A. Jamal

First‐trimester screening for chromosomal abnormalities by integrated application of nuchal translucency, nasal bone, tricuspid regurgitation and ductus venosus flow combined with maternal serum free β‐hCG and PAPP‐A: a 5‐year prospective study

To investigate the performance of first‐trimester screening for chromosomal abnormalities by integrated application of nuchal translucency thickness (NT), nasal bone (NB), tricuspid regurgitation (TR) and ductus venosus (DV) flow combined with maternal serum free β‐human chorionic gonadotropin (fβ‐hCG) and pregnancy‐associated plasma protein‐A (PAPP‐A) at a one‐stop clinic for assessment of risk (OSCAR).

Role of clinical and ultrasound findings in the diagnosis of retained products of conception

To assess the role of clinical and ultrasound findings as predictors of retained products of conception (RPOC) in women with a suspicion of incomplete miscarriage.

High and low dose oxytocin in augmentation of labor

Objective: To compare the efficacy and safety of high dose oxytocin in the augmentation of labor. Method: Two hundred pregnant women requiring augmentation of labor were randomly assigned to receive oxytocin by either a low dose protocol (1.5 μm/min initially, increased by 1.5 μm/min every 30 min) or a high dose protocol (4.5 μm/min initially, increased by 4.5 μm/min every 30 min) Results: High dose of oxytocin was associated with a significant shortening of labor 4 (1.10–10) vs. 6 (1–10) h, p<0.0001 without a significant difference in cesarean delivery rate, neonatal and maternal outcome. Conclusion: The use of high dose oxytocin is associated with significantly shorter labor without any adverse fetal and maternal effects.

Comparison of magnetic resonance urography with ultrasound studies in detection of fetal urogenital anomalies

PURPOSE Prenatal ultrasonography detects the vast majority of urogenital anomalies, but in some cases the diagnosis remains in doubt. We assessed the potential of magnetic resonance urography (MRU) in the evaluation of different urogenital anomalies in fetuses when ultrasound study was equivocal. PATIENTS AND METHODS We retrospectively reviewed the medical records of 46 fetuses in whom the presence of urogenital anomalies was suspected at ultrasound studies, but remained inconclusive. Fetal MRU was performed within the same week as ultrasound studies. All patients underwent MRU, comprising overview, fast, thick-slab, heavily T2-weighted sequences, followed by focused, high-resolution T2-weighted sequences obtained in sagittal, axial and coronal planes. T1-weighted sequences were obtained in selected cases for assessment of the gastrointestinal tract. All MRU results were compared with ultrasound findings. Sensitivity of each imaging modality was estimated based on definite diagnoses made after birth or abortion. RESULTS The mean (range) gestational age was 27 (18-36)weeks. The final diagnosis was ureteropelvic junction obstruction in 12, ureteral dilation (due to vesicoureteral junction obstruction) in five, ureterocele in five, posterior urethral valve in 16, multicystic dysplastic kidney in six, mesenteric cyst in one and abdominoscrotal hydrocele in one. Overall diagnostic sensitivity of fetal MRU was 96% compared to sonography with 58% sensitivity (p<0.05). Fetal MRU studies provided additional information to sonography in 17 (37%) cases, and were especially more sensitive in evaluation of ureteral anatomy. CONCLUSIONS Fetal MRU can accurately diagnose a wide variety of urinary tract disorders and must be regarded as a valuable complementary tool to ultrasound in the assessment of the urinary system, particularly in cases of inconclusive ultrasound findings. The present study had a selection bias, as only fetuses with possible anomalies proposed by sonography were referred for MRU; however, this is the population that probably benefits most from MRU studies.

Pre-pregnancy weight, low pregnancy weight gain, and preterm delivery

Preterm birth significantly contributes to infant mortality and morbidity; short stature and poor weight gain during pregnancy are believed to be involved in an increased incidence of preterm birth. The nature of the association between pre-pregnancy BMI pregnancy weight gain and preterm delivery remains undetermined. Although pre-pregnancy BMI has genetic as well as nutritional components a low BMI might be a general marker of minimal tissue reserves. Using data collected during 2001--2003 on 2163 pregnant women receiving care in University Hospital clinics in Tehran we explored the association of pre-pregnancy and pregnancy weight gain and preterm delivery with consideration for underlying mechanisms. (excerpt)

Ruptured corpus luteum cysts and anticoagulant therapy

The records of 46 women who required surgical intervention at Shariati Hospital for a ruptured corpus luteum cyst between March 1993 and March 1999 were studied retrospectively. Cases of suspected ruptured ovarian cyst that had been treated conservatively were excluded from the study. All specimens were examined by the hospital’s pathology department to confirm the diagnoŽ . sis. Almost 50% of the women 22 of 46 had received a mechanical prosthetic valve and were taking anticoagulants. We compared their characteristics with those of the remaining 24 women Ž . the control group using as a chi-square test or Fisher’s exact test. The groups were similar in age. All women presented with severe pelvic pain. Two women treated with Warfarin had experienced recurrent ruptured corpus luteum cysts. There was a sig-

Intrapartum maternal glucose infusion and fetal acid-base status.

Objective: To compare the effects of an intrapartum infusion of a lactated Ringer solution or a glucose‐boosted saline solution on the acid‐base status of umbilical arterial blood. Method: In a prospective clinical trial 178 women in labor were randomized to receive intravenously either a lactated Ringer solution or a saline solution boosted with 5% glucose. Umbilical arterial blood was then assessed for acid‐base status. Results: There were significant differences between the lactated Ringer group and the glucose group in umbilical artery pH values (7.25 ± 0.07 vs. 7.28 ±0.06; P = 0.008), pCO2 values (44.8 ± 5.6 mm Hg vs. 41.6 ± 4.1 mm Hg; P = 0.001), and base excess (− 7.3 ± 2.1 mEq/L vs. − 6.6 ± 1.8 mEq/L; P = 0.02). Conclusion: Intrapartum intravenous fluid containing a 5% glucose solution reduces umbilical cord acidemia and hypercarbia.

Second trimester biparietal diameter size and the risk of adverse pregnancy outcomes

To identify the relationship between biparietal diameter (BPD) in the second trimester and adverse pregnancy outcomes in low‐risk pregnancies.

Role of 'angle of progression' in prediction of delivery mode.

The aim of this study was to investigate the role of the ‘angle of progression’ (AOP) in the prediction of vaginal delivery.

OP22.01: Comparison of Bishop score and transvaginal ultrasound assessment of the cervix in prediction of labor induction

Conclusions: It might be expected that risk of T21 would be the major factor in deciding whether to have an amniocentesis. Although we have shown that risk is indeed a factor that women use to make that decision, our data support our experience that the risk itself is of relatively little importance and other issues are frequently the deciding factor. The issues to resolve are what are the most important factors in the decision making process and what would women chose if not divided into low and high risk but just given their figure?