern of tissue motion parallel to the long axis of the heart and in the opposite direction to the blood flow, both in systole and diastole. This pattern is easily obtained from the tricuspid valve annulus in normal sinus rhythm and shows characteristic changes in various fetal arrhythmias. CONCLUSION PW-TDE of atrioventricular valve annulus movement patterns may prove to be a valuable additional tool for assessing fetal cardiac arrhythmias.
Collapse
Affiliation(s)
- B Tutschek
- Department of Obstetrics and Gynecology, Bern University Hospital, Bern, Switzerland; Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
| | | |
Collapse
|
34
|
Giers G, Wenzel F, Riethmacher R, Lorenz H, Tutschek B. Repeated intrauterine IgG infusions in foetal alloimmune thrombocytopenia do not increase foetal platelet counts. Vox Sang 2011; 99:348-53. [PMID: 20624268 DOI: 10.1111/j.1423-0410.2010.01367.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVES Foetal alloimmune thrombocytopenia (FNAIT) is often treated transplacentally with maternally administered i.v. immunoglobulins, but not all foetuses show a consistent platelet increase during such treatment. MATERIALS AND METHODS We retrospectively analysed data from a cohort of ten foetuses with FNAIT treated by direct foetal immunoglobulin infusion. Foetal treatment was begun between 17 and 25 weeks and continued until 36 weeks with weekly cordocenteses and foetal immunoglobulin infusions. RESULTS While foetal IgG levels increased steadily during weekly IgG infusions, foetal platelet counts remained unchanged. CONCLUSION Our retrospective study presents a unique analysis of a historical cohort, contributing to the ongoing debate about the treatment of choice for foetal alloimmune thrombocytopenia.
Collapse
Affiliation(s)
- G Giers
- Clinical Hemostaseology and Transfusion Medicine, Düsseldorf, Germany.
| | | | | | | | | |
Collapse
|
35
|
Tutschek B, Braun T, Chantraine F, Henrich W. A study of progress of labour using intrapartum translabial ultrasound, assessing head station, direction, and angle of descent. BJOG 2010; 118:62-9. [DOI: 10.1111/j.1471-0528.2010.02775.x] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
36
|
Salvesen KA, Lees C, Tutschek B. Basic European ultrasound training in obstetrics and gynecology: where are we and where do we go from here? Ultrasound Obstet Gynecol 2010; 36:525-529. [PMID: 20981718 DOI: 10.1002/uog.8851] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
|
37
|
Giers G, Riethmacher R, Wenzel F, Tutschek B. Die fetale/neonatale Alloimmun-Thrombozytopenie (FNAIT). Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1250068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
38
|
Giers G, Wenzel F, Fischer J, Stockschläder M, Riethmacher R, Lorenz H, Tutschek B. Retrospective comparison of maternal vs. HPA-matched donor platelets for treatment of fetal alloimmune thrombocytopenia. Vox Sang 2010; 98:423-30. [DOI: 10.1111/j.1423-0410.2009.01268.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
39
|
Bonel HM, Diedrichsen L, Tutschek B, Raio L, Nelle M, Stolz B, Frei KA, Wiest R. Bedeutung der Diffusionsgewichtung bei Patienten mit Placentainsuffizienz. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
40
|
Tutschek B, Pilu G. Virtual reality ultrasound imaging of the normal and abnormal fetal central nervous system. Ultrasound Obstet Gynecol 2009; 34:259-267. [PMID: 19634149 DOI: 10.1002/uog.6383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES In fetal ultrasound imaging, teaching and experience are of paramount importance to improve prenatal detection rates of fetal abnormalities. Yet both aspects depend on exposure to normal and, in particular, abnormal 'specimens'. We aimed to generate a number of simple virtual reality (VR) objects of the fetal central nervous system for use as educational tools. METHODS We applied a recently proposed algorithm for the generation of fetal VR object movies to the normal and abnormal fetal brain and spine. Interactive VR object movies were generated from ultrasound volume data from normal fetuses and fetuses with typical brain or spine anomalies. Pathognomonic still images from all object movies were selected and annotated to enable recognition of these features in the object movies. RESULTS Forty-six virtual reality object movies from 22 fetuses (two with normal and 20 with abnormal brains) were generated in an interactive display format (QuickTime) and key images were annotated. The resulting .mov files are available for download from the website of this journal. CONCLUSIONS VR object movies can be generated from educational ultrasound volume datasets, and may prove useful for teaching and learning normal and abnormal fetal anatomy.
Collapse
Affiliation(s)
- B Tutschek
- Department of Obstetrics and Gynecology, University Hospital Bern, Effingerstrasse 102, Bern CH-3010, Switzerland.
| | | |
Collapse
|
41
|
Schramm T, Gloning KP, Minderer S, Daumer-Haas C, Hörtnagel K, Nerlich A, Tutschek B. Prenatal sonographic diagnosis of skeletal dysplasias. Ultrasound Obstet Gynecol 2009; 34:160-170. [PMID: 19548204 DOI: 10.1002/uog.6359] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To assess the types and numbers of cases, gestational age at specific prenatal diagnosis and diagnostic accuracy of the diagnosis of skeletal dysplasias in a prenatal population from a single tertiary center. METHODS This was a retrospective database review of type, prenatal and definitive postnatal diagnoses and gestational age at specific prenatal diagnosis of all cases of skeletal dysplasias from a mixed referral and screening population between 1985 and 2007. Prenatal diagnoses were grouped into 'correct ultrasound diagnosis' (complete concordance with postnatal pediatric or pathological findings) or 'partially correct ultrasound diagnosis' (skeletal dysplasias found postnatally to be a different one from that diagnosed prenatally). RESULTS We included 178 fetuses in this study, of which 176 had a prenatal ultrasound diagnosis of 'skeletal dysplasia'. In 160 cases the prenatal diagnosis of a skeletal dysplasia was confirmed; two cases with skeletal dysplasias identified postnatally had not been diagnosed prenatally, giving 162 fetuses with skeletal dysplasias in total. There were 23 different classifiable types of skeletal dysplasia. The specific diagnoses based on prenatal ultrasound examination alone were correct in 110/162 (67.9%) cases and partially correct in 50/162 (30.9%) cases, (160/162 overall, 98.8%). In 16 cases, skeletal dysplasia was diagnosed prenatally, but was not confirmed postnatally (n = 12 false positives) or the case was lost to follow-up (n = 4). The following skeletal dysplasias were recorded: thanatophoric dysplasia (35 diagnosed correctly prenatally of 40 overall), osteogenesis imperfecta (lethal and non-lethal, 31/35), short-rib dysplasias (5/10), chondroectodermal dysplasia Ellis-van Creveld (4/9), achondroplasia (7/9), achondrogenesis (7/8), campomelic dysplasia (6/8), asphyxiating thoracic dysplasia Jeune (3/7), hypochondrogenesis (1/6), diastrophic dysplasia (2/5), chondrodysplasia punctata (2/2), hypophosphatasia (0/2) as well as a further 7/21 cases with rare or unclassifiable skeletal dysplasias. CONCLUSION Prenatal diagnosis of skeletal dysplasias can present a considerable diagnostic challenge. However, a meticulous sonographic examination yields high overall detection. In the two most common disorders, thanatophoric dysplasia and osteogenesis imperfecta (25% and 22% of all cases, respectively), typical sonomorphology accounts for the high rates of completely correct prenatal diagnosis (88% and 89%, respectively) at the first diagnostic examination.
Collapse
Affiliation(s)
- T Schramm
- Prenatal Medicine Munich, Munich, Germany.
| | | | | | | | | | | | | |
Collapse
|
42
|
Abstract
3D ultrasound can be used to study the fetal spine, but skeletal mode can be inconclusive for the diagnosis of fetal spina bifida. We illustrate a diagnostic approach using 2D and 3D ultrasound and indicate possible pitfalls.
Collapse
|
43
|
Abstract
Three-dimensional (3D) ultrasound volume acquisition, analysis and display of fetal structures have enhanced their visualization and greatly improved the general understanding of their anatomy and pathology. The dynamic display of volume data generally depends on proprietary software, usually supplied with the ultrasound system, and on the operator's ability to maneuver the dataset digitally. We have used relatively simple tools and an established storage, display and manipulation format to generate non-linear virtual reality object movies of prenatal images (including moving sequences and 3D-rendered views) that can be navigated easily and interactively on any current computer. This approach permits a viewing or learning experience that is superior to watching a linear movie passively.
Collapse
Affiliation(s)
- B Tutschek
- Bern University Hospital, Bern, Switzerland.
| |
Collapse
|
44
|
Abstract
Cord entanglement affects the majority of monoamniotic (MA) twins, accounting for the high proportion of intrauterine deaths of MA twins, and it is often present from early gestation. 3D ultrasound can be used to acquire volume data comprising information on umbilical colour Doppler flow, providing a very graphic depiction of cord entanglement. We have used 2D, "conventional" and a novel 3D display of colour Doppler ultrasound showing cord entanglement.
Collapse
Affiliation(s)
- W Henrich
- Geburtsmedizin, Charité Virchow-Klinikum, Berlin
| | | |
Collapse
|
45
|
Tutschek B, Schmidt KG. Levoatrial cardinal vein in mitral atresia and closed foramen ovale: prenatal diagnosis and perinatal management. Ultrasound Obstet Gynecol 2008; 32:229-232. [PMID: 18634108 DOI: 10.1002/uog.5381] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A levoatrial cardinal vein is a rare cardiovascular anomaly that may be present in malformed hearts with severe left heart obstruction and restrictive interatrial communication. We report the prenatal diagnosis at 23 weeks of a fetus with mitral atresia, double-outlet right ventricle, premature closure of the foramen ovale and a levoatrial cardinal vein draining into the innominate vein. In a prior examination performed elsewhere the levoatrial cardinal vein had been interpreted as an aortic arch perfused retrogradely, and hypoplastic left heart syndrome with aortic atresia had been diagnosed. Prenatal management, induction at 38 weeks and postnatal examinations and treatment are reported. To the best of our knowledge, this is the first reported prenatal diagnosis of this embryological vessel, presenting a potential pitfall for prenatal echocardiography.
Collapse
Affiliation(s)
- B Tutschek
- Department of Obstetrics, University Hospital of Berne, Berne, Switzerland.
| | | |
Collapse
|
46
|
Tutschek B, Sahn DJ. Semi-automatic segmentation of fetal cardiac cavities: progress towards an automated fetal echocardiogram. Ultrasound Obstet Gynecol 2008; 32:176-180. [PMID: 18634109 DOI: 10.1002/uog.5403] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To develop a novel application of a tool for semi-automatic volume segmentation and adapt it for analysis of fetal cardiac cavities and vessels from heart volume datasets. METHODS We studied retrospectively virtual cardiac volume cycles obtained with spatiotemporal image correlation (STIC) from six fetuses with postnatally confirmed diagnoses: four with normal hearts between 19 and 29 completed gestational weeks, one with d-transposition of the great arteries and one with hypoplastic left heart syndrome. The volumes were analyzed offline using a commercially available segmentation algorithm designed for ovarian folliculometry. Using this software, individual 'cavities' in a static volume are selected and assigned individual colors in cross-sections and in 3D-rendered views, and their dimensions (diameters and volumes) can be calculated. RESULTS Individual segments of fetal cardiac cavities could be separated, adjacent segments merged and the resulting electronic casts studied in their spatial context. Volume measurements could also be performed. Exemplary images and interactive videoclips showing the segmented digital casts were generated. CONCLUSION The approach presented here is an important step towards an automated fetal volume echocardiogram. It has the potential both to help in obtaining a correct structural diagnosis, and to generate exemplary visual displays of cardiac anatomy in normal and structurally abnormal cases for consultation and teaching.
Collapse
MESH Headings
- Algorithms
- Cardiac Volume/physiology
- Echocardiography, Doppler, Color/methods
- Echocardiography, Doppler, Color/standards
- Echocardiography, Three-Dimensional/methods
- Echocardiography, Three-Dimensional/standards
- Female
- Fetal Heart/diagnostic imaging
- Gestational Age
- Heart Ventricles/diagnostic imaging
- Humans
- Hypoplastic Left Heart Syndrome/diagnostic imaging
- Image Interpretation, Computer-Assisted
- Infant, Newborn
- Male
- Pregnancy
- Retrospective Studies
- Software
- Transposition of Great Vessels/diagnostic imaging
- Ultrasonography, Prenatal/methods
- Ultrasonography, Prenatal/standards
Collapse
Affiliation(s)
- B Tutschek
- Department of Obstetrics, University Hospital of Berne, Berne, Switzerland.
| | | |
Collapse
|
47
|
Friebe U, Tutschek B, Hucke J. Myotone Dystrophie in der Schwangerschaft: Fallbericht und Übersicht zum prä-, peri- und postnatalen Management. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2007-1022753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
48
|
Fuchs I, Tutschek B, Henrich W. Visualization of the fetal fontanels and skull sutures by three-dimensional translabial ultrasound during the second stage of labor. Ultrasound Obstet Gynecol 2008; 31:484-486. [PMID: 18383473 DOI: 10.1002/uog.5309] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- I Fuchs
- Department of Obstetrics, Charité Campus Virchow, Berlin, Germany
| | | | | |
Collapse
|
49
|
Tutschek B, Minderer S, Daumer-Haas C, Hörtnagel K, Gloning K, Schramm T. Pränatale Diagnostik von Skelett-Dysplasien (n=165). Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-1002840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
50
|
Ritgen J, Rath W, Tutschek B. Fetale kardiale Ventrikel-Volumina und -Massen – Pilotstudie mit 4D-Ultraschall und STIC. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-1002897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|