No abstract

A 19-year-old patient presented with intractable uterine bleeding, 11 weeks post-abortion. A pelvic ultrasound with Doppler and color imaging suggested a uterine arteriovenous malformation. Failing conservative therapies, the patient consented to uterine artery embolization (UAE). Two months later, she conceived and had an uneventful normal vaginal delivery at term. Since this is an extremely rare condition, allowing limited clinical exposure and experience, there may be an underlying reluctance by general practitioners to treat these cases with uterine artery embolization for fear of compromising future fertility and pregnancies. However, data from the 20 pregnancies embolized for uterine AVM cited in the present report and data from embolization for uterine fibroids indicate that such fears may be unfounded since pregnancy rates and outcomes may not be compromised after UAE.

Objectives: To explore the value of AO/SVC ratio in three-vessel view and Y sign appearance in descending aorta coronary view for the prenatal diagnosis of fetus CoA. Methods: 21 cases suspected aortic arch narrow or stenosis by prenatal ultrasound were followed up (except for complex deformities). Two groups (CoA group and normal group) were divided according to postnatal examinations or the same confirmed diagnosis by another prenatal diagnostic institution (labour induction cases). Compared the differences including first diagnostic gestational age (GA), the proportion of left and right heart in four chambers view, pulmonary artery/aortic ratio (PA/AO) and AO/SVC ratio in 3-V view, the morphology in aortic arch long axis view, the Y-sign be imaged and inner diameter of the aortic isthmus(D AI ) in descending aorta coronary view. Results: 6 cases confirmed CoA postnatally (3 had well prognosis and 1 died after surgery operation, 2 died before surgery operation), 4 cases selected induction of labour, 11 cases were normal in aortic arch (1 case combined VSD, 1 case suspected ASD, 1case combined congenital bicuspid aortic valve;GAs first diagnosed were 25.4±3.47 weeks in CoA group and 29.27±3.07 weeks in normal group (P < 0.05); 8 cases (8/10) in CoA group when D AO ≤ D SVC while 1 case (1/11) in normal group, (P < 0.05); in the descending aorta coronary view, Y-sign can be imaged in 2cases (2/8) in CoA group and 10 cases (10/11) in normal group (P < 0.05), the D AI >1.5mm in CoA group and <1.5mm in CoA fetuses; PA/AO were 1.81±0.45 in CoA group and 1.55±0.25 in normal groups, (P > 0.05). Conclusions:The prenatal diagnostic accuracy of CoA by echocardiography was less than 50% according to the dominant right heart, narrowed inner diameter of aortic artery and distortional aortic arch, It might be improved when the first diagnosed GA in the 2rd trimester, D AO ≤ D SVC in 3-V view, Y-sign appeared difficultly or D AI <1.5mm in the descending aorta coronary view. EP12.15Prenatal diagnosed single ventricle associated with TAPVC, TGA, right atrial isomerism and pulmonary stenosis