Dennis Wood

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Papers by Dennis Wood

OP36.05: Isolated intra-abdominal umbilical vein (IAUV) varix in 163 fetuses: antenatal management and postnatal outcomes

by Eman El Gammal and Dennis Wood

Ultrasound in Obstetrics and Gynecology, 2010

Objectives: Tetralogy of Fallot with absent pulmonary valve syndrome (TETAPV) is a rare form of t... more

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Role of the Pulmonary Circulation in the Distribution of Human Fetal Cardiac Output During the Second Half of Pregnancy

Circulation, 1996

Background By using Doppler echocardiography, we determined the normal distribution of human feta... more Background By using Doppler echocardiography, we determined the normal distribution of human fetal combined cardiac output (CCO) from the left and right ventricles. We also established weight-indexed pulmonary and systemic vascular resistances (R Pi and R Si , respectively) and changes during the second half of pregnancy. Methods and Results Blood flows at the aortic and pulmonary valve annuli (LVCO and RVCO, respectively), right and left pulmonary arteries (Q P ), and ductus arteriosus (Q DA ) were calculated in 63 normal fetuses. Foramen ovale blood flow (Q FO =LVCO−Q P ) was estimated. From 20 to 30 weeks of gestation, the proportion of Q P of the CCO increased (from 13% to 25%, P <.001), while the proportion of Q FO decreased (from 34% to 18%, P <.001). After 30 weeks, the proportions of Q P and Q FO were unchanged. At 38 weeks, the proportion of RVCO (60%) was higher ( P <.05) than that of LVCO (40%). The proportion of Q DA did not change significantly. The correlation...

Prenatal prediction of lethal pulmonary hypoplasia: The hyperoxygenation test for pulmonary artery reactivity

American Journal of Obstetrics and Gynecology, 2002

The purpose of this study was to determine the predictive accuracy of a test for neonatal death f... more The purpose of this study was to determine the predictive accuracy of a test for neonatal death from pulmonary hypoplasia by measuring changes in fetal pulmonary artery blood flow on room air and during maternal hyperoxygenation. Women who were carrying fetuses with congenital anomalies that may cause pulmonary hypoplasia were offered participation in the study as part of a comprehensive fetal echocardiogram. Each fetus at &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =30 weeks of gestation underwent Doppler measurement of the blood flow pattern in the first branch of either the right or the left pulmonary artery before and again during exposure to maternal breathing of 60% oxygen by mask. An increase in the fetal pulmonary blood flow with oxygen (a decrease of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =20% of the pulsatility index) was considered a reactive test. A change of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;20% in the flow pattern during maternal hyperoxygenation was a nonreactive test and suggested pulmonary hypoplasia. The primary outcome for this study was neonatal death from pulmonary hypoplasia. Twenty-nine pregnancies met the criteria for inclusion in our study. Of the 14 fetuses who had a nonreactive hyperoxygenation test, 11 fetuses (79%) died of pulmonary hypoplasia. Of the 15 fetuses who had a reactive hyperoxygenation test, only one fetus (7%) died in the neonatal period. Sensitivity, specificity, and positive and negative predictive values were 92%, 82%, 79%, and 93%, respectively, with an odds ratio of 51 (95% CI, 4.6-560). Testing fetal pulmonary vascular reactivity with maternal hyperoxygenation is highly predictive of pulmonary hypoplasia. A reactive test predicted 92% of surviving infants; a nonreactive test predicted 79% of fetal deaths from pulmonary hypoplasia.

Perinatal echocardiography: protocols for evaluating the fetal and neonatal heart

Journal of Perinatal Medicine, 2009

This Protocol for Evaluating the Fetal and Neonatal Heart details the indications, views, and mea... more This Protocol for Evaluating the Fetal and Neonatal Heart details the indications, views, and measurements to be obtained for both (1) the basic screening examination of the fetal heart (a necessary component of all complete fetal anatomy evaluations) and the specialty study called (2) echocardiography as applied to either the fetus or neonate, using 2D and Doppler ultrasound. While the purpose of the screening study is to detect or exclude the possibility of a cardiac abnormality, echocardiography attempts to diagnose the specific anatomic and physiologic disruption. Also emphasized is the value of a collaborative team approach to management of the fetus and its parents when a cardiovascular anomaly is present, in an effort to achieve a smoother transition from fetus to neonate across the continuum of perinatal care.

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Association between fetal myocardial performance index and fetal heart rate monitoring: a prospective observational cohort study

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, Jan 13, 2017

To evaluate whether the left myocardial performance index (MPI) changes in association with the f... more To evaluate whether the left myocardial performance index (MPI) changes in association with the fetal heart rate (FHR) tracing during labor. Women with term, singleton pregnancies, in labor were recruited to this prospective cohort study. difference in left MPI between Category of fetal heart rate tracings. differences in left MPI by FHR characteristics. Participants underwent ultrasound examination, during which fetal MPI was measured. Twenty-four laboring patients were recruited. There were 13 patients with Category I FHR, 11 patients with Category II FHR, and 0 patients with Category III FHR. Demographics were similar between the groups. MPI was not significantly different between fetuses with Category I or Category II FHR (0.67 versus 0.65, p = .385). MPI was significantly higher in fetuses with accelerations versus those without (0.71 versus 0.59, p = .045). MPI was not significantly different for fetuses with or without decelerations (0.65 versus 0.68, p = .350), between decel...

P09.03: A bided intra abdominal umbilical vein

Ultrasound in Obstetrics & Gynecology

P09.07: Agenesis of the right superior vena cava (SVC) with dilated coronary sinus (CS)

Ultrasound in Obstetrics & Gynecology

P39.14: The ductus venosus is responsive to maternal hyperoxygenation in fetuses with severe growth restriction

Ultrasound in Obstetrics and Gynecology

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P39.12: Giant sacrococcygeal teratoma with normal cardiac function

Ultrasound in Obstetrics and Gynecology

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OC19.02: The spectrum of presentations of tetralogy of Fallot with absent pulmonary valve leaflet syndrome (ToF/APVLS) by fetal echocardiography

Ultrasound in Obstetrics & Gynecology

corrected age in infants who had been complicated by growthrestricted in utero and very low birth... more corrected age in infants who had been complicated by growthrestricted in utero and very low birth weight (VLBW). Methods: Sixty-four singleton pregnancies complicated by both fetal growth restriction (FGR) and estimated fetal weight (EFW) below 1500 g were observed. Multiple pregnancies and fetal anomalies were excluded. Still birth and neonatal-infantile death were excluded. FGR was defined as EFW below −1.5 SD. EFW and SD were calculated by local standards (JSUM). The relationships of umbilical artery (UA), middle cerebral artery (MCA), gestational age at delivery (GA), EFW and SD with a 3-year neurodevelopmental delay were evaluated. In 64 infants at corrected 3 years, the Kyoto Scale of Psychological Development (KSPD) was administered by trained psychologists. KSPD is standard developmental test for Japanese children. KSPD was assessed by developmental quotient (DQ) in the following three areas: postural-motor (PM), cognitiveadaptive (CA) and language-social (LS). A total DQ was obtained by PM-DQ, CA-DQ and LS-DQ. Developmental outcome was classed as delay for DQ for KSPD < 70. Results: There was no case complicated with blindness and/or hearing loss. In total DQ, neurodevelopmental delay was associated with EFW below 600 g (P = 0.048, AUC:0.674) and GA below 27 weeks (P = 0.027, AUC:0.694). PM delay was associated with EFW below 700 g and GA below 27 weeks. CM delay was associated with GA below 27 weeks. LS delay was associated with EFW below 600 g and GA below 27 weeks. In all categories, Z scores, UA Doppler and MCA Doppler was not associated with neurodevelopmental delay. Conclusions: GA and EFW remain the predominant factors for poor neurodevelopment in FGR and VLBW fetuses.

Fetal myocardial index during labor

Prenatal Cardiology, 2016

BACKGROUND: The Myocardial Performance Index (MPI) is a Doppler derived myocardial function tool ... more BACKGROUND: The Myocardial Performance Index (MPI) is a Doppler derived myocardial function tool and can be used to evaluate systolic and diastolic function in fetuses. The objectives of this study were to investigate the MPI during labor and compare it to values in non-laboring women.METHODOLOGY: 40 women with uncomplicated, term, singleton pregnancies were recruited to this prospective observational study at Thomas Jefferson University Hospital. Controls were a retrospective cohort of women…

Recommendations for fetal echocardiography in twin pregnancy in 2016

Prenatal Cardiology, 2016

Progress in the fields of fetal cardiology and fetal surgery have been seen not only in singleton... more Progress in the fields of fetal cardiology and fetal surgery have been seen not only in singleton pregnancies but also in multiple pregnancies. Proper interpretation of prenatal echocardiography is critical to clinical decision making, family counseling and perinatal management for obstetricians, maternal fetal medicine specialists, neonatologists and pediatric cardiologists. Fetal echocardiography is one of the most challenging and time-consuming prenatal examinations to perform, especially in multiple gestations. Performing just the basic fetal exam in twin gestations may take an hour or more. Thus, it is not practical to perform this exam in all cases of multiple gestations. Therefore our review and recommendations are related to fetal echocardiography in twin gestation.