The March issue of Ultrasound in Obstetrics & Gynecology includes a study validating a novel artificial intelligence tool for detecting CNS abnormalities and a study evaluating fetal growth patterns in monochorionic twin pregnancies complicated by Type-III selective fetal growth restriction. To coincide with Endometriosis Awareness Month, this issue also features a large prospective multicenter study evaluating the accuracy of ultrasound for detection of ovarian and deep endometriosis using #Enzian classification. Also, look out for the recently accepted State-of-the-Art Review on the strengths and limitations of diagnostic tools for endometriosis by an international group of experts in the field of endometriosis research.

Please see below a selection of articles from the March issue of the Journal chosen specially by the UOG team. To view all UOG content, become an ISUOG member today or login and upgrade.

Use of real-time artificial intelligence in detection of abnormal image patterns in standard sonographic reference planes in screening for fetal intracranial malformations

Artificial intelligence is a promising tool for improving prenatal ultrasound screening. In a new study involving 43,890 images from 16,297 pregnancies and 169 videos from 166 pregnancies, Lin et al. developed and validated a novel artificial intelligence system, the Prenatal Artificial Intelligence Conduct System (PAICS), which allows the detection of different patterns of fetal intracranial abnormality in standard sonographic reference planes for screening for congenital CNS malformations. The PAICS demonstrated excellent diagnostic performance, comparable to that of expert sonologists, on both internal and external validation. The PAICS system also required significantly less time to read each image and reach a diagnosis, indicating its potential as an effective and efficient tool to aid in screening for fetal CNS malformations.

Growth patterns of monochorionic twin pregnancy complicated by Type-III selective fetal growth restriction

Little is known about patterns of fetal growth in monochorionic twin pregnancies complicated by Type-III selective fetal growth restriction (sFGR). Shinar et al. demonstrated that, in monochorionic twin pregnancies with Type-III sFGR, the smaller twin exhibits restricted fetal growth from very early in pregnancy, whereas the larger twin remains normal throughout gestation. Moreover, normalization of umbilical artery Doppler is associated with improved growth of the smaller twin. These findings have important implications for early detection of Type-III sFGR and monitoring of affected pregnancies.

Accuracy of sonography for non-invasive detection of ovarian and deep endometriosis using #Enzian classification: prospective multicenter diagnostic accuracy study

The #Enzian classification can be used for both intraoperative assessment and non-invasive imaging evaluation of endometriotic lesions. In a prospective multicenter study of 745 women, Montanari et al. evaluated the accuracy of transvaginal and transabdominal sonography for the preoperative, non-invasive diagnosis of endometriosis using the #Enzian classification. Sonographic evaluation according to the #Enzian classification demonstrated high accuracy for the assessment of localization and severity of endometriotic lesions and was highly concordant with surgical findings. This study contributes further evidence to support the use of the #Enzian classification, which can improve communication between surgeons and sonographers, planning of surgical procedures and the comparison of findings between centers for clinical and research purposes.

Coming up next month…

  • The April issue will have a series of papers on the theme of abnormally adherent placenta and Cesarean scar pregnancy and will include the following:
    • A Delphi study involving 16 experts in an effort to develop a standardized sonographic evaluation and reporting system for Cesarean scar pregnancy in early gestation. Preview the Accepted Article.
    • A systematic review and meta-analysis comparing the performance of sonography and MRI for the diagnosis of placenta accreta spectrum in high-risk women. Preview the Accepted Article.
    • A prospective study of the impact of uterine scarification following Cesarean section on the perinatal diagnosis of placenta accreta spectrum. Preview the Accepted Article.
  • The April issue will also feature a brief report on the clinical severity of SARS-CoV-2 infection among vaccinated and unvaccinated pregnant women during the Omicron wave. Preview the Accepted Article.