Florjański J

Quantitative assessment of placental vasculature and placental volume in normal pregnancies with the use of 3D Power Doppler

PURPOSE The aim of the study was to determine reference values for placental vascular indices and placental volume according to gestational age. MATERIAL/METHODS The assessment of placental vascular indices and placental volume using 3D Power Doppler and the Virtual Organ Computer-aided Analysis (VOCAL) technique was performed on 100 normal fetuses between 22 and 41 weeks of gestation. In this study the method of the individual setting of the power Doppler gain value was used. Only patients with entirely visualized placenta were included in the study. RESULTS No statistically relevant difference in the values of placental vascular indices and placental volume between different localizations of the placenta was detected. No statistically significant changes to placental vascular indices depending on gestational age were found. It enabled to determine the 10th, 50th and 90th percentile values for the vascularization index (VI), flow index (FI), vascularization-flow index (VFI), which are independent of gestational age. No correlation was found between placental volume and placental vascular indices. CONCLUSIONS The values of placental vascular indices are constant between the 22nd and 41st week of a normal pregnancy. Placental volume measured with the use of the VOCAL program increases between 22nd and 41st week of a normal pregnancy. In a normal pregnancy the placental vasculature increases adequately to the increase of its volume. The method of the individual setting of the power Doppler gain value makes it possible to achieve comparable values of placental vascular indices regardless of the distance between the probe and the placenta.

Women with inflammatory bowel diseases have a suboptimal cervical cancer screening rate and are not aware of the recommended human papilloma virus vaccine

Abstract The aim of the study was to assess the self-reported cervical cancer screening rate among patients with inflammatory bowel diseases (IBD) and patient attitude towards human papilloma virus (HPV) vaccination. A self-designed survey was conducted in hospitalized IBD patients. The survey comprised demographic data, questions regarding cervical smear test frequency and vaccinations recommended for an IBD patient. Randomly, patients completed the survey with a physician present to determine question comprehension. In order to provide test–retest reliability a group of 10 patients completed it twice. Survey data from 150 IBD patients (mean age: 36 years, SD ± 13; mean IBD duration: 10 years, SD ± 6.5) were analyzed. Fifteen percent of the patients reported irregular cervical testing and 15% do not remember when having had a previous cervical testing performed. Only 69% of the patients undergo testing regularly; 30% annually, 32% every 2–3 years; 7% every 5 years. The mean age of patients tested regularly was 22 years, vs. 32 years tested irregularly (p < .001). Only 10% of women claimed that HPV vaccine is recommended for an IBD patient. There is a low adherence to the recommendations regarding cervical cancer screening and prophylaxis. Better multi-disciplinary cooperation between patients and physicians is required to improve patient education and outcomes.

Fetal sigmoid colon mesentery – In relevance in fetal ultrasound application. A pilot study

INTRODUCTION Ultrasound examinations during pregnancy are routine procedures used to detect fetal congenital malformations. Ultrasound monitoring of sigmoid colon mesenterial development could be useful for early detection of subjects at risk of sigmoid colon volvulus. OBJECTIVE The aim of our paper was to assess the sigmoid colon length, and sigmoid colon mesentery width and height in the late fetal period, and, using the results, to estimate the surface area of the mesocolon (in mm2) in living fetuses. Moreover, we attempted to repeat some of these measurements in living fetuses using ultrasound imaging. METHODS The study was carried out on 209 formalin fixed human fetuses (100 female and 109 male) aged from 4th to 7th gestational months (102-203 days), with a crown-rump length of 132-342mm. The length of the sigmoid colon, as well as the height and width of its mesentery were measured. The surface area of the mesocolon was estimated. Correction for formalin induced shrinkage was applied. Pilot ultrasound examinations of live fetuses were performed. RESULTS Mean values of sigmoid colon length, mesenteric width and height (formalin fixed fetuses) for respective gestational ages were: month 4: 21.46±6.7mm, 6.80±2.1mm, 5.5±1.49mm; month 5: 27.32±1.2mm, 7.62±2.01mm, 7.33±2.17mm; month 6: 47.56±9.57mm, 11.68±3.8mm, 10.3±3.05mm; month 7: 56.92±17.48mm. 15.32±8 mm, 12.81±3.16mm. The surface area ranges of the sigmoid colon mesentery found for respective gestational months (intrauterine fetuses) were as follows: month 4: 33.24-51.95mm2; month 5: 49.63-77.6mm2; month 6: 106.89-167.15mm2 and month 7: 145.69-272.53mm2. CONCLUSION The surface area of the sigmoid colon mesentery can be used as a simple parameter applied in fetal ultrasonographic evaluation. The development of the sigmoid colon accelerates in the 6th gestational month, and decelerates in the 7th gestational month. The sigmoid colon mesentery width was larger than its height between the 4th and 7th gestational months.