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, , , , Summary
Rev Bras Ginecol Obstet. 2020;42(3):152-159
, , , , To analyze the interobserver and intraobserver reproducibility of the visualization and continuity of the juncional zone (JZ) by three-dimensional (3D) ultrasound in infertile women, and to evaluate the sociodemographic, hormonal, and structural factors that influence these assessments.
A prospective study conducted at the Assisted Reproductive Technology Unit of Hospital Senhora da Oliveira, in the city of Guimarães, Portugal. Transvaginal 3D ultrasonography was performed, and 2 volumes were generated per case. Two observers who were blinded to each other's work analyzed these volumes, choosing the best coronal section. Four months later, one of the observers performed the same methodology. The JZ visualization was classified as optimal, satisfactory, and unsatisfactory, and the JZ continuity, as continuous and discontinuous. The interobserver and intraobserver agreements were analyzed. The influence of hormonal, structural, and sociodemographic factors on the JZ was evaluated.
In total, 65 women were included in the present study. The interobserver reproducibility was substantial for JZ visualization and continuity (k = 0.635 and 0.753 respectively), and the intraobserver reproducibility was very good for JZ visualization and continuity (k = 0.884 and 0.816 respectively). Trilaminar endometrial pattern was associated with optimal JZ visualization (p = 0.012). The increase of 1 unit in the level of serum estradiol represents a 9.9% decrease in the odds of unsatisfactory visualization of the JZ (odds ratio [OR] = 0.9; 95% confidence interval [95%CI] = 0.814–0.996; p = 0.042). Endometriosis increases the odds of unsatisfactory visualization by 24 times (OR = 23.7; 95%CI = 1.262–437.057; p = 0.034). The prevalence of discontinuous JZs was of 60%. Myomas and endometriosis were associated with discontinuous JZs (p = 0.034 and 0.016 respectively).
The assessment of JZ visualization and continuity by 3D ultrasound is reproducible enough to be used in the clinical practice.
Summary
Rev Bras Ginecol Obstet. 2020;42(3):152-159
, , , , To analyze the interobserver and intraobserver reproducibility of the visualization and continuity of the juncional zone (JZ) by three-dimensional (3D) ultrasound in infertile women, and to evaluate the sociodemographic, hormonal, and structural factors that influence these assessments.
A prospective study conducted at the Assisted Reproductive Technology Unit of Hospital Senhora da Oliveira, in the city of Guimarães, Portugal. Transvaginal 3D ultrasonography was performed, and 2 volumes were generated per case. Two observers who were blinded to each other's work analyzed these volumes, choosing the best coronal section. Four months later, one of the observers performed the same methodology. The JZ visualization was classified as optimal, satisfactory, and unsatisfactory, and the JZ continuity, as continuous and discontinuous. The interobserver and intraobserver agreements were analyzed. The influence of hormonal, structural, and sociodemographic factors on the JZ was evaluated.
In total, 65 women were included in the present study. The interobserver reproducibility was substantial for JZ visualization and continuity (k = 0.635 and 0.753 respectively), and the intraobserver reproducibility was very good for JZ visualization and continuity (k = 0.884 and 0.816 respectively). Trilaminar endometrial pattern was associated with optimal JZ visualization (p = 0.012). The increase of 1 unit in the level of serum estradiol represents a 9.9% decrease in the odds of unsatisfactory visualization of the JZ (odds ratio [OR] = 0.9; 95% confidence interval [95%CI] = 0.814–0.996; p = 0.042). Endometriosis increases the odds of unsatisfactory visualization by 24 times (OR = 23.7; 95%CI = 1.262–437.057; p = 0.034). The prevalence of discontinuous JZs was of 60%. Myomas and endometriosis were associated with discontinuous JZs (p = 0.034 and 0.016 respectively).
The assessment of JZ visualization and continuity by 3D ultrasound is reproducible enough to be used in the clinical practice.
Summary
Rev Bras Ginecol Obstet. 2011;33(4):164-169
DOI 10.1590/S0100-72032011000400003
PURPOSE: to assess the validity of several fetal weight charts, commonly used in Portugal, to classify its population. METHODS: observational retrospective study. Singleton birth data was analyzed, from a two- year period (May 2008 to April 2010), from pregnancies with an ultrasound in the same institution, between the 8th and 14th gestational week. Upon data validation, percentiles for each completed gestational week were created, smoothed by a quadratic function, analyzed and compared to the tables more commonly utilized, in the institution and country, by using Z-scores, percentile comparison, sample 10th percentile detection sensibility and birthweight means comparison. RESULTS: a total of 5,378 newborns (NB) were born in the period; 2,195 (42%) NB were included, born from the 24th to 42nd gestational week, allowing statistical analysis from the 34th to the 41st week. There were differences in the mean birthweight for each gestational age, between references and with the sample, as well as between sexes. The 10th percentile from some references has shown differences ranging from -288g at 37 weeks (-11% in Lubchenco et al. data), with and +133g at 34 weeks (+7,6% with Carrascosa et al. data) compared to the values found with the sample. Differences were also found concerning the sensitivity of the identification of a sample birthweight below the 10th percentile, which was between 14.1 and 100%, depending on the reference used. DISCUSSION: the limitation of these kinds of reference values must be remembered and minimized, with the adoption of regionally or nationally produced references, contemplating other variables, such as sex, with precisely known gestation duration and with validation of the utilized references in loco.
Summary
Rev Bras Ginecol Obstet. 2011;33(4):164-169
DOI 10.1590/S0100-72032011000400003
PURPOSE: to assess the validity of several fetal weight charts, commonly used in Portugal, to classify its population. METHODS: observational retrospective study. Singleton birth data was analyzed, from a two- year period (May 2008 to April 2010), from pregnancies with an ultrasound in the same institution, between the 8th and 14th gestational week. Upon data validation, percentiles for each completed gestational week were created, smoothed by a quadratic function, analyzed and compared to the tables more commonly utilized, in the institution and country, by using Z-scores, percentile comparison, sample 10th percentile detection sensibility and birthweight means comparison. RESULTS: a total of 5,378 newborns (NB) were born in the period; 2,195 (42%) NB were included, born from the 24th to 42nd gestational week, allowing statistical analysis from the 34th to the 41st week. There were differences in the mean birthweight for each gestational age, between references and with the sample, as well as between sexes. The 10th percentile from some references has shown differences ranging from -288g at 37 weeks (-11% in Lubchenco et al. data), with and +133g at 34 weeks (+7,6% with Carrascosa et al. data) compared to the values found with the sample. Differences were also found concerning the sensitivity of the identification of a sample birthweight below the 10th percentile, which was between 14.1 and 100%, depending on the reference used. DISCUSSION: the limitation of these kinds of reference values must be remembered and minimized, with the adoption of regionally or nationally produced references, contemplating other variables, such as sex, with precisely known gestation duration and with validation of the utilized references in loco.
