Zhenhong Xu

To establish reference ranges for fetal gastric parameters via two-dimensional (2D) and three-dimensional (3D) ultrasound virtual organ computer-aided analysis (VOCAL) technology and assess fetal gastric development and function in normal and hyperglycemia in pregnancy (HIP) cases. A prospective cross-sectional study was conducted with 457 normal fetuses (11–40 gestational weeks) via 2D and 3D ultrasound VOCAL techniques to measure gastric parameters (maximum length, transverse diameter, anteroposterior diameter, circumference, area, and volume) and calculate the gastric circumference-to-abdominal circumference (GC/AC), gastric area-to-abdominal area (GA/AA), and gastric emptying rate (GER). Nomograms were developed according to gestational age (GA). Intra- and inter-observer reliability were assessed in 50 randomly selected cases. Additionally, 126 HIP cases (90 well-controlled, 36 poorly-controlled) were analyzed via these nomograms. Comprehensive nomograms for 2D and 3D gastric parameters were established. The gastric dimensions (maximum length, transverse diameter, anteroposterior diameter, circumference, area, and volume) and GER increased with increasing GA (p < 0.05), whereas the GC/AC and GA/AA ratios were not correlated (p > 0.05). The measurements revealed high intra- and inter-observer reliability. Compared with both the well-controlled HIP and normal groups, the poorly-controlled HIP group had significantly greater gastric parameters and lower GERs (p < 0.05), with no significant differences between the well-controlled HIP and normal groups (p > 0.05). Both HIP groups had lower GC/AC and GA/AA ratios than that in the normal group (p < 0.05), with significant differences between the poorly-controlled and well-controlled HIP groups (p < 0.05). Fetal gastric parameter nomograms using 2D and 3D ultrasound VOCAL technology provide valuable tools for assessing fetal gastric development and function in normal and HIP pregnancies, highlighting the impact of glycemic control.

Background: We aimed to develop a nomogram that can be combined with point-of-care gastric ultrasound and utilised to predict postoperative nausea and vomiting (PONV) in adult patients after emergency surgery. Methods: Imaging and clinical data of 236 adult patients undergoing emergency surgery in a university hospital between April 2022 and February 2023 were prospectively collected. Patients were divided into a training cohort (n = 177) and a verification cohort (n = 59) in a ratio of 3:1, according to a random number table. After univariate analysis and multivariate logistic regression analysis of the training cohort, independent risk factors for PONV were screened to develop the nomogram model. The receiver operating characteristic curve, calibration curve, decision curve analysis (DCA) and clinical impact curve (CIC) were used to evaluate the prediction efficiency, accuracy, and clinical practicability of the model. Results: Univariate analysis and multivariate logistic regression analysis showed that female sex, history of PONV, history of migraine and gastric cross-sectional area were independent risk factors for PONV. These four independent risk factors were utilised to construct the nomogram model, which achieved significant concordance indices of 0.832 (95% confidence interval [CI], 0.771–0.893) and 0.827 (95% CI, 0.722–0.932) for predicting PONV in the training and validation cohorts, respectively. The nomogram also had well-fitted calibration curves. DCA and CIC indicated that the nomogram had great clinical practicability. Conclusions: This study demonstrated the prediction efficacy, differentiation, and clinical practicability of a nomogram for predicting PONV. This nomogram may serve as an intuitive and visual guide for rapid risk assessment in patients with PONV before emergency surgery.