Objective To assess the incidence of aberrant right subclavian artery (ARSA)

Surveillance of human papillomavirus (HPV) prevalence and genotype distribution in migrant women from middle and low-income countries to developed countries is limited. The aim of this study was to analyze the spectrum of HPV genotypes and prevalence of cervical abnormalities in women emigrated mainly from Eastern Europe and West Africa and living in Southern Italy. The study included 233 migrant and 98 Italian-born women who self-referred to two gynecological outpatient clinics in the Campania region. Cervical specimens were subjected to cytological examination and viral testing by broad spectrum PCR. The prevalence rates of HPV infection were 57.9% and 94.1% among migrant and 19.4% and 88.5% among Italian women with normal and abnormal cytology respectively. HPV infection was detected in 56.1% of Southern and Eastern European, 62.5% of Central and South American, 55.5% of West African, and 73.3% of Southern Asian women with normal cervix. Among the 140 HPV-positive migrants, a total of 28 mucosal HPV genotypes were identified of which 11 types (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, and 58), epidemiological classified as carcinogenic to humans (group 1), accounted for 73.4% of all infections. As expected, HPV16 was the most common viral type in all groups with frequency rates ranging from 12.5% in African to 30.1% in Eastern and Southern European women. In conclusion, the estimated prevalence of HPV infection among migrant women is very high, probably reflecting either lifestyle or high incidence of HPV in their country of origin. The implementation of vaccination strategies and cervical cancer surveillance are critical for women in this risk group.

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Methods: Conventional three dimensional acquisition of volumes permits multiplanar analysis in three orthogonal straight planes. Newer software permits analysis of curved or irregular sections along any plane. This was a prospective study which included second trimester pregnancies referred to a tertiary centre for one of the following indications: a malformation diagnosed elsewhere, a previous history of a malformation, exposure to known teratogens, maternal diabetes mellitus, evidence of an intra-uterine infection, a bad obstetric history, abnormal liquor volume and early onset growth restriction. Each patient was evaluated by a detailed twodimensional anomalies scan, three dimensional volume acquisition of the cranium, face, spine, thorax, abdomen and limbs, biometry, and, an amniotic fluid index. Straight orthogonal and curvilinear non-orthogonal evaluation of all regions was carried out. Ultrasound data was noted and archived. Follow up included detailed gross examination of abortuses/infants, neonatal records and autopsy notes. Results: 1000 pregnancies were included in the study and complete follow up data was possible in 902 patients. The mean gestational age was 19 weeks (13-26 weeks). Conventional three dimensional analysis yielded additional information on anomalies of the cranium and face in 42 cases and curvilinear non-orthogonal plane analysis yielded additional information in another 13 cases. Time taken for analysis was considerably less using the newer technique. There were two false positives in the former group and none in the latter. Conclusions: Non-orthogonal curvilinear three dimensional ultrasound increases the efficiency and accuracy of assessing cranio-facial anomalies in an at-risk population.

at 2 referral centers for congenital heart defects (CHD). Postnatal follow-up was available in all cases. Karyotyping and FISH for microdeletion 22q11.2 were performed in all cases. Results: 22 cases of isolated IAA (15 type B and 7 type A, 7 and 3 of which, respectively, underwent B-flow and STIC) were detected among 2520 cases of fetal CHD. In 7 of the 15 type B cases, a right subclavian artery arose anomalously (ARSA). 2D US failed to distinguish the type of IAA in only 2 cases and the ARSA in 5 of the 7 cases. B-flow and STIC successfully identified IAA types in all 10 cases examined and clearly visualized the ARSA, including cervical ones. FISH detected microdeletion in 10/15 type B cases and an unusual association with type A in 1 of the 7 cases. Fetal/neonatal outcome included: 8 terminations of pregnancy, 1 intrauterine death and 4 postoperative deaths in the neonatal period, and 9 neonates were alive after surgery at a mean follow-up time of 58 months. Conclusions: Our results confirm the feasibility of prenatal characterization of IAA and its different types based on 2D examination, albeit with some limitations in the thorough assessment. 4D US with B-flow and STIC can facilitate the detailed examination of the anatomical features of IAA types, including visualization of the neck vessels, thus supplying additional information with respect to 2D US. Our data indicate that types A and B are distinct, there being a close association of microdeletion only with IAA type B. Objectives: To assess the incidence of ARSA and other strong markers of DS and their correlation in a large population of DS fetuses assessed in a tertiary referral center. Methods: Presence or absence of ARSA and other major ultrasound markers of DS was assessed in a population of 116 DS fetuses referred to our unit for expert assessment and termination of pregnancy after karyotyping performed for positive 1 st or 2 nd trimester screening, maternal age, maternal decision. All cases in which the diagnosis of DS followed the ultrasound detection of major anomalies or soft markers were excluded from the study. The ARSA was searched for on the three-vessel view using color or power Doppler. All fetuses underwent a thorough anatomic assessment. The other DS markers assessed in the study period were: absent or hypoplastic nasal bone (NB-) defined as length < 5 th centile, nuchal fold (≥ 5 mm), mild pyelectasis. In addition, the presence of major cardiac and/or extracardiac defects was recorded. A correlation analysis was then performed with the SPSS package in order to ascertain possible associations between markers and/or major anomalies. Autopsy or postnatal diagnostic confirmations were available in all cases. Results: Mean gestational age at ultrasound assessment was 20.4 weeks (SD: 4.1). The incidence of the various variables in the population of DS fetuses was as follows: ARSA 24%; NB-41%; nuchal fold 15%; pyelectasis 16%; major heart defects 39%; AVSD 23%; extracardiac anomaly 25%. The presence of ARSA did not correlate with any of the ...