Search

Your search keyword '"Gembruch U"' showing total 264 results
Start Over Author "Gembruch U" Publisher wiley
264 results on '"Gembruch U"'

4. First-trimester ductus venosus velocity ratio as a marker of major cardiac defects

Author

Wagner, P., Eberle, K., Sonek, J., Berg, C., Gembruch, U., Hoopmann, M., Prodan, N., Kagan, K. O., Wagner, P., Eberle, K., Sonek, J., Berg, C., Gembruch, U., Hoopmann, M., Prodan, N., and Kagan, K. O.

Abstract

Objectives To examine ductus venosus (DV) flow in fetuses with and those without a cardiac defect and to evaluate different phases of DV flow in addition to the standard assessment of DV pulsatility index for veins (PIV) and the a-wave. Methods This was a retrospective study of singleton pregnancies that underwent first-trimester ultrasound screening, which included DV flow assessment, at the University of Tubingen (between 2010 and 2017) or the University of Cologne (between 2013 and 2016). The study population comprised normal fetuses and fetuses with major cardiac defects at a ratio of 10: 1. For each fetus, the following parameters of the DV waveform were evaluated: qualitative assessment of the a-wave, PIV measurement and ratios of flow velocities during the S-wave (S) or D-wave (D) and the a-wave (a) or v-wave (v). Reproducibility of DV-PIV and DV flow ratios was evaluated in 30 fetuses in which the DV flow was assessed twice. Results Our study population included 480 anatomically normal fetuses and 48 with a cardiac defect. Median fetal nuchal translucency (NT) in the normal and in the affected group was 1.9mm and 2.6 mm, respectively. In five (1.0%) of the normal and 18 (37.5%) of the affected cases, fetal NT thickness was above the 99th centile. In the normal group, the DV a-wave was reversed in 15 (3.1%) cases and the DV-PIV was above the 95th centile in 25 (5.2%). In the cases with cardiac defects, the a-wave was reversed and the DV-PIVmeasurement was above the 95th centile in 26 (54.2%). The reproducibility ofmeasurement of the ratios of DV flow velocities was similar to that of the DV-PIV. Most cardiac defects were associated with an abnormal a/S or a/D ratio. If the cut-off for these two ratios was set at the 5th centile of the normal distribution, the detection rate of fetal cardiac anomalies would be 62.5%. This compares favorably with the DV-PIV, which detects 26 (54.2%) of the affected fetuses for the same threshold. Conclusion In the first trimest

Published
2019

9. Prenatal diagnosis of absent pulmonary valve syndrome from first trimester onwards: novel insights into pathophysiology, associated conditions and outcome

Author

Gottschalk, I., Jehle, C., Herberg, U., Breuer, J., Brockmeier, K., Bennink, G., Hellmund, A., Strizek, B., Gembruch, U., Geipel, A., Berg, C., Gottschalk, I., Jehle, C., Herberg, U., Breuer, J., Brockmeier, K., Bennink, G., Hellmund, A., Strizek, B., Gembruch, U., Geipel, A., and Berg, C.

Abstract

Objective To assess the spectrum of associated anomalies, intrauterine course and outcome in fetuses with absent pulmonary valve syndrome (APVS). Methods All cases with a prenatal diagnosis of APVS at two centers over a period of 13 years were analyzed retrospectively. APVS was diagnosed in the presence of rudimentary or dysplastic pulmonary valve leaflets with to-and-fro blood flow in the pulmonary trunk on color and pulsed-wave Doppler ultrasound. Data on demographic characteristics, presence of associated conditions, Doppler studies and pregnancy outcome were reviewed. Results During the study period, 40 cases of APVS were diagnosed prenatally. Thirty-seven (92.5%) cases were associated with tetralogy of Fallot (TOF) and three (7.5%) had an intact ventricular septum. Patency of the ductus arteriosus (DA) was found in 17/37 (45.9%) TOF cases and in all three cases with an intact ventricular septum. Mean gestational age at diagnosis was 19.7 (range, 12-34) weeks with 10 (25.0%) cases (all with TOF) diagnosed in the first trimester. TOF was an isolated finding in 15 (37.5%) cases. Chromosomal anomalies, cardiac defects and extracardiac anomalies were present in 18 (45.0%), four (10.0%) and three (7.5%) cases, respectively. Among the 40 cases, there were 19 (47.5%) terminations of pregnancy, six (15.0%) intrauterine deaths, four (10.0%) neonatal deaths and 11 (27.5%) survivors. Patency of the DA, reversed flow during atrial contraction in the ductus venosus, umbilical artery or fetal middle cerebral artery, and hydrops/increased nuchal translucency thickness were significantly associated with non-survival. All 10 cases diagnosed in the first trimester had a patent DA and abnormal Doppler parameters, eight had hydrops and/or increased nuchal translucency, six were associated with trisomy 13 or 18 and none survived. Conclusion APVS diagnosed in the first trimester is significantly associated with TOF, patency of the DA, abnormal Doppler parameters, lethal trisomies and

Published
2017

10. First-trimester intervention in twin reversed arterial perfusion sequence: does size matter?

Author

Roethlisberger, M., Strizek, B., Gottschalk, I., Mallmann, M. R., Geipel, A., Gembruch, U., Berg, C., Roethlisberger, M., Strizek, B., Gottschalk, I., Mallmann, M. R., Geipel, A., Gembruch, U., and Berg, C.

Abstract

Objective To evaluate the outcome of first-trimester intervention (12 + 0 to 14 + 0 weeks of gestation) in pregnancies complicated by twin reversed arterial perfusion (TRAP) sequence. Methods All monochorionic diamniotic twin pregnancies diagnosed with TRAP sequence that underwent intrafetal laser ablation (IFL) of the feeding vessels before 14 + 0 weeks of gestation at the University of Bonn between 2010 and 2015 were analyzed retrospectively for intrauterine course and outcome. Results In the study period, 12 pregnancies with TRAP sequence were treated by IFL. Median gestational age at intervention was 13.2 (interquartile range (IQR), 12.6-13.6) weeks. In all cases, one intervention sufficed to disrupt the perfusion of the TRAP twin. There was no case of miscarriage, preterm prelabor rupture of membranes or hemorrhage. In five (41.7%) pregnancies, intrauterine death of the pump twin occurred at a median of 72.0 (IQR, 54.0-90.0; range, 48-96) h after intervention. The remaining seven pregnancies continued uneventfully resulting in birth of a healthy infant at term. A comparison of survivors and non-survivors identified a significant difference in median discordance between crown-rump length (CRL) of the pump twin and upper pole-rump length (URL) of the TRAP twin ((CRL-URL)/CRL ratio, 0.56 vs 0.31; P < 0.05 and URL/CRL ratio, 0.44 vs 0.68; P < 0.05). Survivors were treated at a significantly later gestational age than were non-survivors (median, 13.4 (IQR, 12.9-14.1) vs 12.6 (IQR, 12.5-13.1); P < 0.05). However, none of these parameters independently predicted survival. Conclusions Although technically feasible, IFL performed in the first trimester for TRAP sequence is associated with a significant fetal loss rate. Gestational age at intervention, (CRL-URL)/CRL ratio and URL/CRL ratio are potential predictors of pregnancy outcome. Copyright (C) 2016 ISUOG. Published by John Wiley & Sons Ltd.

Published
2017

15. Cranial and cerebral signs in the diagnosis of spina bifida between 18 and 22 weeks of gestation: a German multicentre study

Author

Bahlmann, F., primary, Reinhard, I., additional, Schramm, T., additional, Geipel, A., additional, Gembruch, U., additional, von Kaisenberg, C. S., additional, Schmitz, R., additional, Stupin, J., additional, Chaoui, R., additional, Karl, K., additional, Kalache, K., additional, Faschingbauer, F., additional, Ponnath, M., additional, Rempen, A., additional, and Kozlowski, P., additional

Published
2015
Full Text
View/download PDF

17. Bronchopulmonary sequestration with massive pleural effusion: pleuroamniotic shunting vs intrafetal vascular laser ablation

Author

Mallmann, M. R., Geipel, A., Bludau, M., Matil, K., Gottschalk, I., Hoopmann, M., Mueller, A., Bachour, H., Heydweiller, A., Gembruch, U., Berg, C., Mallmann, M. R., Geipel, A., Bludau, M., Matil, K., Gottschalk, I., Hoopmann, M., Mueller, A., Bachour, H., Heydweiller, A., Gembruch, U., and Berg, C.

Abstract

Objective To assess the incidence of complications among a relatively large cohort of fetuses with bronchopulmonary sequestration (BPS) and the success of two different intrauterine treatment modalities. Methods All cases with a prenatal diagnosis of BPS detected in a 10-year period (2002-2011) in two tertiary referral centers were reviewed retrospectively for intrauterine course and outcome. Up to May 2010 severe pleural effusions were treated with pleuroamniotic shunting. Thereafter, they were treated with ultrasound-guided laser coagulation of the feeding artery. Results A total of 41 fetuses with BPS were included in the study. In 29 (70.7%) there was no pleural effusion or hydrops and they were treated conservatively. In 19/29 (65.5%) there was partial or complete regression of the lesion during the course of pregnancy. All were born alive (median age at delivery, 38.3 (interquartile range (IQR), 34.0-39.6) weeks) and 16 (55.2%) required sequestrectomy. Intrauterine intervention was performed in all 12 (29.3%) fetuses with pleural effusion. Seven fetuses were treated with pleuroamniotic shunting. One fetus with severe hydrops died in utero. There was no complete regression in any case of BPS in this group. Six infants were born alive (median age, 37.2 (IQR, 30.3-37.4) weeks), of which five (83.3%) required sequestrectomy. Five fetuses were treated with laser ablation of the feeding vessel. In all cases of BPS there was regression after laser ablation. All infants were delivered at term (median age, 39.1 (IQR, 38.0-40.0) weeks). One (20.0%) neonate required sequestrectomy after birth. Following intrauterine shunt placement complete regression of the lesion was significantly less frequent (0/7 (0%) with shunt placement vs 4/5 (80%) with intrafetal laser treatment) and gestational age at birth was significantly lower, compared to treatment with intrafetal laser. Complete regression of the lesion was also significantly more frequent in the laser group compared to c

Published
2014

38. OC02.01: Ebstein's anomaly of the tricuspid valve in the fetus: a multicentre experience

Author

Gottschalk, I., primary, Gottschalk, L., additional, Stressig, R., additional, Ritgen, J., additional, Herberg, U., additional, Breuer, J., additional, Oberhoffer, R., additional, Schneider, M., additional, Asfour, B., additional, Hraska, V., additional, Tchatcheva, K., additional, Gembruch, U., additional, Geipel, A., additional, and Berg, C., additional

Published
2012
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results