The February issue of Ultrasound in Obstetrics & Gynecology has a special focus on abnormally adherent and invasive placenta, with relevant articles including an Opinion piece on terminology used to describe the disorder, a Systematic Review on its prediction using first-trimester ultrasound signs, an original article on the cross-over sign for prediction of surgical outcome in diagnosed women, and a Systematic Review on expectant management of women diagnosed with Cesarean scar pregnancy.
Articles on other topics in this issue include an Original Article on center-specific variation in measurement of observed-to-expected lung area-to-head-circumference ratio for prognosis in congenital diaphragmatic hernia, and an agreement and reliability study on use of International Endometrial Tumor Analysis terminology.
Please see below a selection of articles from the February issue of the Journal chosen specially by the UOG team. To view all UOG content, become an ISUOG member today or login and upgrade.
Abnormally adherent and invasive placenta
This issue has a special focus on abnormally adherent and invasive placenta, including an Opinion article by Collins et al. on the varied and inconsistent use of terminology to describe the disorder and the need for its standardization. Also included is a Systematic Review by D’Antonio et al. on the presence of ultrasound signs suggestive of abnormally invasive placenta in the first trimester of pregnancy and their predictive accuracy. It was found that, whilst these signs can be present during the first trimester, their individual predictive accuracy is not high. This issue’s free-access Journal Club article is an Original Article by Calì et al. on the cross-over sign as a first-trimester indicator of surgical outcome in women diagnosed with abnormally invasive placenta. This study found that, in such women, assessment of the cross-over sign may help in stratifying those at higher risk of intra- and postoperative complications (view the accompanying Journal Club slides).
Also related to this topic is a Systematic Review by Calì et al. on the outcome in women managed expectantly following the diagnosis of Cesarean scar pregnancy (CSP), finding that CSP with positive embryonic/fetal heart activity managed expectantly is associated with a high burden of maternal morbidity, whilst expectant management of CSP with no cardiac activity may be a reasonable option.
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Look out in March for a virtual issue on abnormally adherent and invasive placenta containing a selection of relevant articles from UOG
Also in the February issue…
Prognosis of isolated congenital diaphragmatic hernia using lung-area-to-head-circumference ratio: variability across centers in a national perinatal network
Observed-to-expected lung area-to-head-circumference ratio (o/e-LHR) has been shown to be a good predictor for prognosis in fetuses diagnosed with congenital diaphragmatic hernia (CDH) when measured in CDH referral centers with expertise and a large caseload. In this Original Article, Senat et al. investigated o/e-LHR for prediction of subsequent survival of fetuses diagnosed with CDH when measurement was performed in fetal medicine units with different levels of expertise. It was found that, although measurement of o/e-LHR on two-dimensional ultrasound has less predictive capacity in centers with a smaller caseload, it is still a good indicator of neonatal prognosis in CDH and can be used in these centers.
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International Endometrial Tumor Analysis (IETA) terminology in women with postmenopausal bleeding and sonographic endometrial thickness ≥ 4.5 mm: agreement and reliability study
Endometrial variables detected on ultrasound have been designed to calculate the risk of malignancy in women with postmenopausal bleeding and sonographic endometrial thickness ≥ 4.5 mm but without fluid in the uterine cavity. The IETA group proposed standardized terminology for describing grayscale and color/power Doppler ultrasound images of the endometrium. This Original Article by Sladkevicus et al. investigated intra- and interrater agreement and reliability with regard to describing ultrasound images of the endometrium using the IETA terminology. The study found substantial interrater differences in the prevalence of most categories of most IETA variables, and that some categories were rarely observed.
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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 for full access to UOG.
Coming up in the next issue of UOG…
- An Editorial by Mathieu et al. on the imaging challenges and opportunities for improvement in screening for ovarian cancer. Preview the accepted article here.
- A Randomized Controlled Trial by Dodd et al. on fetal MCA Doppler peak systolic velocity as an indicator for the timing of intrauterine transfusions in pregnancies complicated by red cell alloimmunization. Preview the accepted article here.
- A Systematic Review on the prognostic accuracy of the cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome. Preview the accepted article here. This article has been chosen for the Journal Club, so look out for the accompanying downloadable slides next month.