E. Araujo

Three‐dimensional Doppler evaluation of single spherical samples from the placenta: intra‐ and interobserver reliability

To evaluate the intra‐ and interobserver reliability of assessment of three‐dimensional power Doppler (3D‐PD) indices from single spherical samples of the placenta.

Evaluation of Placental Volume at 7–10 + 6 Weeks of Pregnancy by 3D-Sonography

The aim of the study was to establish normative data for placental volume (PV) at 7-10+6 weeks of gestation using three-dimensional ultrasound (3DUS). The cross-sectional study involved 70 healthy pregnancies between 7 and 11 weeks. The VOCAL (Virtual Organ Computer-aided Analysis) method with a 30 degrees rotation angle and six planes was used for volumetric calculations. Regression models were constructed to assess the correlation between PV and crown-rump length (CRL) adjusted by the determination coefficient (R2). The method proposed by Royston and Wright was used to establish the 2.5th; 10th; 50th; 90th and 97.5th percentiles (percentile=mean+KxSD). The intraclass correlation coefficient (ICC), Bland-Altman graphs and Students paired t-tests were used to assess intra- and interobserver variability. PV ranged from 1.7 to 42.6 cm3, with a mean of 13.6cm3 (+/-9.4cm3). There was a strong correlation between PV and CRL; the exponential equation was the model that best expressed the correlation between them (R2=0.76). For CRL between 9 and 40 mm, the mean PV increased 10.5 times, while CRL increased only 4.4 times. Inter- and intraobserver correlation were excellent (ICC=0.979 and 0.971, respectively). Bland-Altman graphs indicated a good reproducibility with a mean intraobserver and interobserver difference of 0.2 cm3 (95% CI: -0.7-1.2cm3) and -0.2cm3 (95% CI: -1.3-0.9cm3), respectively. Reference limits were generated for first trimester PV assessed by 3DUS using the VOCAL method. There is a strong correlation between PV and CRL. Placental volume obtained through this method was highly reproducible.

Reference ranges of atrioventricular valve areas by means of four-dimensional ultrasonography using spatiotemporal image correlation in the rendering mode.

This study aims to determine reference curves for fetal atrioventricular valve areas by means of three‐dimensional ultrasound using the spatiotemporal image correlation (STIC) software.

Reference Intervals for Fetal Heart Volume From 3-Dimensional Sonography Using the Extended Imaging Virtual Organ Computer-Aided Analysis Method at Gestational Ages of 20 to 34 Weeks

The purpose of this study was to establish the reference range for fetal heart volume from 3‐dimensional (3D) sonography using the extended imaging virtual organ computer‐aided analysis method.

Fetal thigh volume by 3D sonography using XI VOCAL: reproducibility and reference range for Brazilian healthy fetuses between 20 and 40 weeks

To provide reference values for fetal thigh volume using three‐dimensional (3D) ultrasound and the eXtended Imaging Virtual Organ Computer‐aided AnaLysis (XI VOCAL) method.

Investigation of pseudogenes RHDΨ and RHD-CE-D hybrid gene in D-negative blood donors by the real time PCR method.

INTRODUCTION The Rh system is the most polymorphic and immunogenic of all systems of blood groups. Currently more than 49 antigens were identified with five major antigens D, C, c, E, e. Knowledge of the molecular basis of the Rh system permitted the understanding of both the mechanism of Rh phenotype on the antigen variants of RHD and RHCE In Caucasians the primary mechanism of D-negative phenotype is the complete deletion of RHD gene, while the black Africans is the presence of pseudogene and gene hybrid RHD-CE (3-7)-D. OBJECTIVE To determine the prevalence gene pseudogene and hybrid gene and standardization of molecular techniques in method of Taqman on real-time PCR for RHD genotyping. PATIENTS AND METHODS 203 samples of D-negative donor were used to establish and validate the effectiveness of RHD genotyping in real-time PCR using Taqman technology. The extraction was performed using a commercial kit QIAmp DNA mini kit. Samples exon 10 and 7 positive were submitted to amplification of exon 5, confirming the pseudogene RHDΨ, whereas exon 10+exon 7--for the hybrid gene (C) cdes and mutation C733G (Leu245Val) of the RHCE gene. RESULTS Twenty-five (12.3%) samples were positive, 14 amplified for both exons 10 and 7 while in 11 only for the exon 10. When extended the screening using exon 10, 7 and 5, only 06 amplified. The pseudogene was present in 07 samples (3.5%) and the hybrid RHD-CE (3-7) in 04 (1.97%), while in 177 (87.2%) of Rh negative donors were RHD gene deletion. In 07 samples not amplified for exon 3 had mutated and the mutation C733G antigen. CONCLUSION The prevalence of pseudogene was 3.5% and the gene hybrid RHD-CE of 1.9%. This approach for real-time PCR as a complementary tool is technically feasible and the results of this study helped develop a new strategy for RHD genotyping.

Assessment of renal volume by three-dimensional ultrasonography in pregnant bitches: an experimental study using virtual organ computer-aided analysis.

BackgroundTo assess and to compare the renal volume evolution in bitches during pregnancy by two-dimensional (2D) ultrasonography using the ellipsoid technique (volume = length x width x depth x 0.523) and three-dimensional (3D) ultrasonography using the Virtual Organ Computer-aided AnaLysis (VOCAL) method. A longitudinal prospective study was performed with 17 normal Golden Retrievers bitches during pregnancy from heat to the last third of gestation. The ultrasound scans were performed by two veterinarians. The left and right kidneys were assessed in three moments (day 0 = non-pregnant bitches; days 1st to 20th of pregnancy and days 21st to 40th of pregnancy) by three techniques (ellipsoid; VOCAL 12° and VOCAL 30°). For reproducibility calculations, we used the intraclass correlation coefficient (ICC).ResultsThe inferential result of the volumes in ANOVA revealed the interaction effect between side and moment (p = 0.009). The 3D techniques showed, in average, the same renal volumes (p = 0.137) regardless of the side and moment. Considering the right side, the renal volume in the day 0 was smaller than the day 21st to 40th (p = 0.029). Considering the left side, the renal volume at day 0 was smaller than the day 1st to 20th (p = 0.020) and day 21st to 40th (p = 0.007). It was found good intra observer reproducibility (ICC > 0.9) and none of the three techniques showed a good inter observer reproducibility (ICC < 0.7).ConclusionThe renal volume bitches by 3D ultrasonography using the VOCAL method (12° and 30°) had good correlation with the volume obtained by 2D ultrasonography method.

Fulminant Adenocarcinoma of the Rectum with Hepatic Metastasis in a Young Pregnant Woman: A Case Report

Cancer is the second leading cause of death during the reproductive years, but the incidence during pregnancy is low. The incidence of cancer of the rectum during pregnancy is very rare (1:50,000 to 1:100,000 pregnancies). Usually, the symptoms of this type of cancer are nonspecific and sometimes they are confused with normal changes of pregnancy. The diagnosis of rectal cancer is usually made in the late stage of pregnancy. The treatment of this cancer involves surgery, chemotherapy and radiotherapy, but each type of treatment involves risks to the fetus and the pregnant woman. We present a case of a young primiparous woman who had a quick and bad evolution of an adenocarcinoma of the rectum diagnosed during pregnancy. This patient had extensive involvement of the liver with metastasis and she died two weeks after diagnosis. In this case, we present the clinical, radiological and pathology findings of this disease.

EP03.02: Modified myocardial performance index in pregnancies with well-controlled type I and type II diabetes mellitus.

In 2 weeks later, induced labour was performed and she vaginally delivered a male fetus with weight of 3260gm and APGAR scores 1’-1 and 5’-3. Postpartum MRI revealed the same finding as prenatal ultrasound. The baby died from pneumonia when he was 18 month old. This case report provides evidence that congenital hydranencephaly may survive for more than 1 year and routine prenatal care needs to be taken for early detection of hydranencephaly.

EP03.06: Reference range for fetal tricuspid annular plane systolic excursion (TAPSE) measurement using spatiotemporal image correlation (STIC) M-mode in a Brazilian population.

G. Tedesco4,5, L.C. Bussamra4,5, L.C. Rolo1, F.S. Barros1, W.P. Martins4,3, L. Nardozza2, A.F. Moron4, E. Araujo4 1Department of Obstetrics, Federal University of São Paulo-UNIFESP, São Paulo, Brazil; 2São Paulo Federal University, São Paulo, Brazil; 3Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil; 4Department of Obstetrics, Paulista School of Medicine-Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil; 5Department of Obstetrics, Medical College Science of Santa Casa of São Paulo (FCMSCSP), São Paulo, Brazil