The December issue of Ultrasound in Obstetrics & Gynecology includes a study on the outcome of monochorionic twin pregnancies with selective fetal growth restriction according to the new Delphi definition, a study on the impact of measurement of the outflow tracts in the prediction of coarctation of the aorta, a study and accompanying video abstract on transperineal ultrasound assessment of the pelvic floor at term and fetal head engagement, a study and accompanying video abstract on the prevalence of a negative sliding sign representing pouch of Douglas obliteration during pelvic transvaginal ultrasound for any indication, and an acknowledgment of the essential contributors to UOG’s peer-review process in 2020.
Outcome of monochorionic twin pregnancy with selective fetal growth restriction at 16, 20 or 30 weeks according to new Delphi consensus definition
Use of different definitions of selective fetal growth restriction (sFGR) in twin pregnancy hampers comparison of data between studies. Recently, uniform criteria were proposed using the Delphi consensus process, but they have not yet been validated in clinical practice. Couck et al. reported the outcome of sFGR diagnosed according to the new Delphi consensus definition and determined potential predictors of survival. Isolated sFGR was found to be associated with a 90% survival rate in monochorionic diamniotic twin pregnancies. The subsequent development of twin–twin transfusion syndrome, absent or reversed end-diastolic flow in the umbilical artery of the smaller twin and the presence of a major anomaly were found to adversely affect survival in sFGR.
Impact of prospective measurement of outflow tracts in prediction of coarctation of the aorta
Prenatal diagnosis of coarctation of the aorta (CoA) is associated with reduced mortality and morbidity; however, accurate prenatal prediction remains challenging. To date, studies have used retrospective measurements of the outflow tracts to evaluate their potential to predict CoA. Vigneswaran et al. evaluated prospectively acquired measurements of the outflow tracts and reported the postnatal prevalence of bicuspid aortic valve in fetuses with prenatally suspected CoA. It was found that measurement of the distal transverse aortic arch and arterial duct diameters can be used to ascertain the risk for postnatal CoA in a selected cohort. A high incidence of bicuspid aortic valve was found in false-positive cases. Parents should therefore be counseled regarding the possibility of a bicuspid aortic valve in prenatally suspected CoA.
Prevalence of negative sliding sign representing pouch of Douglas obliteration during pelvic transvaginal ultrasound for any indication
Pouch of Douglas (POD) obliteration can be predicted with a high degree of certainty and reproducibility using the dynamic transvaginal ultrasound (TVS) sliding-sign technique. So far, studies on POD obliteration prediction have focused on tertiary-care populations with high prevalence of endometriosis. Leonardi et al. determined the prevalence of a negative sliding sign, representing POD obliteration, in a cohort of patients undergoing TVS for any gynecological indication. The findings demonstrated an overall prevalence of a negative sliding sign of 5.2%. The prevalence of a negative sliding sign in low-risk women was not negligible (3.4%). These women are most likely to have asymptomatic endometriosis or another important etiology of POD obliteration. Watch the accompanying video abstract:
Transperineal ultrasound assessment of maternal pelvic floor at term and fetal head engagement
Using transperineal ultrasound, both pelvic floor dimensions and fetal head engagement can be assessed reliably and quantitatively. At term, pelvic floor dimensions and levator ani muscle coactivation, as well as angle of progression, have been shown to be associated with the outcome of labor. Youssef et al. evaluated the association between pelvic floor dimensions in nulliparous women at term and fetal head engagement, as assessed by transperineal ultrasound. Smaller pelvic floor dimensions and levator ani muscle coactivation were found to be associated with higher fetal head station and with a longer second stage of labor in nulliparous women at term. Watch the accompanying video abstract:
Acknowledgment of Referees, 2020
We would like to express our gratitude to the reviewers of UOG who participated in the peer-review process of UOG in 2020. We are extremely grateful to the reviewers who continued to contribute their expertise and time to the Journal despite the unprecedented challenges that the coronavirus pandemic presented. The continued success of UOG is largely attributable to their hard work and timeliness. A list of these essential contributors can be found here.
Coming up next month is our 30th anniversary Special Issue, which will include:
- A series of insightful Opinions from key contributors to the field over the last three decades.
- Cutting-edge research from influential groups, including those of Kypros Nicolaides, Basky Thilaganathan, Jan Deprest, Ahmet Baschat, Elisabeth Epstein, and more.
- The winner of our cover-image competition and a gallery featuring the shortlisted images.