P20Early membrane funnelling may occur from 16 weeks onwards and carries a worse prognosis

J. Bellver, G. Lberico, C. Lara, J. Ferro, J. Remohí, A. Pellicer, V. Serra-Serra
2000 Ultrasound in Obstetrics and Gynecology  
The aim of the study was to assess prospectively the evolution of multiple clinical parameters throughout the first trimester of pregnancy. Method: A transvaginal ultrasound examination and a blood test was weekly performed until the 13th gestational week in a group of healthy volunteers. A total of 25 spontaneously conceived singleton pregnant women with good pregnancy outcome finally completed the study. The evolution of 10 transvaginal ultrasound parameters, 5 Doppler measurements and 6
more » ... parameters was studied. Results: An increasing trend with advancing gestation was evident for the mean gestational sac (MSD) and amniotic sac (AS) diameters, trophoblastic rim, CRL and serum progesterone. The uterine, umbilical and fetal cerebral arteries PI decreased with advancing gestation. The FM yolk sac (YS) diameter and b-hCG levels showed an initial rise and a final decrease. A great interindividual variation was evident for the b-hCG titer. The YS/CRL progressively approached to 0, whereas the MSD/CRL and the AS/MSD progressively approached to 1. The corpus luteum diameter, corpus luteum arteries PI, subehorionic arteries PI, complement levels (C3 and C4), platelet count and activated partial thromboplastin time experienced minimal changes. Conclusion: First trimester normograms for multiple clinical parameters are provided. P02 The first results of the ultrasound transvaginal screening in early pregnancies in Kazan city, Tatarstan, Russia In 1 January 2000 in order of Tatarstan Health Care Ministry transvaginal first trimester screening was introduced in Kazan city. All pregnant women have to be examined in one of 5 the medical centers. We present the results of six month screening for all pregnant women between 10 and 14 weeks gestation. Method: Routine transvaginal ultrasound examination included the measurement of fetal crown-rump length, nuchal translucency and estimation of fetal anatomy. Results: A total 1620 pregnant women of 10±14 weeks of gestation were examined from January till June 2000. All abnormalities were detected at the 12±13 weeks gestational ages. The increasing of nuchal translucency thickness were found in 23 cases, 7 of them chromosomal defects had, in this group in 5 cases cystic hygroma with hydrops were identified. In 12 cases structural anomalies were found: 1-body stalk anomaly, 1 case-omphalocele with liver in it, 1-holoprosencephaly with proboshisis and microphtalmia, 1-encephalocele, 3-acrania, 5-anencephaly. In the cases of holoprosencephaly and encephalocele nuchal translucency measured at 10±11 week was normal. Conclusion: Even the first results of early pregnancy transvaginal screening show its great significance in our city. The most adequate period for transvaginal screening is 12±13 weeks. Objective: Evaluation of routine screening in the early pregnancy by transvaginal sonography (TVS) in an unselected population. Design and methods: A routine ultrasound examination was offered to every woman in the 12th week of her pregnancy. Besides a detailed survey of fetal anatomy, a measurement of nuchal translucency and karyotyping was performed as appropriate. Results: In a five-year period (from 1. Jan. 1995 ± to 31. Dec. 1999) 9556 women were examined. Fetal anomalies were diagnosed in 54 cases at the 12th week of pregnancy: 63 morphological abnormalities and 16 chromosomal aberrations. The detection rate for structural and chromosomal abnormalities in early pregnancy was 50.5% (54/ 107) of all anomalies, which were diagnosed antenatally. Conclusions: It is possible to detect fetal abnormalities very early in pregnancy. The ultrasound screening may increase the detection rate of chromosomal disorders. The interpretation of fetal anatomy in the first trimester requires comprehensive understanding of embryological development. The detection rate of fetal malformations is increased significantly by introducing an early pregnancy scan in addition to the mid-trimester scan. The fetopathological examination can add more information to the clinicians and to genetic counselling. Background: The aim of this study was to audit prospectively the value of pre-abortion ultrasonography. Methods: All women who came in our Centre because of doubt unplanned pregancy in first trimester from March 1994 to March 1996 were underwent an exam by vaginal ultrasound before abortion. We analysed these data and compared them with complications after legal induced abortion. Results: During two years a total of 334 women were surveyed. Twenty-seven women (8.08%) were not being pregnant. In thirtythree cases (10.75%) the pregnancy was greater for two weeks than we expected on the basis of last menstrual period. Also we founded: 21 (6.84%) myoma uteri, 5 (1.62%) ovarian cysts, 5 (1.62%) multiple pregnancy, 4 (1.3%) anomaly of the uterus, 1 (0.32%) blighted ovum and 1 (0.32%) nuchal translucency greater than 5 mm. Conclusion: Pre-abortion ultrasonography increases security of this intervention by elimination some problems about induced abortion. Since the elimination is simple, fast and cheap we recommended it for routine use. We hope that is one of the way for decreasing of late complications after abortion like as infertility. Background: The aim of the study was to introduce Prognostic Biophysical Test (PBT) in ultrasound diagnostic practice to evaluate spontaneous abortion risk in the first trimester of pregnancy. PBT consists of 3 routine USG parameters estimated together: Crown Rump Length and Yolk Sac (YS) measurement and visualization of Fetal Heart Rate (FHR). Method: USG examination with, 7.0 MHz transvaginal Bruel & Kjaer transducer was performed in 199 pregnant women between 5 and 12 weeks of pregnancy. YS diameter and cram-rump length were measured and compared to nomograms. FHR presence or absence was stated. PBT score was 1 point for correct value off each parameter, and 0 for incorrect one. PBT score of 3±2 points were considered to be good prognostic value, 0±1 points as poor prognostic value. PBT results were compared with pregnancy outcome. Results: PBT allowed prediction of spontaneous abortion with a sensitivity of 97%, specificity of 67%, false positive of 33%, false negative of 3% and positive predictive value of 72%. Conclusion: The test called by the authors PBT seems to be a simple and sensitive option in prediction of spontaneous abortion risk in the first trimester of pregnancy using ultrasound examination. Background: The purpose of this study is to describe the monographic features and outcome of fetuses with isolated hyperechogenic foci in the thalamic region. Method: A detailed monographic survey was performed in 46244 consecutive pregnancies. Both low and high-risk pregnancies were included. Transvaginal examinations were performed at 14± 16 weeks' gestation, while transabdominal examinations were performed after 18 weeks' gestation. Results: Isolated hyperechogenic foci in the thalamic region were observed in 7 fetuses. All cases were diagnosed at 14±16 weeks' gestation. Six fetuses had one hyperechogenic focus, and one fetus had two foci. The size of these foci ranged from 2 to 4 mm. A serologic work-up was negative in all these fetuses and their karyotype was normal. The hyperechogenic foci disappeared in mid-pregnancy in all cases, and fetuses were normal at delivery and on follow-up up to the age of 9 years. Conclusion: Isolated hyperechogenic foci in the thalamic region in the early pregnancy have probably a benign nature. P07 Fetal gender determination in the first trimester using the transverse view: the importance of the third point
doi:10.1046/j.1469-0705.2000.00004-1-20.x fatcat:g7u2igsnn5f5pcdemwh6vghzva