Search Results (93)

Elastography is an ultrasound-based technique that enables the non-invasive assessment of tissue stiffness. In endoscopic ultrasound (EUS), elastography was initially introduced as a strain-based method, providing qualitative or semi-quantitative information on tissue deformation. More recent technological developments have enabled the integration of shear-wave-based elastography into EUS platforms, including shear-wave measurement (SWM), point shear-wave elastography (pSWE), and two-dimensional shear-wave elastography (2D-SWE). Unlike strain elastography, shear-wave techniques provide quantitative estimates of tissue stiffness by measuring shear-wave velocity or a derived elastic modulus. This invited narrative review summarizes the technical principles, terminology, quality-control requirements, and current clinical evidence for EUS-guided shear-wave-based elastography in pancreatic and hepatobiliary diseases. Because much of the available EUS literature derives from EUS-SWM or point SWE rather than true 2D-SWE, acquisition mode is a central determinant when interpreting clinical evidence and clinical readiness. Current data suggest that EUS-guided shear-wave-based elastography is technically feasible and biologically plausible, but its clinical maturity remains indication-specific. Evidence is most encouraging in chronic pancreatitis, early chronic pancreatitis, autoimmune pancreatitis activity monitoring, and selected endo-hepatology settings, particularly liver fibrosis assessment in patients in whom transabdominal techniques may be suboptimal. In contrast, available evidence does not support EUS-guided shear-wave-based elastography as a standalone diagnostic test for differentiating solid pancreatic lesions, including pancreatic ductal adenocarcinoma, because absolute stiffness values often overlap among malignant lesions, inflammatory masses, and background parenchyma. Before routine clinical implementation, standardized acquisition protocols, disease-specific cut-offs, multicenter reproducibility data, and evidence of incremental clinical value beyond established diagnostic pathways are required. Full article

Background/Objective: Anterior compartment prolapse is commonly described as cystocele or anterior vaginal wall descent, although these terms do not identify the underlying mechanism of support failure. Similar POP-Q findings may result from different anatomical defects, including central cystocele, paravaginal support loss, apical descent, levator ani injury, hiatal ballooning, or combined abnormalities. Pelvic floor ultrasound may improve anatomical characterization, but its role in defect-specific phenotyping remains unclear. Our objective was to map the current evidence on the use of pelvic floor ultrasound for anatomical phenotyping of anterior compartment prolapse beyond POP-Q staging. Methods: A scoping review was conducted according to PRISMA-ScR guidelines. PubMed/MEDLINE, Scopus, and Web of Science were searched through May 2026. Studies evaluating anterior compartment prolapse using pelvic floor ultrasound were included. Non-ultrasound anatomical, clinical, and MRI studies were considered only as contextual literature and were not included in the evidence synthesis. Results: Twelve ultrasound-based studies were included. Most studies focused on lateral/paravaginal support abnormalities, while fewer investigated central cystocele configuration, apical-related anterior prolapse, levator-related abnormalities, and hiatal ballooning. Ultrasound techniques were heterogeneous and included transabdominal, introital, transvaginal, and translabial/transperineal approaches, frequently using three-dimensional and four-dimensional imaging. Conclusions: The available evidence suggests that anterior compartment prolapse represents a heterogeneous anatomical condition rather than a single entity defined by POP-Q descent alone. Pelvic floor ultrasound may complement clinical examination by providing dynamic information on different components of anterior compartment support, including cystocele configuration, levator ani integrity, and hiatal dimensions. However, the clinical interpretation of several phenotypes remains limited by heterogeneous terminology, variable imaging protocols, and the lack of standardized diagnostic criteria, particularly for paravaginal defects and the apical contribution to anterior wall descent. Future research should focus on harmonized ultrasound definitions, reproducible acquisition protocols, and prospective validation against anatomical and clinical outcomes to determine the role of ultrasound-based phenotyping in individualized management. Full article

Background: Technology like ultrasonography (US) has revolutionised the process of measuring cervical dilatation, cervical elasticity, station, and position of the foetal head to assess progress of labour. Ultrasound (US) is deemed non-traumatic, accurate, and user-friendly, offering an objective alternative to traditional vaginal examination (VE). Alternative methods such as position-tracking systems with fingertip sensors have shown limited precision, despite their widespread use. Additionally, US technologies have not been shown to measure effacement, caput, and moulding, as compared to VE. There is a lack of strong evidence supporting US effectiveness in improving outcomes for women and babies. Further research is required to enable respectful care in monitoring of women during labour and birth while eradicating preventable morbidity and mortality by utilising US. Objective: This scoping review aimed to map intrusive and non-intrusive ultrasound technologies and devices used in vaginal examinations during intrapartum. Methods: This scoping review followed Arksey and O’Malley’s five-step framework and the population, concepts, and contexts (PCC) model. A comprehensive search was conducted across seven databases using refined keywords. The protocol for this scoping review has been registered on the open science framework. The data were extracted, charted, synthesised, and summarised. Result: This scoping review included 47 original articles with a combined sample size of over 9000 women in labour or delivery. Most studies focused on ultrasound-based labour monitoring methods such as transabdominal, transperineal, 2D, 3D, and automated approaches—compared to traditional vaginal examination (VE). These ultrasound techniques were consistently praised for their accuracy, reliability, and feasibility in assessing cervical dilation, foetal head station, and angle of progression. Ultrasound was particularly effective in determining foetal head engagement during the second stage of labour, which can influence clinical decision-making and outcomes. Additionally, the review identified emerging intrapartum technologies, including non-invasive purple line observation and low-intensity light imaging probes. These innovations reflect a growing shift toward objective and less invasive labour monitoring methods. Tools like ultrasound and automated tracking algorithms demonstrated superior sensitivity, specificity, and patient comfort compared to VE. However, challenges remain in clinical applicability, standardisation, and implementation, particularly in resource-limited settings. Overall, the findings suggest a transition toward digital and ultrasound-based technologies as central components of modern labour monitoring, with further research needed to validate newer devices and ensure equitable integration into clinical practice. Conclusions: This scoping review highlights a shift toward ultrasound-based technologies transabdominal, transperineal with 2D/3D, and automated as more accurate and patient-friendly alternatives to vaginal examination. These methods improve assessment of cervical dilation, foetal head station, and progression angle. Emerging tools like the purple line and light imaging probes show promise but require further validation. Policymakers should support investment in affordable digital tools; clinical practice must prioritise training and integration; and research should focus on standardisation, long-term outcomes, and feasibility to ensure equitable and effective implementation of these technologies in labour monitoring. Full article

Transvaginal ultrasound (TVS) remains the most frequently performed examination in gynecological patients to evaluate the uterine cavity. Visualization of the endometrium may be limited due to certain uterine positions, particularly axial and retroverted orientations. Alternative diagnostic methods, such as transabdominal ultrasound (TAS) and transrectal ultrasound (TRS), may be useful in patients in whom visualization is suboptimal using the TVS. The aim of the study was to analyze the literature regarding the diagnostic performance of TVS, TAS, and TRS in detecting uterine cavity abnormalities in women with various uterine positions. Studies evaluating ultrasound assessment of uterine cavity pathologies with reference to uterine position were included in this review. The available research suggests that uterine position may influence ultrasound visualization. TAS has been shown to demonstrate lower diagnostic reliability in retroverted or axial uteri, particularly in patients with obesity or when focal lesions are present. TRS may provide improved assessment of endometrial thickness in patients with axial uteri compared with TVS. Uterine position may be a factor affecting the accuracy of evaluation of the uterine cavity in ultrasound. Awareness of these limitations and the use of additional imaging modalities may improve diagnostic accuracy in selected patients. Further studies are needed. Full article

Background/Objectives: Magnetotactic bacteria therapy is an emerging active intratumoral drug delivery platform in which drug-loaded, magnetically responsive bacteria are injected into a tumor and navigated through its microenvironment toward defined targets using an external magnetic field, fundamentally distinct from passive intratumoral injection. No endoscopic ultrasound (EUS)- or ultrasound (US)-guided delivery workflow for MTBT has been described, and five critical technical prerequisites for clinical translation remain unaddressed: three-body image registration, minimum contrast concentration for cone-beam computed tomography (CBCT) bolus localization, needle repositioning accuracy, optimal fiducial strategy, and EUS/US procedural feasibility within the magnetic guidance apparatus. Methods: In three healthy female swine, we tested an image-guided intratumoral workflow at pancreatic and rectal sites. Gold rod fiducials were implanted under EUS in two animals and via transabdominal/endorectal US in one animal. A needle was navigated toward the implanted fiducial group using real-time gold-fiducial shine-through, and 2 mL of saline mixed with iodine contrast (Isovue-370) at 15%, 10%, or 5% v/v (one concentration per animal) was injected. Scan with CBCT was acquired before and after injection; fiducials, needle tip, and contrast bolus were segmented in 3D Slicer and their centroids compared to quantify targeting accuracy. Contrast visibility and artifact were scored by an expert radiologist on a five-point Likert scale. EUS feasibility within the magnetic apparatus was assessed using a full-scale cardboard replica of the CuraDrone PolarTrak. Results: Five percent v/v Isovue-370 was the minimum concentration for reliable CBCT bolus identification (280–360 HU; 1:1 injection-to-volume ratio). Needle repositioning accuracy was ≤2 cm in 5/6 sites using fiducial shine-through guidance. Gold rod fiducials served a dual role: CBCT tumor registration and real-time EUS/US navigation, not previously described for intratumoral injection. EUS was feasible within the PolarTrak with defined workflow adaptations. Conclusions: This pilot study demonstrates the technical feasibility of an EUS/US–CBCT workflow for MTBT, yielding quantitative, actionable parameters for first-in-human trial design. These feasibility findings, obtained in a small healthy animal cohort, are intended to inform the design of subsequent clinical studies. Full article

Background: The total vaginal hysterectomy (TVH) technique has been performed for many gynecological surgeries but is less used than total abdominal hysterectomy (TAH). The purpose of this study was to analyze the outcomes in patients who underwent either TVH or TAH for enlarged diffuse uterine adenomyosis (ADS). Methods: In this retrospective study, 160 hysterectomies with bilateral adnexectomy were scheduled for premenopausal women with diffuse ADS between 2020 and 2024 at a tertiary care center in Romania. The diagnosis was established based on clinical symptomatology, color Doppler transvaginal ultrasound, transabdominal ultrasonography and magnetic resonance imaging with histopathological confirmation of diffuse uterine ADS post-operatively from the hysterectomy specimen. All surgical procedures were performed by the same surgeon. The patients were divided into two groups: the TVH group (n = 80) and the TAH group (n = 80). Patient characteristics, including age, uterine weight, body mass index (BMI), parity, operative time, intraoperative blood loss, length of hospital stay, medical history, surgical history, intra- and postoperative complications, and the presence of adhesions, were evaluated. Results: No differences were observed between the two groups with regard to uterine weight, BMI, or parity. However, the TVH group was associated with significantly younger age, shorter operative time, lower intraoperative blood loss, and a reduced length of hospital stay (p < 0.001). Additionally, both medical and surgical histories were more frequently observed in the TAH group than in the TVH group. However, intra- (i.e., 3.75%) and postoperative complications (i.e., 13.75% vs. 3.75%) were slightly more frequent in the TAH group, as well as adhesions (i.e., 17.50% vs. 8.75%). Uterine hemisection, tactical myomectomy, or morcellation were frequently employed in the TVH group, being required in 77.5% of cases. Conclusions: In our cohort of patients with enlarged diffuse uterine ADS, TVH was associated with younger age, shorter operative time, reduced intraoperative blood loss, and a shorter length hospital stay compared with TAH, without an observed increase in perioperative complications. These results support the use of TVH as a feasible surgical approach for selected enlarged diffuse uterine ADS. Full article

Perinatal lymphangiomas are rare benign congenital malformations of the lymphatic system, whose potential for rapid growth and local invasiveness may pose significant risks to fetal well-being. This report presents a case of a large fetal lymphangioma diagnosed prenatally during a second-trimester ultrasound examination. The lesion was initially asymptomatic but subsequently progressed, resulting in ascites and pericardial effusion. In light of progressive fetal deterioration, prenatal sclerotherapy was performed using ultrasound-guided transabdominal administration of bleomycin. Despite the technical success of this procedure, the neonate developed severe cardiorespiratory failure and died shortly after delivery. This case highlights both the potential benefits and limitations of prenatal intervention in severe lymphatic malformations. This study also includes a concise review of current perinatal and postnatal management strategies. Despite advances in prenatal imaging and therapy, further studies are needed to optimize treatment and improve neonatal outcomes. Full article

Objective: We aimed to determine the ability of prenatal ultrasound to detect velamentous cord insertion (VCI) in twin pregnancies and identify factors influencing diagnostic sensitivity. Methods: This single-center retrospective study included twins delivered between April 2018 and March 2024. We excluded monochorionic monoamniotic twins, those without chorionicity or umbilical cord insertion data, and fetuses that died in utero. Umbilical cord insertion sites assessed by second-trimester transabdominal ultrasound (16 + 0 to 21 + 6 weeks of gestation) using color Doppler imaging were classified as normal, marginal, or velamentous. The results of postnatal macroscopic examinations served as reference standards. We calculated accuracy, sensitivity, specificity, positive (PPV) and negative (NPV) predictive values. The effects of examiner expertise, chorionicity, placental location, ultrasound device, and maternal body mass index (BMI) on diagnostic sensitivity were analyzed in subgroups. Results: We confirmed VCI in 45 (8.8%) of 514 delivered fetuses. Prenatal ultrasound correctly identified 14 VCI cases. Sensitivity, specificity, PPV, and NPV were 31.1% (14/45), 98.9% (464/469), 73.7% (14/19), and 93.7% (464/495), respectively. The overall accuracy was 93.0% (478/514). Sensitivity was significantly higher when ultrasound specialists conducted examinations compared with non-specialists and when twins were monochorionic diamniotic twins than dichorionic. Anterior placental location and high-performance ultrasound equipment were also associated with increased sensitivity, but were not statistically significant. Maternal BMI did not affect diagnostic sensitivity. Conclusions: Prenatal ultrasonographic detection of VCI in twin pregnancies has high specificity but limited sensitivity. Diagnostic performance was influenced by examiners’ experience and chorionicity. Routine assessment of cord insertion sites and targeted training might improve detection and support the optimized perinatal management of twin pregnancies. Full article

Botulinum toxin type A (BoNT/A) injection into the bladder wall is a milestone in the treatment of urinary incontinence in patients with neurogenic detrusor overactivity (NDOi) or overactive bladder syndrome (OABi) who are refractory to or unable to tolerate oral or transdermal therapies. However, the efficacy of BoNT/A is hampered by the low long-term adherence of patients to a treatment that requires repeated bladder injections under cystoscopy control. The discontinuation is particularly evident among incontinent patients with spontaneous voluntary voiding, regardless of whether the cause is NDOi or OABi, although clearly more marked among the latter group. In addition to the bother and pain associated with repeated cystoscopies, these patients show low tolerance to the high incidence of urinary tract infections (UTIs) and transient urinary retention, the two most common adverse events. Fewer injection points may render treatments less painful, apparently without reducing efficacy, but will not avoid the need for repeated cystoscopies, and no studies have demonstrated that such modification increases adherence. Eventually, accessing the bladder wall for BoNT/A administration via a transabdominal approach, under real-time ultrasound guidance, may overcome trans-urethral limitations, but the technique’s reproducibility remains unknown. An intensive investigation is ongoing to identify aids that facilitate the passage of the large, fragile BoNT/A molecule across the urothelium to reach the bladder nerves without injections. Electromotive Drug Administration (EMDA) of BoNT/A demonstrated efficacy and safety over a 6-year follow-up in NDOi patients at a single center, but the results were not reproduced at other institutions. The application of shock waves to the bladder using shock waves generated by Extracorporeal Shock Wave Lithotripsy (ESWL) machines to tear the urothelium and facilitate the passage of BoNT/A instilled in the bladder is ingenious, but the experience is very limited. Dimethyl sulfoxide, liposomes, and thermal-reversal hydrogel to deliver the toxin failed in pilot trials. BoNT/A in nano-formulations has high heat stability, resistance to pH changes, and to enzymatic degradation. Extended efficacy in dermal and intramuscular pilot applications is promising but needs to be replicated in the bladder. Full article

Background and Objectives: Total vaginal hysterectomy (TVH) has been performed quite often for a uterus with prolapse, although less used than total abdominal hysterectomy (TAH). The purpose of this study was to compare the perioperative outcomes of patients who underwent either TVH or TAH for a uterus with a weight between 250 and 300 g and uterine prolapse (UP). Materials and Methods: In this retrospective study, 180 hysterectomies were planned for women with UP between 2020 and 2024 in a tertiary center in Romania. Patients were diagnosed based on clinical symptomatology and transabdominal ultrasound. All hysterectomies were performed by the same surgeon and were divided into two groups: TVH group (n = 90) and TAH group (n = 90). Patients’ characteristics like age, uterine weight, body mass index (BMI), parity, operative time, intra-operative blood loss, hospital stay, medical history, surgical history, intra- and post-operative complications, and adhesions were evaluated. Results: No significant differences were found between groups in terms of mean age, uterine weight, BMI, or parity. TVH was associated with significantly shorter operative time, lower intra-operative blood loss, and reduced hospital stay compared to TAH (p < 0.001). Both medical and surgical histories were more common in the TAH group compared with the TVH group. However, post-operative complications were slightly more frequent in the TAH group (9.99% vs. 3.33%), as were adhesions (33.33% vs. 13.33%). Uterine hemisection, tactical myomectomy, or morcellation were used in most cases to obtain a reduction in uterine size for the TVH group (81.11%). Conclusions: Our results showed that shorter operating time, lower intra-operative blood loss, and reduced hospital stay support the use of TVH in the case of an enlarged uterus with UP. The present study showed that all patients requiring hysterectomy for such conditions can be offered TVH, which could represent a better therapy option. Full article

Objective: This study aimed to compare fetal adrenal gland volume (AGV), fetal zone (FZ) depth, and middle adrenal artery pulsatility index (MAA-PI) between pregnancies presenting with preterm labor and gestational age-matched asymptomatic controls, and to evaluate size-adjusted adrenal metrics (corrected AGV [cAGV] and fetal zone–total gland depth ratio) in relation to gestational age at delivery and neonatal outcomes. Methods: This prospective analytical cross-sectional (case–control) study included 60 singleton pregnancies (30 with preterm labor and 30 asymptomatic controls) evaluated at a tertiary perinatology unit between 24 + 0 and 36 + 6 weeks’ gestation. Transvaginal cervical length and transabdominal fetal adrenal measurements (AGV, FZ depth, and MAA-PI) were obtained at enrollment. Estimated fetal weight (EFW) at the index scan was retrieved, and corrected AGV (cAGV = AGV/EFW) and fetal zone–total gland depth ratio were calculated. Outcomes were gestational age at delivery, birthweight, Apgar scores, and neonatal intensive care unit (NICU) admission. Nonparametric group comparisons and Spearman correlations were used. Results: Gestational age at ultrasound was identical between groups (median 31 + 6 weeks). Compared with controls, the preterm labor group had shorter cervical length (12.5 vs. 33.5 mm, p < 0.001), higher AGV (1.53 vs. 1.08 cm³, p < 0.001) and FZ depth (7.45 vs. 5.30 mm, p < 0.001), and lower MAA-PI (1.11 vs. 1.46, p < 0.001). EFW at the index scan did not differ between groups (p = 0.900). Corrected AGV (cAGV) was higher in the preterm labor group (0.87 (0.76–1.06) vs. 0.59 (0.51–0.70), p < 0.001), and the fetal zone–total gland depth ratio was higher (0.328 (0.312–0.346) vs. 0.263 (0.241–0.278), p < 0.001). The preterm labor group delivered earlier (33 + 0 vs. 36 + 2 weeks, p < 0.001), had lower birthweight (1875 vs. 3188 g, p < 0.001), and more frequent NICU admission (50.0% vs. 6.7%; odds ratio 14.0, 95% CI 2.82–69.56; p < 0.001). Within the preterm labor group, gestational age at delivery correlated positively with cervical length (ρ = 0.900) and MAA-PI (ρ = 0.770) and negatively with AGV (ρ = −0.770) and FZ depth (ρ = −0.733), all p < 0.001; correlations were stronger for cAGV (ρ = −0.953, p < 0.001). Conclusions: Enlarged fetal adrenal gland volume and fetal zone depth together with reduced middle adrenal artery pulsatility index are associated with preterm labor and earlier delivery. Size-adjusted adrenal metrics (cAGV and fetal zone–total gland depth ratio) remained significantly different between groups, supporting these measures as potential adjuncts for risk stratification at presentation. Full article

Background: Pelvic floor dysfunction, more prevalent in women but affecting both genders, impairs sphincter control and sexual health, and causes pelvic pain. Pelvic floor muscle (PFM) training is the first-line treatment for urinary incontinence, supported by robust evidence. Rehabilitative ultrasound imaging (RUSI) serves as a visual biofeedback tool, providing real-time imaging to enhance PFM training, motor learning, and treatment adherence. Aim: This narrative review evaluates the role and efficacy of RUSI in pelvic floor rehabilitation. Method: A comprehensive search of PubMed, Cochrane, and MEDLINE was conducted using keywords related to pelvic floor rehabilitation, ultrasound, and biofeedback, limited to English-language publications up to July 2025. Systematic reviews, meta-analyses, and clinical trials were prioritized. Results: Transperineal and transabdominal ultrasound improve PFM function across diverse populations. In post-prostatectomy men, transperineal ultrasound-guided training enhanced PFM contraction and reduced urinary leakage. In postpartum women with pelvic girdle pain, transabdominal ultrasound-guided biofeedback combined with exercises decreased pain and improved function. Ultrasound-guided pelvic floor muscle contraction demonstrated superior performance compared to verbal instruction. Notably, 57% of participants who were unable to contract the pelvic floor muscles with verbal cues achieved a correct contraction with ultrasound biofeedback, and this approach also resulted in more sustained improvements in PFM strength. Compared to other biofeedback modalities, RUSI demonstrated outcomes that are comparable to or superior to those of alternative methods. However, evidence is limited by a lack of standardized protocols and randomized controlled trials comparing RUSI with other modalities. Conclusions: RUSI is an effective visual biofeedback tool that enhances outcomes of PFM training in pelvic floor rehabilitation. It supports clinical decision-making and patient engagement, particularly in cases where traditional assessments are challenging. Further research, including the development of standardized protocols and comparative trials, is necessary to optimize the clinical integration of this method and confirm its superiority over other biofeedback methods. Full article

Small intestine tumors are rare. The four main groups include adenocarcinomas, neuroendocrine neoplasms (NEN), lymphomas, and mesenchymal tumors. The jejunum and ileum can only be examined endoscopically with device-assisted enteroscopy techniques (DAET), which are indicated only when specific clinical or imaging findings are present. The initial diagnosis of tumors of the small intestine is mostly made using computed tomography (CT). Video capsule endoscopy (VCE), computed tomography (CT) enterography, and magnetic resonance (MR) enterography are also time-consuming and costly modalities. Modern transabdominal gastrointestinal ultrasound (US) with high-resolution transducers is a dynamic examination method that is underrepresented in the diagnosis of small intestine tumors. US can visualize wall thickening, loss of wall stratification, luminal stenosis, and dilatation of proximal small-intestinal segments, as well as associated lymphadenopathy. This review aims to highlight the role and imaging features of ultrasound in the diagnosis of small-intestinal tumors. Full article

Background/Objectives: Chorionic villus sampling (CVS) is a pivotal diagnostic tool for early prenatal detection of chromosomal and genetic abnormalities; however, the safety and diagnostic efficacy of different CVS approaches remain a subject of clinical interest. This monocentric study compares transcervical (TC-CVS), transabdominal (TA-CVS) and transvaginal (TV-CVS) techniques, focusing on procedure-related fetal loss and diagnostic yield. Methods: In this 15-year, single-operator prospective study, a total of 5500 women underwent CVS between 10 and 14 weeks of gestation at a single center. Sampling was performed via TA-CVS (n = 4500), TC-CVS (n = 850), or TV-CVS (n = 150). Outcomes assessed included fetal loss rates, sample adequacy, early complications and hemodynamic changes measured by Doppler ultrasound. A p-value < 0.05 (two-tailed) was considered statistically significant. Results: Spontaneous abortion rates were significantly lower following TA-CVS (0.18%; 8/4500) compared to TC-CVS (0.6%; 5/850) and TV-CVS (1.3%; 2/150) (χ² = 24.56, p < 0.001). Post hoc pairwise analysis showed significantly lower fetal loss in TA-CVS compared to TC-CVS, but not between TA-CVS and TV-CVS. Cytogenetic abnormalities were detected in 220 cases (4.0%), and clinically significant copy number variants (CNVs) were confirmed in fetuses with major structural malformations. Five-year follow-up showed no diagnosed intellectual disability among assessed children. Optimal tissue weight (10–20 mg) was more frequent with TA-CVS (66.7%) than TC-CVS (35.3%) or TV-CVS (36.7%) (χ² = 350.92, p < 0.001). In a Doppler subset (n = 400), uterine, spiral, and interplacental artery PI changes were non-significant; the umbilical (p = 0.032) and middle cerebral arteries (p < 0.001) showed transient PI reductions after sampling. Conclusions: Transabdominal CVS demonstrated the most favorable balance of safety and diagnostic quality, suggesting it should be the preferred first-line technique in early prenatal diagnosis. Standardized technique and operator training remain critical to optimize outcomes. Full article

Objectives: To assess the correlation and agreement of uterocervical angle (UCA) measurements obtained via transabdominal (TAUS), transperineal (TPUS), and transvaginal ultrasound (TVUS) between 16 and 24 weeks of gestation. Methods: In this prospective cross-sectional study, 136 pregnant women underwent UCA and cervical length (CL) assessments using TVUS, TAUS, and TPUS. All measurements were performed by a single experienced operator with an empty bladder. Correlation was assessed using Pearson analysis, while consistency and agreement were evaluated with intraclass correlation coefficient (ICC) and Bland–Altman plots. Results: Mean UCA values differed significantly between modalities (p < 0.001). Moderate correlation (r = 0.547) and consistency (ICC = 0.545) were found between TAUS and TVUS. The Bland–Altman analysis showed a systematic bias of –8° between TAUS and TVUS, with wide limits of agreement (–64° to +32.6°). TPUS showed a higher correlation with TVUS (r = 0.686), but poor consistency (ICC = 0.052), with broader limits of agreement (–32° to +49.2°). Conclusions: Although both TAUS and TPUS showed significant correlation with TVUS for UCA measurement, only TAUS demonstrated moderate consistency, suggesting that it should be used cautiously in clinical practice. TPUS demonstrated considerable variability in individual assessments and does not seem appropriate as a replacement for TVUS. Further studies are needed to validate these findings and improve measurement reliability. Full article