Abstract:
BACKGROUND:Noninvasive imaging autopsy alternatives for fetuses weighing <500 grams are limited. Microfocus computed tomography has been reported as a viable option in small case series with the potential to avoid an invasive autopsy. Implementation of postmortem microfocus computed tomography in a large cohort as part of routine clinical service has yet been unreported, and realistic "autopsy prevention rates" are unknown. OBJECTIVE:This study aimed to describe the range of abnormalities detectable on fetal microfocus computed tomography in a clinical setting and additional findings identified on the antenatal ultrasound and to estimate the invasive autopsy avoidance rate (ie, cases in which imaging was sufficient to deem autopsy unnecessary). STUDY DESIGN:A prospective observational case series of all fetuses referred for microfocus computed tomography imaging at a single institution was conducted for 3 years (2016-2019). Imaging was reported by 2 pediatric radiologists before autopsy, with "decision to proceed" based on the specialist perinatal pathologists' judgment and parental consent. Agreement rates between microfocus computed tomography and antenatal ultrasound were evaluated, and where feasible, diagnostic accuracy for microfocus computed tomography was calculated using autopsy as a reference standard. RESULTS:A total of 268 fetuses were included (2-350 grams body weight; 11-24 weeks' gestation), with cause for demise in 122 of 268 (45.5%). Of the 122 fetuses, 64 (52.5%) exhibited fetal anomalies. Although 221 of 268 (82.5%) fetuses had consent for invasive autopsy, only 29 of the 221 (13.1%) underwent this procedure, which implied an autopsy avoidance rate of 192 of 221 (86.9%). Complete agreement was present for all brain, thoracic, and abdominal pathologies, whereas sensitivity and specificity for cardiac anomalies were 66.7% and 91.7%, respectively. Microfocus computed tomography and antenatal ultrasound agreement was found in 219 of 266 cases (81.9%), with partial agreement in 21 of 266 (7.9%) and disagreement in 26 of 266 (10.5%), mostly because of additional cardiac, soft tissue, or genitourinary findings by microfocus computed tomography, which were not seen on the ultrasound. CONCLUSION:Fetal microfocus computed tomography imaging is a viable and useful tool for imaging early gestational fetuses and can avoid the need for invasive autopsy. Confirmation of antenatal diagnoses is achieved in most cases, and additional anomalies may also be detected.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Shelmerdine SC,Simcock IC,Hutchinson JC,Guy A,Ashworth MT,Sebire NJ,Arthurs OJdoi
10.1016/j.ajog.2020.07.019subject
Has Abstractpub_date
2021-01-01 00:00:00pages
103.e1-103.e15issue
1eissn
0002-9378issn
1097-6868pii
S0002-9378(20)30740-7journal_volume
224pub_type
杂志文章abstract::The effects of maternal hyperexcitability on the fetus were studied in 17 baboons. In the period of agitation, induced by stressful stimulus such as exposure to bright light or by clamping of the toe, the mother exhibited an increase in arterial blood pressure and, in some instances, arrhythmia. These changes were acc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33032-0
更新日期:1979-06-01 00:00:00
abstract::Amniotic fluid creatinine, percentage of lipid-positive cells, and L/S ratio were determined on 285 samples from normal pregnancies and 222 samples from abnormal pregnancy states (Rh isoimmunization, diabetes, hypertensive disorders, intrauterine growth retardation, and hydramnios). In normal pregnancy the coefficient...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90777-8
更新日期:1976-07-01 00:00:00
abstract::The human tumor stem cell assay (HTSCA) has broad research applications in the field of cell biology as well as in clinical chemotherapy. This report examines the applicability of the HTSCA to patient treatment planning, asking: (1) How often will gynecologic tumors grow in the assay? (2) What kinds of therapeutically...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90114-x
更新日期:1983-09-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess the involvement of rho kinase (ROK) in agonist-dependent contraction of omental, myometrial, and placental arteries of pregnant women at term. STUDY DESIGN:Wire myography was used to assess if contractions of intact or alpha-toxin-permeabilized arteries obtained from w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.02.076
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVES:Extraperitoneal approaches to removal of lymph nodes for staging in cervical cancer patients are numerous, and each has disadvantages. We developed a supraumbilical transverse incision to initiate irradiation within days of cervical cancer staging. STUDY DESIGN:Twenty patients with advanced stage IIB or III...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90080-3
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess self-reported side effects in women after they received the oral contraceptive (OC) and to compare discontinuation rates, according to presence or absence of side effects. STUDY DESIGN:The study comprised 1716 women aged <25 years who initiated the OC at 3 publicly fun...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ajog.2006.12.015
更新日期:2007-04-01 00:00:00
abstract::Pyridoxal phosphate (vitamin B6) concentrations in peripheral and cord blood obtained at the time of delivery were measured in 30 women. The average plasma concentration in nine women with normal pregnancy was 4.3 ng. per milliliter; in 10 women with pre-eclampsia, 3.3 ng. per milliliter; and in nonpregnant women, 17 ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33591-8
更新日期:1975-04-15 00:00:00
abstract::It is demonstrated that for rats N,N'-bis(dischloroacetyl)-1,8-octamethylenediamine (Win 18,446) is a highly efficient embryocidal N,N'-bis(dichloroacetyl)-1,8-octamethylenediamine It was previously used to supress spermatogenesis in man and other mammals. In the initial rat studies, a fixed dosage of Win 18,446 was...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(74)90117-3
更新日期:1974-07-01 00:00:00
abstract::Partial mole is distinguishable from complete mole with coexisting normal twin after delivery by DNA polymorphysm analysis. Our patient had chorionic villus sampling of a molar-appearing placenta with coexisting fetus at 12.3 weeks. Absent maternal alleles confirmed a diandrogenetic complete mole. Prenatal DNA diagnos...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.151
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:We sought to identify factors associated with adverse perinatal outcomes (APO) among term breech neonates with planned vaginal deliveries. STUDY DESIGN:We conducted univariable and multilevel multivariable analysis of the data collected in the multicenter prospective observational study PREsentation et MODe ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.08.027
更新日期:2012-10-01 00:00:00
abstract::Our subjects were 32 patients whose old complete perineal lacerations were repaired in the 10 hospitals in the South Hampton Roads Metropolitan area over a 20-year period. The layer technique of repair (26 patients) and the Warren flap procedure (6 patients) were used. Function improved in 24 of 26 patients (92%) with...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(88)80053-x
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine whether obese women and underweight women have an increased risk of birth defects in their offspring. STUDY DESIGN:A geographically based case-control study of women living in California and Illinois was performed. There were 499 mothers of offspring with neural tube defects, 337...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70224-1
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the risk of adverse perinatal outcomes among pregnant women previously hospitalized for bipolar disorder. STUDY DESIGN:We completed a population-based cohort study of women with a singleton delivery in Ontario, Canada (2003 to 2011). Women previously hospitalized for bipolar disorder (n = 1859) o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.10.020
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare pregnancy outcomes in women with diet-treated gestational diabetes mellitus (GDM) that was diagnosed at < 24 weeks of gestation to those women who received the diagnosis at > or = 24 weeks of gestation. STUDY DESIGN:This was a retrospective cohort study of 2596 women ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.11.049
更新日期:2008-03-01 00:00:00
abstract::The neuropathologic conditions in 120 perinatal deaths attributed to fetal or newborn asphyxia were examined. Central nervous system necrosis was present in 16 of these deaths. The approximate time of asphyxial insult was established by determining the duration of the process, based on the findings of neuronal necrosi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(89)80040-7
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:We estimated the risk of complications at birth of extremely large babies (≥5000 g). STUDY DESIGN:This was a cohort study including all births of extremely large babies in 1996 through 2005 and comparison cohort with normal birthweight (1:2) identified in the national birth registration. RESULTS:There were ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.12.036
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:Although a few studies have evaluated the effect of meconium on the lecithin/sphingomyelin ratio for testing of fetal lung maturity, to date these studies have assessed only the lecithin-sphingomyelin ratio of amniotic fluid contaminated with meconium. The purpose of this study was (1) to determine whether me...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70038-9
更新日期:1998-12-01 00:00:00
abstract::A study of fetal activity was undertaken as the first step in a series of physiologic fetal movement studies. A simple, safe, noninvasive, clinically applicable method for studying fetal movement with a tocodynamometer is described. Four basic types of fetal movement have been seen and defined in terms of their durati...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90467-1
更新日期:1976-09-01 00:00:00
abstract::The investigation of estrogen and/or androgen administration on physical and psychological symptoms in the surgical menopause was carried out in a prospective, double-blind, crossover design. When patients who received either a combined estrogen-androgen drug or androgen alone were compared with those who received est...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(85)90001-8
更新日期:1985-01-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe the outcome of peripartum cardiomyopathy in patients cared for in a community hospital. STUDY DESIGN:The cases of peripartum cardiomyopathy treated at Central Baptist Hospital in Lexington, Kentucky, from January 1, 1992, to December 31, 1998, were reviewed. RESULTS...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.105402
更新日期:2000-05-01 00:00:00
abstract::A robotic-assisted laparoscopic technique for transabdominal cerclage placement could offer improvements over the traditional laparoscopic approach. A gravid female with no vaginal portion of the cervix underwent a robotic-assisted laparoscopic cerclage at 12 weeks' gestation and ultimately delivered a healthy infant ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.10.029
更新日期:2009-02-01 00:00:00
abstract::The rates of regression of human chorionic gonadotropin (hCG) in patients with complete hydatidiform moles, partial hydatidiform moles, and nonmolar abortions were compared. No difference in rates of regression was found among the three groups, but levels of hCG immediately after uterine evacuation were significantly ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90184-4
更新日期:1984-05-15 00:00:00
abstract::Maternal urinary 6 beta-hydroxycortisol (6 beta-OHF) and creatinine levels were measured in 28 patients with singleton pregnancies admitted in apparent premature labor and in 17 women with singleton pregnancies delivered at term. Urine specimens were collected immediately after admission but prior to the initiation of...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90003-x
更新日期:1981-02-01 00:00:00
abstract::Theories of intimal injury leading to plaque formation include platelet adhesion and production of growth factors, hypercholesterolemia, smooth muscle cell proliferation, macrophage activity, defective utilization of low-density lipoproteins via deficient receptors, and deficiency in cellular lysosomal enzymes. High l...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(88)90194-9
更新日期:1988-06-01 00:00:00
abstract::Fetal movements were directly visualized with a real-time ultrasound unit, and they were recorded after the random intravenous administration of either glucose or saline solution to the mother. A significant increase in fetal activity was seen 1 hour after the administration of glucose. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9378(80)91128-x
更新日期:1980-06-15 00:00:00
abstract::The use of reconstructive surgical techniques accelerates recovery from radical pelvic surgery. It also allows the surgeon greater latitude in the type of procedure and the selection of patients for extended pelvic surgery. The techniques involved in three such reconstructive procedures are described, and their applic...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90783-9
更新日期:1977-10-01 00:00:00
abstract::Generally there is a tendency to underrate the value of uterine height in the diagnosis of intrauterine growth retardation (IUGR). This fact is probably due to the lack of standard normal values for this measurement. In a group of 298 healthy pregnant women, the 10th, 50th, and 90th percentile were calculated by week ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90824-4
更新日期:1978-07-15 00:00:00
abstract:OBJECTIVE:We sought to determine if periconceptional exposure to agrichemicals was associated with the development of gastroschisis. STUDY DESIGN:We conducted a retrospective, case-controlled study using Washington State Birth Certificate and US Geological Survey databases. Cases included all live-born singleton infan...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.01.023
更新日期:2010-03-01 00:00:00
abstract::Denaturing gradient gel electrophoresis was used to identify single-base differences in the cytochrome P-450 21-hydroxylase (CYP21) genes of 132 unrelated control individuals and family members of three unrelated patients with 21-hydroxylase deficiency. The salt-wasting variety was caused by gene deletion and gene con...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91857-7
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:Our purpose was to document noninvasively the effect of sickle cell disease on left ventricular systolic and diastolic function during the third trimester of pregnancy. STUDY DESIGN:Fifteen patients with sickle cell disease underwent a two-dimensional M-mode echocardiography obtained using the long axis with...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70393-0
更新日期:1994-01-01 00:00:00