To establish the inter- and intra-operator reproducibility of key fetal brain structures throughout gestation using 3D ultrasound. 3D volumes of the fetal head between 15 and 40 weeks of gestation were acquired prospectively using a standardized protocol as part of the INTERGROWTH-21st Project. For this reproducibility study a random sample of 90 volumes was used. The following measurements were taken: width of the posterior lateral ventricle in the transventricular plane; depth of the parieto-occipital fissure and Sylvian fissure in the transthalamic plane; and width of the cisterna magna and transcerebellar diameter in the transcerebellar plane. Operators worked in pairs. The first extracted the three planes of interest and took all measurements twice; this was repeated by the second operator. The effect of caliper replacement was also assessed. Mean differences and limits of agreement (LOA) were calculated using Bland-Altman plots. As there was a significant change with gestation in the transcerebellar diameter measurements, differences were expressed in percentage terms; the mean difference (95% LOA) was <1% (±12%). All other structures were compared in mm, and their mean differences (95% LOA) were ≤ 0.2mm (±2.8mm) (table 1). The greatest proportion of variability was due to caliper replacement. OP13.02: Table 1. Measurement of brain structures using standardized 3D fetal head volumes is highly reproducible. Caliper placement accounts for most of the observed variation among operators.

Calipers

Coefficient of variation

Fetal head

10.1002/uog.13757

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Citations (1)

The potential anti-inflammatory benefits of improving physical fitness in hypertension

Journal of Hypertension (2007)

Kate M. Edwards Michael G. Ziegler Paul J. Mills

Hypertension is associated with an increased risk of stroke and atherosclerosis. In addition to elevated blood pressure, hypertension is characterized by neuroendocrine and immune activation, including elevated levels of C-reactive protein, inflammatory cytokines, and soluble adhesion molecules, which are predictive of morbidity and mortality outcomes. Pharmacological treatment for hypertension reduces blood pressure, but has limited effectiveness in reducing the accompanying inflammation and its associated morbidity and mortality. Exercise and diet interventions regularly show reductions in blood pressure in hypertensive individuals. Similar interventions in other populations show reductions in many inflammatory markers, but these effects have not been routinely examined in hypertensive individuals. The mechanisms through which exercise might exert an anti-inflammatory action include the sympathetic nervous system, the hypothalamic-pituitary-adrenal axis, as well as direct effects of blood pressure. Here, exercise is promoted as a potentially effective treatment for both the elevated blood pressure and chronic inflammation found in hypertension.

Stroke

Sympathetic nervous system

10.1097/hjh.0b013e328165ca67

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Citations (45)

Every Time I Say Good-Bye

Palgrave Macmillan US eBooks (2016)

Kate M. Edwards

10.1057/9781137489715_14

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Antibody response to vaccination is enhanced by eccentric exercise in women but not in men