Ectopic endometrial epithelium associates a wide spectrum of symptomatology. Their evolution can be influenced by inflammatory and vascular changes, that affect not only the structure and cell proliferation rate, but also symptoms. This prospective study involved tissue samples from surgically treated patients, stained using classical histotechniques and immunohistochemistry. We assessed ectopic endometrial glands (CK7+, CK20−), adjacent blood vessels (CD34+), estrogen/progesterone hormone receptors (ER+, PR+), inflammatory cells (CD3+, CD20+, CD68+, Tryptase+), rate of inflammatory cells (Ki67+) and oncoproteins (BCL2+, PTEN+, p53+) involved in the development of endometriosis/adenomyosis. A CK7+/CK20− expression profile was present in the ectopic epithelium and differentiated it from digestive metastases. ER+/PR+ were present in all cases analyzed. We found an increased vascularity (CD34+) in the areas with abdominal endometriosis and CD3+−:T-lymphocytes, CD20+−:B-lymphocytes, CD68+:macrophages, and Tryptase+: mastocytes were abundant, especially in cases with adenomyosis as a marker of proinflammatory microenvironment. In addition, we found a significantly higher division index-(Ki67+) in the areas with adenomyosis, and inactivation of tumor suppressor genes-p53+ in areas with neoplastic changes. The inflammatory/vascular/hormonal mechanisms trigger endometriosis progression and neoplastic changes increasing local pain. Furthermore, they may represent future therapeutic targets. Simultaneous-multiple immunohistochemical labelling represents a valuable technique for rapidly detecting cellular features that facilitate comparative analysis of the studied predictors.

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Malformations of the lower extremities are rare and poorly described. Although fibular agenesis is the most common lower extremity malformation, there are few published cases of prenatal diagnosis. We report a clinical case of fibular agenesis that was presented at the Hospital de Carabineros de Chile and its subsequent discussion.Supporting information can be found in the online version of this abstract EP10.05 Relationship between absent or hypoplastic fetal nasal bone at 20-23 +6 weeks of gestation and chromosomal defects in an unselected Chinese population L. CaoUltrasonic Diagnosis Department of Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China Objectives: To investigate the relationship between absent or hypoplastic fetal nasal bone and chromosomal defects during the second trimester in an unselected Chinese population. Methods: From January 2012 to December 2015, included were 58133 pregnant women who underwent routine ultrasound examination between 20 and 23+6 gestational weeks as a screening test. We collected all the cases of absent or hypoplastic fetal nasal bone, followed up the results of karyotype analysis and the information on neonatal development. Results: (1)150 fetuses were found to have absent or hypoplastic fetal nasal bone in the 58651 fetuses(2.56‰), of which 57636 were singleton,476 were twins and 21 were triplets. With 14 cases of misdiagnosis, missing or incomplete data excluded,136 cases were included in the study. 113 underwent interventional prenatal diagnostic test, and fetal chromosomal defects were detected in 24 cases (17.6%), including 18 cases (75%) of Trisomy 21, 3 cases (12.5%) of Trisomy 18, 1 case (4.2%) of Klinefelter syndrome and 2 cases (8.3%) of microdeletion syndrome. (2) There was no significant difference in the incidence of chromosomal defects between absent fetal nasal bone and hypoplastic fetal nasal bone[22.5%(16/71) vs 12.3%(8/65),x2=2.442, P=0.118]. (3) The incidence of chromosome defects in fetuses without other structural defects was significantly lower than that with structural defects [3.9%(3/76) vs 35.0% (21/60), corrected x2=22.247,P=0.000]. (4)A total of 38 cases of Down syndrome were found in 56707 cases of delivery or induced labour in our hospital. When the fetal nasal bone dysplasia was used as an indicator of Down's syndrome, the sensitivity was 47% and the specificity was 99.8%. Conclusions: The absent and hypoplastic fetal nasal bone are closely related to fetal chromosomal defects. When combined with other sonographic defects, it is necessary to carry out a detailed prenatal diagnosis to exclude fetal chromosomal defects. Objectives: In our routine examinations we noticed that we could follow fetal swallowing using colour Doppler -we tried to study if this technique could be used to monitor the contour of the fetal palate in order to screen for posterior palate defects. Methods: We shared the idea with our team in the Prenatal Diagnosis Unit and we monitored the accessibility of HD -Flow in assessing the contour of the f...

to the patient; as well as the need to go to a level III hospital for surveillance and resolution of pregnancy.In conclusion, BPS is a rare pulmonary malformation with a good prognosis in most cases, being only necessary to perform ultrasound controls to check its evolution.

Objectives: Cavum septum pellucidum (CSP) is an important intracranial structure that is necessarily visualised during routine second trimester sonography. A small or a large CSP may suggest abnormal cerebral development. Therefore, determination of CSP volumes can be useful. However, consistency of sonographic measurements for this relatively small structure is a concern. For this purpose, we sought to assess the reliability of CSP volume measurements with three-dimensional ultrasound between 19-24 weeks of gestational age in structurally normal fetuses. Methods: Three-dimensional Virtual Organ Computer-aided Analysis (VOCAL) software was used to calculate the CSP volume from transabdominal multiplanar datasets obtained during 99 consecutive normal fetal ultrasound examinations within a single unit. Agreement among 3 independent observers with different experience levels of ultrasonography (year 2 obstetrics and gynecology resident, year 2 maternal-fetal medicine fellow, and maternal-fetal medicine specialist) was evaluated, using absolute agreement intraclass correlation coefficients (ICC) and 95% confidence intervals (CI). Results: Measurement of CSP volume was possible in all of the fetuses by all examiners. Interobserver agreement between fellow and specialist was relatively high (ICC, 0.78; 95% CI, 0.70-0.85), whereas limited ultrasound experience (resident) was associated with fair agreement with other observers (ICC for resident and specialist, 0.50; 95 CI%, 0.29-0.65 and ICC for resident and fellow, 0.57; 95% CI, 0.38-0.71). Conclusions: Three-dimensional ultrasound CSP calculations using VOCAL software between 19-24 weeks of gestational age seem feasible, but are reliable only when evaluated by an examiner with particular fetal sonography experience. Objectives: To analyse the outcome of fetuses detected with absence of a normal CSP in the last 5 years, in the Prenatal Diagnosis Unit of our tertiary centre. Methods: We performed a retrospective review of the cases with abnormal CSP evaluated in our tertiary unit, diagnosed between January 2012 and February 2016. The fetal anatomy was evaluated in all cases following the recommendations of the international guidelines. In abnormal CSP cases, fetal neurosonogram and an extended fetal anomaly scan were performed and amniocentesis was proposed to identify genetic disorders. Results: The absence of a normal CSP was observed in 0.49% of the cases (38/7740) examined for morphological purposes. Absent CSP was the initial observation that triggered further investigation and diagnosis of 7 cases with agenesis of corpus callosum and 2 septo-optic dysplasias. In heavily malformed brain cases, as the neural tube defects, hydrocephaly, porencephaly, schizencephaly and holoprozencephaly, the absence of CSP was only an observation, with less diagnostic importance and clinical implications. Almost half of the total abnormal CSP cases (16) associated genetic disorders, most of them with abnormal karyotype and all of them were associated with the absence of CSP. Cystic m...

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