Comparing three cardiothoracic ratio measurement techniques and creating multivariable scoring system to predict Bart's hydrops fetalis at 17-22 weeks' gestation.

To assess the diagnostic performance of three cardiothoracic (CT) ratio techniques, including diameter, circumference, and area, for predicting hemoglobin (Hb) Bart's disease between 17 and 22 weeks' gestation, and to create a multivariable scoring system using multiple ultrasound markers. Before invasive testing, three CT ratio techniques and other ultrasound markers were obtained in 151 singleton pregnancies at risk of Hb Bart's disease. CT diameter ratio demonstrated the highest sensitivity among the other techniques. Significant predictors included CT diameter ratio > 0.5, middle cerebral artery-peak systolic velocity (MCA-PSV) > 1.5 multiples of the median, and placental thickness > 3 cm. MCA-PSV exhibited the highest sensitivity (97.8%) in predicting affected fetuses. A multivariable scoring achieved excellent sensitivity (100%) and specificity (84.9%) for disease prediction. CT diameter ratio exhibited slightly outperforming the other techniques. Increased MCA-PSV was the most valuable ultrasound marker. Multivariable scoring surpassed single-parameter analysis in predictive capabilities.

Reference Ranges and Development Patterns of Fetal Myocardial Function Using Speckle Tracking Echocardiography in Healthy Fetuses at 17 to 24 Weeks of Gestation.

OBJECTIVE: The purposes of the study were to develop reference ranges and maturation patterns of fetal cardiac function parameters measured by speckle tracking echocardiography (STE) using multiple biometric variables at 17 to 24 weeks' gestation among Thai fetuses and to compare with other previous reports. STUDY DESIGN: The four-chamber view of the fetal heart in 79 healthy fetuses was suitably analyzed by STE to establish the best-fit regression model. The 95% reference intervals and Z-score equations of fetal cardiac function parameters were computed. RESULTS: The fractional area change of both ventricles, left ventricular (LV) end-diastolic and end-systolic volumes, LV stroke volume, LV cardiac output (CO), and LV CO per kilogram were all increased according to gestational age (GA) and five fetal biometric measurements. However, the global longitudinal strain, basal-apical length fractional shortening (BAL-FS), BAL annular free wall and septal wall FS, BAL free wall and septal wall annular plane systolic excursions, 24-segment transverse width FS, as well as LV ejection fraction were all independent of GA or other somatic characteristics. There were varying development patterns between fetal right and left ventricles of these cardiac function indices across the gestation period. CONCLUSION: Our study created Z-score and corresponding centile calculators, 5th and 95th centile reference tables, and corresponding graphs and determined the normal evolution across gestation using multiple somatic growth and age variables between 17 and 24 gestational weeks. These nomograms serve as an essential prerequisite for quantitatively evaluating fetal cardiac contractility and allow for precisely detecting early changes in the fetal heart function. KEY POINTS: · Most fetal cardiac function measurements were correlated with all the independent variables.. · Fetal ventricular function parameters have their own characteristic maturation changes.. · Racial variability may not occupy an important place for fetal myocardial function during these GA..

Assessment of the Size and Shape of the 4-Chamber View and the Right and Left Ventricles Using Fetal Speckle Tracking in Normal Fetuses at 17-24 Gestational Weeks.

INTRODUCTION: The aim of the study was to establish normal reference values obtained by fetal speckle tracking analysis of the fetal heart between 17 and 24 weeks of gestation among Thai fetuses and compare the nomograms with previous studies. METHODS: The 4-chamber view (4CV) of the fetal heart in 79 normal fetuses was analyzed by speckle tracking analysis to determine the best-fit regression model. The 95% reference intervals and Z-score equations of fetal cardiac parameters were computed. RESULTS: The end-diastolic length, width, area, and circumference of the 4CV as well as the ventricular end-diastolic length, 24-segment widths, and area were all increased as a function of gestational age (GA), and 5 fetal biometric parameters. In contrast, the global sphericity index (SI), 24-segment SI, and right ventricle/left ventricle width and area ratios did not change with GA or fetal biometric measurements. There were few differences in Z-score reference ranges of fetal cardiac measurements between the current study and previous studies conducted in different patient populations. CONCLUSION: Our study provided z-score and corresponding centile calculators, 5th and 95th centile reference tables, and corresponding graphs for evaluating the size and shape of the 4CV and the right and left ventricles using 6 independent variables between 17 and 24 weeks of gestation. These results provide normal reference ranges for future studies of fetuses with pathologies that may alter the size and shape of the 4CV and ventricles.

Influence of water intake on the waiting time prior to gynecologic transabdominal ultrasound.

OBJECTIVE: To investigate the effect of volume of water intake on the length of time before the bladder is sufficiently full prior to undergoing transabdominal ultrasound. METHODS: Ninety-three patients scheduled for transabdominal ultrasound were enrolled between November 2007 and April 2008 and randomly allocated to 3 study groups by volume of water intake: 300, 400, and 500 mL. The total waiting time was recorded when the bladder was sufficiently full to undergo transabdominal ultrasound. The final bladder volume was measured using three-dimensional ultrasound. RESULTS: Mean waiting times were 68.65+/-30.12 min, 64.2+/-26.18 min, and 54.38+/-12.75 min for patients ingesting 300, 400, and 500 mL of water, respectively (P=0.060). The final bladder volumes for the 3 groups were not statistically different (263.06+/-99.21 mL, 275.37+/-113.05 ml, and 316.17+/-101.31 mL; P=0.113). CONCLUSION: Differences in the volume of water ingested in the range of 300-500 mL did not affect the waiting time before undergoing transabdominal ultrasound.