The March issue of Ultrasound in Obstetrics & Gynecology includes a systematic review evaluating the applications of artificial intelligence to ultrasound imaging for benign gynecological disorders, a study reporting the predictive performance of angiogenic factors alone or in combination with ultrasound Doppler criteria for adverse perinatal outcome, a study on the association of maternal body mass index with hemodynamic and vascular alterations at 35–37 weeks' gestation, and a cross-sectional study assessing the impact of deep or ovarian endometriosis on pelvic pain and quality of life.
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.
Application of artificial intelligence to ultrasound imaging for benign gynecological disorders: systematic review
The use of artificial intelligence (AI) in ultrasound imaging is revolutionizing the management and diagnosis of gynecological disease, with a wide array of applications. In this systematic review, Moro et al. synthesized and evaluated the literature on how AI technologies can enhance the accuracy, efficiency and predictive capability of ultrasound imaging for the diagnosis, management and monitoring of benign gynecological disorders. Most studies (40/59) focused on creating AI classification models to distinguish between normal and pathological cases, while others developed AI models to automatically segment or measure ovarian volume or follicles, with the aim of facilitating improved surveillance of the ovarian cycle. This review informs on the various applications of AI to gynecological ultrasound imaging, demonstrating that AI models are useful in several benign gynecological conditions and show promise for future clinical translation.
Angiogenic factors alone or in combination with ultrasound Doppler criteria for risk classification among late-onset small fetuses with or without pre-eclampsia
Maternal angiogenic factors, specifically soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio, are useful in the prediction and diagnosis of pre-eclampsia, which shares common pathogenic features with fetal growth restriction (FGR). Therefore, this study assessed if maternal angiogenic factors are also of prognostic value in the risk stratification of small fetuses. Youssef et al. demonstrated that sFlt-1/PlGF ratio alone had a low predictive value for adverse perinatal outcome, but when combined with estimated fetal weight (EFW), its predictive performance was similar to that of the currently used combination of EFW and Doppler parameters. The authors therefore support the incorporation of angiogenic factors as an additional criterion to those currently used for identifying high-risk FGR fetuses among late-onset small fetuses.
Association of maternal body mass index with hemodynamic and vascular alterations at 35–37 weeks' gestation
Although there is a known association of high maternal body mass index (BMI) with an increased risk of adverse pregnancy outcome, it is unclear what mediates this relationship. In this study, Charakida el al. assessed the hemodynamic and vascular indices in a large screening population of women with a singleton pregnancy at 35–37 weeks' gestation, and demonstrated that increased BMI at 11–13 weeks and gestational weight gain between 11–13 weeks and 35–37 weeks were independently associated with increases in all cardiovascular indices, apart from total peripheral resistance. These findings support the notion that optimization of prepregnancy weight and gestational weight gain may improve maternal cardiovascular health and, therefore, pregnancy outcome. Future research should address whether these hemodynamic changes are part of the causal pathway between obesity and adverse pregnancy outcomes.
Impact of deep or ovarian endometriosis on pelvic pain and quality of life: prospective cross-sectional ultrasound study
Endometriosis is a recognized cause of chronic pelvic pain, yet the intricacies of this relationship are poorly understood, since numerous factors can influence the level of pain experienced by the individual and other pelvic pathology commonly co-exists with endometriosis. In this study, Chaggar et al. investigated the impact of sonographically diagnosed deep or ovarian endometriosis on pelvic pain and quality of life. Multivariable analysis demonstrated that the presence of most pelvic pain symptoms did not vary between women with or without deep or ovarian endometriosis, indicating that endometriosis may not always be the source of pelvic pain, even if present. These findings encourage ruling out other causes of pain in symptomatic endometriosis patients before considering surgical procedures, which may not alleviate the pain if it is not directly related to endometriosis.