scholarly journals OP03.07: Ultrasonographic evaluation of ovarian mass for prediction of malignancy in pregnant women: comparison of scoring systems in a multicentre study

2019 ◽  
Vol 54 (S1) ◽  
pp. 93-94
Author(s):  
S. Lee ◽  
Y. Kim ◽  
M. Lee ◽  
H. Ko ◽  
S. Oh ◽  
...  
Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 414
Author(s):  
Artur Czekierdowski ◽  
Norbert Stachowicz ◽  
Agata Smoleń ◽  
Tomasz Kluz ◽  
Tomasz Łoziński ◽  
...  

Background: To evaluate the accuracy of subjective assessment (SA), the International Ovarian Tumor Analysis (IOTA) group Simple Rules Risk (SRR) and the Assessment of Different NEoplasias in the adneXa (ADNEX) model for the preoperative differentiation of adnexal masses in pregnant women. Methods: The study population comprised 36 pregnant women (median age: 28.5 years old, range: 20–42 years old) with a mean gestation age of 13.5 (range: 8–31) weeks at diagnosis. Tumors were prospectively classified by local sonographers as probably benign or probably malignant using SA. Final tumor histological diagnosis was used as the reference standard in all cases. Logistic regression SRR and ADNEX models were used to obtain a risk score for every case. Serum CA125 and human epidydimis protein 4 (HE4) concentrations were also retrieved and the Risk of Ovarian Malignancy Algorithm (ROMA) value was calculated. The calculated predictive values included positive and negative likelihood ratios of ultrasound and biochemical tests. Results: Final histology confirmed 27 benign and 9 malignant (including 2 borderline) masses. The highest sensitivity (89%) and specificity (70%) were found for the subjective tumor assessment. Although no malignancy was classified as benign using the SRR criteria (sensitivity = 100%), the specificity of this scoring system was only 37%. At the cut-off risk level of >20%, the ADNEX model had a sensitivity of 78% and a specificity of 70%. Serum levels of CA125, HE4 and the ROMA risk model correctly identified adnexal malignant tumors with a sensitivity of 67%, 25% and 25%, respectively. Corresponding specificities were 72%, 100% and 100%, respectively. The highest positive and negative likelihood ratios were found for SA (LR+ = 3.0 and LR− = 0.16, respectively). Overall diagnostic accuracy of all predictive methods used in this study were similar (range: 70–75%) except for SRR (53%). Conclusion: Subjective assessment remains the best predictive method in complex adnexal masses found at prenatal ultrasound in pregnant women. For less experienced sonographers, both the SRR and ADNEX scoring systems may be also used for the characterization of such tumors, while serum tumor markers CA125 and HE4, along with the ROMA algorithm appear to be less accurate.


2021 ◽  
Author(s):  
Meiying Cai ◽  
Na Lin ◽  
Xuemei Chen ◽  
Ying Li ◽  
Min Lin ◽  
...  

Abstract Non-invasive prenatal testing (NIPT) is a fast, safe, and non-disruptive diagnostic method. At present, few studies have evaluated the screening efficiency of NIPT positive predictive value (PPV) in study subjects. Here, the results of NIPT in pregnant women were retrospectively analysed, and the detection rate, PPV and follow-up data were evaluated to determine its clinical value. A large multicentre study was conducted involving 52,855 pregnant women who received NIPT. Based on gestational age, amniotic fluid or umbilical cord blood were extracted for simultaneous karyotype and chromosome microarray analysis (CMA) in NIPT-positive patients. Among the 52,855 cases, 754 were NIPT-positive, with a positivity rate of 1.4%. Karyotype analysis and/or CMA confirmed 323 cases of chromosomal abnormalities, with a PPV of 45.1%. PPV of Trisomy 21 (T21), Trisomy 18 (T18), Trisomy 13 (T13), sex chromosomal aneuploidies (SCA) and copy number variations (CNV) were 78.9%, 35.3%, 22.2%, 36.9% and 32.9%, respectively. The PPV of T21, T18, and T13 increased with age whereas, the PPV of SCA and CNVs had little correlation with age. The PPV was significantly high in patients with advanced age along with an abnormal ultrasound.NIPT had a high PPV for T21, and a low PPV for T13 and T18, while screening for SCA and CNVs showed clinical significance. However, in case of NIPT screening for SCA and CNVs, simultaneous karyotype and CMA should be performed to increase the detection rates. Interventional prenatal diagnosis is still required in NIPT-positive cases to avoid false positives or unnecessary termination of pregnancy.


Author(s):  
Ikki Shimizu ◽  
Yuji Hiramatsu ◽  
Yasue Omori ◽  
Masao Nakabayashi ◽  

Background To clarify the relationship between glycated haemoglobin and glycated albumin concentrations during pregnancy with neonatal outcomes, a multicentre study was conducted by the Japanese Society of Diabetes and Pregnancy. Methods A total of 136 patients (type 1: n = 47, type 2: n = 89) who enrolled in the study were diagnosed based on the Japanese Diabetes Society diagnostic criteria for diabetes mellitus. Thresholds for glycated haemoglobin and glycated albumin were set at 5.8% and 15.8%, respectively, as the upper limits of the reference interval in pregnant women. Result Random plasma glucose decreased linearly, and reached the reference interval at 40 weeks. Glycated albumin concentrations also decreased in the same manner. But glycated haemoglobin concentrations were out of the reference interval during the study. The frequency of the neonatal complications did not show significant differences between the glycated haemoglobin ⩾5.8% group and the glycated haemoglobin <5.8% group. On the other hand, the frequency of neonatal complications showed higher tendency of neonatal complications in the incidence of polycythaemia ( P = 0.094) and heavy-for-date ( P = 0.071) in the glycated albumin ⩾15.8% group compared with the glycated albumin <15.8 group. The respiratory disorder in type 1 diabetes was significantly higher than type 2 diabetes. Conclusions For the treatment of pregnant women with diabetes, glycated albumin would be a better marker than glycated haemoglobin. However, glycated albumin is also affected by obesity and albumin, and it is desirable to make a comprehensive judgment with glycated haemoglobin, random plasma glucose and other glycaemic index.


Author(s):  
Se Jin Lee ◽  
Young-Han Kim ◽  
Mi-Young Lee ◽  
Hyun Sun Ko ◽  
Soo-young Oh ◽  
...  
Keyword(s):  

Infection ◽  
2015 ◽  
Vol 44 (2) ◽  
pp. 235-242 ◽  
Author(s):  
S. Baroncelli ◽  
M. F. Pirillo ◽  
R. Amici ◽  
E. Tamburrini ◽  
O. Genovese ◽  
...  

1996 ◽  
Vol 22 (4) ◽  
pp. 401-407 ◽  
Author(s):  
C. P. Lee ◽  
Z. Q. Wang ◽  
S. J. Duthie ◽  
H. K. Ma ◽  
J. Z. Zhang ◽  
...  

2021 ◽  
Vol 12 (2) ◽  
pp. 26-34
Author(s):  
F. Moro ◽  
G. Beneduce ◽  
D. Buonsenso ◽  
Ch. Landolfo ◽  
F. Mascilini ◽  
...  

Lung ultrasound has been recognized as a valid imaging method for diagnosing and monitoring COVID-19 pneumonia in pregnant women. The present review aimed to summarize the main findings reported in the literature and international guidelines on the role of lung ultrasound in the care of pregnant women affected by COVID-19. A search strategy was developed and applied to PubMed, Scopus, Web of Science and EMBASE to identify previous papers reporting the utility of ultrasound in diagnosing and monitoring COVID-19 pneumonia. The search retrieved 369 articles and 23 of these were selected for analysis. The articles mainly focused on the definition of the procedure, development of training programs for obstetricians managing pregnant women with suspicion of COVID-19 and definition of scoring systems. The clinical applications of lung ultrasound in this setting have also been described. This review could encourage obstetricians to learn lung ultrasound to use during critical events like a pandemic.


2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
R. M. Barbosa ◽  
K. C. Andrade ◽  
C. Silveira ◽  
C. M. Almeida ◽  
R. T. Souza ◽  
...  

Background. Adequate thyroid function is essential for normal growth and development of the fetus. Sonographic recognition of alterations in fetal thyroid dimensions may be the first sign of thyroid dysfunction, permitting early diagnosis and intervention. The main goal of this study was to build curves with reference values for ultrasound measurements of the fetal thyroid from 14 to 40 weeks of gestation. Methods. This is a prospective longitudinal study of 90 Brazilian pregnant women, complementary to a cohort multicentre study named “WHO multicentre study for the development of growth standards from fetal life to childhood: the fetal component.” Pregnant women without any pre-existing conditions that might affect fetal growth received antenatal care from the first trimester until childbirth, undergoing serial ultrasound evaluations of the fetus, including the thyroid. Longitudinal, anteroposterior, and transverse diameters of both thyroid lobes were measured in the fetus. Fetal thyroid lobe volume was also estimated. By quantile regression analysis, reference curves of measurements were fitted according to the gestational age. Results. A reference standard of thyroid growth was defined during pregnancy by fitting curves of its measurements. Reference values for the 10th, 50th, and 90th centiles of fetal thyroid measurements (longitudinal, anteroposterior, transverse diameters, and lobe volume) were defined, from 14 to 40 weeks of gestation. Conclusion. We provided a reference curve of optimal thyroid development in a low-risk population that can be used as a standard of comparison to diagnose deviations from the norm. In addition, we demonstrated an alternative and simplified method for early recognition of thyroid morphological alterations by an individualized technique to evaluate the thyroid lobes.


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