Sun Young Nam

Antenatal sonographic features of ileal atresia

Aim:  The purpose of this study was to determine the antenatal sonographic features of ileal atresia.

Progesterone Inhibits Leptin-Induced Invasiveness of BeWo Cells.

Background: This study investigated the roles of progesterone and leptin in placenta invasion, which is closely related to pregnancy prognosis. We examined the effects of leptin and progesterone on the invasion of BeWo cells, a human trophoblastic cell line, and the effect of concurrent treatment. Methods: Cells were treated with leptin (0, 5, 50, or 500 ng/mL) or progesterone (0, 2, 20, or 200 µM) and cultured in an invasion assay. Cells treated with 500 ng/mL leptin were also treated with progesterone (0, 2, 20, or 200 µM) in the invasion assay for 48 h. The number of cells that invaded the lower surface was counted in five randomly chosen fields using a light microscope with a 200× objective. The mRNA expression levels of MMP-9, TIMP1, TIMP2, and E-cadherin were detected by semi-quantitative PCR. Results: Invasion of BeWo cells was promoted by leptin and influenced by both leptin concentration and treatment duration. Invasion was most effective at 500 ng/mL leptin and 48 h culture. Leptin-induced invasiveness was suppressed by progesterone in a dose-dependent manner. Leptin significantly decreased the expression levels of TIMP1 and E-cadherin, whereas progesterone significantly decreased expression of MMP-9 and significantly increased levels of TIMP1, TIMP2, and E-cadherin. Conclusions: Leptin promotes invasion of BeWo cells, and progesterone suppresses leptin-induced invasion by regulating the expressions of MMP-9, TIMP1, TIMP2, and E-cadherin. The balance between leptin and progesterone may play an important role in human placenta formation during early pregnancy.

Complete septate uterus, obstructed hemivagina, and ipsilateral adnexal and renal agenesis in pregnancy

Most cases of double uterus with obstructed hemivagina and ipsilateral renal agenesis were diagnosed at adolescents after menarche. This is the first reported case of complete septate uterus with obstructed hemivagina and ipsilateral renal agenesis in addition to ipsilateral agenesis of fallopian tube and ovary in which the diagnosis was delayed until pregnancy. The pregnancy was uneventful in spite of intermittent vaginal spotting. During the cesarean section, the septum of the uterus was resected and about a 3-cm×3-cm window was made on the vaginal septum to allow an opening for the obstructed vaginal discharge. We followed the patient up for one and half years, and she has not had symptoms such as dysmenorrhea or abnormal vaginal bleeding.

P32.15: The efficacy of measuring a difference of cervical length for prediction of preterm delivery

Objectives: To investigate the feasibility and reliability of transperineal cervical length measurement in the second trimester and to compare the measurement obtained by this approach with those with transvaginal approach. Methods: This was a cross-sectional study including 196 pregnant women referring to Zeinabieh and Hafez hospitals affiliated with Shiraz University of Medical Sciences with 18 to 24 weeks of gestation. Transperineal and transvaginal sonography for cervical length was done for all women. Accuracy values of TVS and TPS at 18 to 24 weeks of gestation were compared in predicting preterm delivery. Results: In our study, preterm delivery occurred in 16 pregnant women (8.2%). Mean cervical lengths measured by TVS and TPS were significantly different in preterm and term delivery groups (P < 0.001). Areas under the ROC curves were 0.973 and 0.978 for the transperineal and transvaginal measurement. The coefficient of correlation between the transvaginal and transperineal sonography at ≤ 28 mm cut-off points, had sensivity and specificity 93.75% and 92.74%, respectively. Conclusions: Transperineal sonography could be an appropriate alternative for prediction of preterm delivery with accuracy comparable to transvaginal sonography.

P32.04: Prediction of postterm induction in VBAC: cervical length versus cervical volume

ir 30.9–31.6), cervical glandular EO thickness (G1 15.6 mm; ir 14.4–18.7, G2 17.2 mm; ir 16.1–18.3), cervical glandular IO thickness (G1 19.5 mm; ir 18.2–25.5, G2 18.1 mm; ir 18–19.3), time interval to delivery (G1 4 days; ir 3–5, G2 3 days; ir 2.25–8.75), gestational age at delivery (G1 39.4 wks; ir 39.1–39.6, G2 40.3 wks; ir 40.1–40.5). Conclusion: Cervical glandular thickness acquired by 3D TVS and enhanced by static VCI was detectable in all cases. No significant difference in glandular thickness was found between nulliparae and multiparae; nulliparae have a minor glandular thickness at OI. Glandular thickness was not related to time to delivery. The small, preliminary, sample size could not allow to reach statistical significance.

P02.15: Recurrent ectopic pregnancy in the tubal remnant stump after ipsilateral total salpingectomy

The incidence of ectopic pregnancy is 2% of all pregnancies and has increased. It is reported that a recurrent ectopic pregnancy rate is 10–15% after salpingotomy compared with 10% after salpingectomy. Corneal pregnancy after ipsilateral total salpingectomy or remnant tubal pregnancy after ipsilateral partial salpingectomy is reported but recurrent ectopic pregnancy in the tubal remnant stump after ipsilateral total salpingectomy is rare and exact incidence is unknown. We present a case of spontaneous ectopic pregnancy occurring in the stump of a remnant fallopian tube following ipsilateral total salpingectomy for an ectopic pregnancy.

P33.19: The prenatal sonographic features of ilojejunal atresia

Introduction: Gastroschisis is a defect in the abdominal wall, typically situated on the right side of a normally inserted umbilical cord, through which bowel and other abdominal contents herniate. Its prevalence is still increasing worldwide for unknown reason. Usually, gastroschisis occurs in isolation, but other organ defects, especially intestinal malrotation, should always be ruled out. Material and methods: We report an interesting case of gastroschisis complicated with bladder herniation, with a well documented iconography, and a meticulous follow-up since its diagnosis in the first trimester and throughout the pregnancy. Results: Secondary bladder exteriorization is rarely reported in gastroschisis. The occurrence of secondary complications due to bladder herniation may alter the management strategy and influence the mode and date of extraction. Typically, bladder herniation occurs in the third trimester, mostly in female fetuses. Conclusion: There is no consensus, up till now, on the ideal time and mode of delivery, close follow up should be installed in fetuses with gastroschisis and bladder herniation as this may be another contributing factor to fetal distress and secondary complications.