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A system, method and medium for standardizing a manner of acquisition and display of ultrasound images. In one embodiment of the invention, a volumetric image of an organ is acquired in a standardized manner. Relationships such as formulas are utilized to automatically generate anatomical planes of interest within the volume that can be displayed independent of the user.

women with a failed trial of labor after cesarean Han-Yang Chen, Suneet Chauhan, William Grobman, Anthony Vintzileos, Cande Ananth, Alfred Abuhamad University of Wisconsin Madison, School of Medicine and Public Health, Center for Urban Population Health, Milwaukee, WI, Eastern Virginia Medical School, Department of Obstetrics and Gynecology, Norfolk, VA, Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Chicago, IL, Stony Brook-Winthrop University Hospitals, Obstetrics and Gynecology, Long Island, NY, Columbia University, Department of Obstetrics and Gynecology, New York, NY OBJECTIVE: Despite the increased maternal risks associated with failed trial of labor after cesarean (TOLAC), it remains unknown whether failed TOLAC is also associated with increased morbidity and mortality in infants. The purpose of this study was to determine rates of early (EMR), late (LMR), post-neonatal (PMR) and infant (IMR) mortality in those with failed TOLAC as compared to those with successful TOLAC, specifically among women at 34-41 weeks who had induction or stimulation of labor. Secondary measures of neonatal morbidity (5-min Apgar score 4 and neonatal seizures) were also compared. STUDY DESIGN: Linked birth and infant death cohort data, between 2000 and 2004, from the US were used to identify women with a prior cesarean who were between 34-41 weeks, delivered non-anomalous singletons, and underwent either labor induction or stimulation. Multivariable log-binomial regression models were fitted to estimate the risk ratio (RR) for infant morbidity and mortality in relation to TOLAC following adjustments for several confounders. RESULTS: During the study period, the rate of successful TOLAC among the 164,113 women who met the inclusion criteria declined from 62% in 2000 to 52% in 2004 (P 0.001). The rates of EMR, LMR, PNMR, and IMR for the overall cohort were 0.3, 0.3, 1.6 and 2.2/1,000 live births, respectively. A failed TOLAC was significantly associated with a higher risk of neonatal and infant mortality, as well as immediate neonatal morbidity (Table). CONCLUSION: Among women undergoing labor induction or stimulation, failed TOLAC is associated with a significantly higher rate of neonatal morbidity, as well as neonatal and infant mortality. 318 The association between induction of labor and primary cesarean delivery in the Northeastern U.S. between 1996 and 2004 Yvonne W. Cheng, Hung Key Nguyen, Sanae Nakagawa, Jonathan Snowden, Aaron Caughey University of California, San Francisco, Obstetrics & Gynecology, San Francisco, CA, Albert Einstein School of Medicine, School of Medicine, Bronx, NY, University of California, San Francisco, Department of Obstetrics, Gynecology, and Reproductive Sciences, San Francisco, CA, Oregon Health and Sciences University, Obstetrics and Gynecology, Portland, OR, Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR OBJECTIVE: The annual incidence rates of labor induction and cesarean delivery have increased dramatically over the past decade. We aim to examine the association between induction of labor and cesarean delivery among low risk nulliparous women in the northeastern U.S. over time. STUDY DESIGN: This was a retrospective cohort study of non-anomalous, singleton, term, vertex live births by nulliparous women in the northeastern U.S. states between 1996 and 2004 using the U.S. Natality birth data. We excluded medical and obstetric conditions, yielding a low-risk population. The association between labor induction and cesarean delivery was examined by time trend in 2-year intervals using chi-square test and multivariable logistic regression. Populationbased expected and observed numbers of cesareans over time were estimated using baseline cesarean risk and adjusted odds ratio based on induction of labor. RESULTS: There were 1,300,393 live births meeting study criteria; of these, 21.4% had cesarean delivery. Compared to women without induction of labor, those induced had about 1.5 times the adjusted odds of cesarean: 1.58 for 1996 and 1998, 1.55 for 2000, 1.54 for 2002, and 1.55 for 2004. Of note, these odds ratios remained stable over the study period. However, the difference between observed and expected numbers of cesarean sections increased over time (Figure). CONCLUSION: While nulliparous women who had induction of labor had higher odds of cesarean, this effect estimates were stable over time. However, the actual number of cesarean deliveries increasingly deviated from the expected amounts, suggesting that increase in labor induction only provides partial explanation for the current cesarean epidemic.

A. Kaasen1, A. Helbig1, A. Heiberg2, K. Eiklid3, T. Naes4,5, U. F. Malt6,7, G. Haugen1,7 1Department of Obstetrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway; 2Department of Medical Genetics, Oslo University Hospital, Rikshospitalet, Oslo, Norway; 3Department of Medical Genetics, Oslo University Hospital, Ulleval, Oslo, Norway; 4Nofima, As, Norway; 5University of Copenhagen, Copenhagen, Denmark; 6Department of Neuropsychiatry and Psychosomatic Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; 7University of Oslo, Oslo, Norway

s S11 termination of pregnancy, four (4,3%) cases of intrauterine fetal death or stillbirth and one case had to be excluded due to the lack of data. 55 (57,9%) cases of CDH were diagnosed prenatally, 40 (42,1%) were diagnosed postnatally. Prenatal detection rate increased over the years (1985-1989 36,4% vs. 2005-2009 72,7%). A surgical repair was carried out in 54 (68,4%) of the 79 liveborn babies; 49 (90,7%) of them survived at least the first postnatal week. The overall survival beyond one week of life was 68,4%. An abnormal karyotype was found in ten (10,5%) infants and 57,1% had associated major anomalies. Conclusion: With a prevalence of 3/10.000 births and the described results, this study on CDH fully supports the findings of other population-based surveys. Detection rate and survival increased over the study period.

To examine the association between electronic fetal heart rate monitoring and neonatal and infant mortality, as well as neonatal morbidity.We used the United States 2004 linked birth and infant death data. Multivariable log-binomial regression models were fitted to estimate risk ratio for association between electronic fetal heart rate monitoring and mortality, while adjusting for potential confounders.In 2004, 89% of singleton pregnancies had electronic fetal heart rate monitoring. Electronic fetal heart rate monitoring was associated with significantly lower infant mortality (adjusted relative risk, 0.75); this was mainly driven by the lower risk of early neonatal mortality (adjusted relative risk, 0.50). In low-risk pregnancies, electronic fetal heart rate monitoring was associated with decreased risk for Apgar scores4 at 5 minutes (relative risk, 0.54); in high-risk pregnancies, with decreased risk of neonatal seizures (relative risk, 0.65).In the United States, the use of electronic fetal heart rate monitoring was associated with a substantial decrease in early neonatal mortality and morbidity that lowered infant mortality.

Objective The objective of the study was to examine the effect of selective fetoscopic laser photocoagulation (SFLP) vs serial amnioreduction (AR) on perinatal mortality in severe twin-twin transfusion syndrome (TTTS). Study Design This was a 5 year multicenter, prospective, randomized controlled trial. The primary outcome variable was 30 day postnatal survival of donors and recipients. Results There was no statistically significant difference in 30-day postnatal survival between SFLP or AR treatment for donors at 55% (11 of 20) vs 55% (11 of 20) ( P = 1.0, odds ratio [OR] 1, 95% confidence interval [CI] 0.242 to 4.14) or recipients at 30% (6 of 20) vs 45% (9 of 20) ( P = .51, OR 1.88, 95% CI 0.44 to 8.64). There was no difference in 30 day survival of 1 or both twins on a per-pregnancy basis between AR at 75% (15 of 20) and SFLP at 65% (13 of 20) ( P = .73, OR 1.62, 95% CI 0.34 to 8.09). Overall survival (newborns divided by the number of fetuses treated) was not statistically significant for AR at 60% (24 of 40) vs SFLP 45% (18 of 40) ( P = .18, OR 2.01, 95% CI 0.76 to 5.44). There was a statistically significant increase in fetal recipient mortality in the SFLP arm at 70% (14 of 20) vs the AR arm at 35% (7 of 20) ( P = .25, OR 5.31, 95% CI 1.19 to 27.6). This was offset by increased recipient neonatal mortality of 30% (6 of 20) in the AR arm. Echocardiographic abnormality in recipient twin Cardiovascular Profile Score is the most significant predictor of recipient mortality ( P = .055, OR 3.025/point) by logistic regression analysis. Conclusion The outcome of the trial did not conclusively determine whether AR or SFLP is a superior treatment modality. TTTS cardiomyopathy appears to be an important factor in recipient survival in TTTS.

Objective: To assess the longitudinal changes in Doppler velocimetry, FHR tracing and BPP in compromised IUGR fetuses. Methods: A prospective longitudinal study of 186 IUGR fetuses. All fetuses were enrolled in the study in the moment abdominal circumference was