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December Highlights

The December issue of Ultrasound in Obstetrics & Gynecology contains 11 Original Articles, a Randomized Controlled Trial comparing the effects of digital vaginal examination with transperineal ultrasound during labor on pain and anxiety, a Systematic Review on assisted reproductive techniques in women with polycystic ovary syndrome, a Systematic Review on associated anomalies, diagnostic accuracy and postnatal outcome in cases of persistent left superior vena cava on prenatal ultrasound, and an Editorial on pelvic organ prolapse.

Please see below a selection of articles from the December issue of the Journal chosen specially by the UOG team. To view all UOG content become an ISUOG journal member today .

Assessment of pelvic organ prolapse
Female pelvic organ prolapse (FPOP) is a common indication for gynecological surgery. A woman’s lifetime risk of FPOP surgery may be as high as 20%. The increasing prevalence of symptomatic FPOP means that this condition is a major public health issue that will continue to grow due to the aging populations in developed countries. There is a pressing need to better understand FPOP to improve both its prevention and treatment. A proper diagnosis is the first step towards achieving these goals. In this Editorial, Shek and Dietz focus on diagnosing significant FPOP on clinical and translabial ultrasound examination and discuss measures to avoid false-negative findings on FPOP assessment.
This article is only available to subscribers of UOG; remember to login to the ISUOG website to access this article, or become an ISUOG member to subscribe to UOG.


Comparison of effects of digital vaginal examination with transperineal ultrasound during labor on pain and anxiety levels
Digital vaginal examination is the most common method for assessing labor progression, however, despite this, data on the psychological effects of this assessment are lacking. Anxiety during labor is associated with a longer labor, increased pain perception, problems with maternal attachment to the newborn and increased rates of postpartum depression. In a single-blinded, parallel, randomized controlled trial by Seval et al., 90 parous pregnant women were assigned randomly to routine digital vaginal examination or transperineal ultrasound assessment during labor. Visual analog scale scores revealed that pain perception was significantly reduced during latent and active stages of labor and during the postpartum period in participants who had a transperineal ultrasound assessment compared with participants who had a digital vaginal examination, suggesting that transperineal ultrasound could be the preferred method for assessing labor progression.
This article is only available to subscribers of UOG; remember to login to the ISUOG website to access this article, or become an ISUOG member to subscribe to UOG.


Strategies for improving outcome of assisted reproduction in women with polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) affects around 2–13% of women of reproductive age, and, according to the World Health Organization, is the most common cause of anovulatory infertility. Primary management of infertility due to PCOS includes lifestyle modification and the use of drugs to induce monofollicular ovulation, with assisted reproductive techniques (ART) being the third line of treatment. Recent developments in ART have introduced measures to reduce the risks of ovarian hyperstimulation syndrome and cycle cancellation and to improve oocyte quality. However, it remains unclear how these new approaches have affected ART outcomes in women with PCOS. In this systematic review and meta-analysis, Kollmann et al. assessed 66 randomized controlled trials to examine the efficacy of all strategies aimed at improving ART outcomes in women with PCOS.
View the full article and accompanying Journal Club slides.
This month’s Journal Club slides were compiled by Dr Joel Naftalin.

Ultrasound-based gestational-age estimation in late pregnancy
Accurate estimation of gestational age is essential for appropriate antenatal care and obstetric management. Abnormal fetal growth patterns such as growth restriction or macrosomia may be undetected or diagnosed incorrectly if gestational age is unknown or incorrect. Dating in late pregnancy is less accurate than in early pregnancy as fetal ultrasound measurements have a larger absolute error, resulting in underestimation of gestational age for an abnormally sized fetus. Many women attend their first antenatal care visit late in pregnancy, making it difficult to manage complications, evaluate fetal growth and implement interventions. In a new study, Papageorghiou et al. evaluate a set of equations to estimate gestational age using fetal biometric measurements, acquired during a single ultrasound scan performed between 14 and 34 weeks’ gestation. They found that a single set of ultrasound measurements combining fetal head circumference and femur length in the second trimester can be used to estimate GA with reasonable accuracy.
View the full article.

Included in this issue of the Journal is a report on the 26th World Congress on Ultrasound in Obstetrics and Gynecology, Rome, featuring transcriptions of the speeches given about the Ian Donald Gold Medal winners, Professor Joachim Hackelöer and Kjell Lindström, and acknowledgment of the winners of the free communication awards.
View the Congress report.
This article is only available to subscribers of UOG; remember to login to the ISUOG website to access this article, or become an ISUOG member to subscribe to UOG.

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