N. Zosmer

Early diagnosis of major cardiac defects in chromosomally normal fetuses with increased nuchal translucency

Objective To determine the value of early ultrasound examination for prenatal diagnosis of cardiac defects in chromosomally normal fetuses with increased nuchal translucency thickness at 10–14 weeks of gestation.

Prediction of early pregnancy viability in the absence of an ultrasonically detectable embryo

To identify clinical, ultrasound and biochemical parameters that may allow prediction of pregnancy viability in women without a detectable embryo on ultrasound examination.

The morbidly adherent placenta: early accurate diagnosis is essential for the meaningful interpretation of outcomes.

hysteropexy, both open and laparoscopic. Obliterative procedures can be combined with continence surgery and they should have been included in the systematic review and meta-analysis. The effect of retro-pubic, transobturator and single incision slings as well as open and laparoscopic colposuspension can be different. The inclusion criteria of individual trials should have been looked at as well, particularly whether preoperative urodynamics were carried out with prolapse reduction or not, as this may influence the decision to perform combined surgery for continence and prolapse at the same time. These points need to be borne in mind when looking at the results of this systematic review and meta-analysis, in terms of subsequent need for continence surgery and voiding dysfunction. They are also relevant for future trials in this respect, which are needed and which would benefit from standardised management protocols and definitions for complications, including voiding dysfunction.&

P18.07: The role of ultrasound in the diagnosis and management of rare complications of Caesarean section

Objectives: Assessment of the fetal head station is of crucial importance if safe operative vaginal delivery is to be attempted. Intrapartum translabial ultrasonography (ITU) has recently been applied to measure the fetal head descent objectively. However, it has not been widely used because the reference point of ITU is different from that of digital examination. Whereas digital examination takes the ischiatic spine as a reference point, ITU uses the pubic symphysis because the ischiatic spine is unable to be detected with ultrasonography. In order to compare the finding of ITU with digital examination, we examined the relationship of the pubic symphysis and the ischiatic spine with using pelvic CT data. Methods: Three-dimensional reconstructions from computed tomographic (CT) datasets of 37 normal Japanese female pelvises were used to measure the spatial relationship between pubic symphysis and ischiatic spine. Results: The distance between the interspinous line and the lower end of pubic symphysis ranges from 70–86 mm (79.7 ± 4.5 mm, mean ± SD)and varies greatly between individuals. The angle between midplane of pelvis and the lower end of pubic symphysis is 104–117◦ (112.3 ± 3.3◦). The correlation function with body height is 0.34. Conclusions: It was impossible to make the interspinous plane on the screen of ITU, but the midplane of pelvis can be traced on it. Therefore, ITU can provide the objective information for the assessment of the fetal head descent which has been dependent on the subjective observations of the digital examination, and it will contribute to the safe operative vaginal delivery.

OC020: Prospective evaluation of a logistic model for the prediction of early pregnancy viability

of gestation with successful vaginal delivery. The same parameters were measured in every two hours until rupture of the membrane. Results: In all but nine women during the first 2 hours the median cervical length 23.6 (10–40) mm changed into 45%, during the 3–4th hours into 35%, and in the 5–6th hours into 26% of the original length. The cervical width became less reliable, for this reason this parameter was not taken into consideration. The median funneling length increased almost 1.8 fold during the first 2 hours, 2.1 fold in the 3–4th hours and 2.4 fold in the 5–6th hours. The median funneling width showed a 1.3 fold increase during the first two hours, a 1.5 fold increase during the 3–4th hours and 1.9 fold increase in the 5–6th hours. In seven cases we did not observe any changes in these parameters during 6–10 hours after the prostaglandin instillation and the instillation finally had to be repeated. Conclusions: Transvaginal sonography seems to be a useful tool in monitoring of cervical changes during artificial induction of labor by prostaglandins. According to our data cervical shortening and funneling proved to be the most important signs of the success of cervical ripening. The need for repeated prostaglandin instillation could be evaluated with objectivity by ultrasonography.

Prediction of pregnancy outcome in women with an empty gestational sac on ultrasound scan

Background:  The ultrasound finding of an empty gestational sac may represent either an early normal pregnancy or a missed miscarriage, and follow up visits are usually required to reach a correct diagnosis. The aim of this study was to examine whether a combination of ultrasound and other clinical data may help to predict the final outcome at the initial visit.