Report on 114 terminations of pregnancy during the second and third trimester of pregnancy with a new prostaglandin E2 derivative "Sulprostone". In 84 cases legal therapeutic abortions were induced. In 30 women an abnormal pregnancy was terminated. "Sulprostone: is a prostaglandin with selective activity in the uterus. It can be administered parenterally or locally. 48 women received intravenous sulprostone, 35 patients had extraamniotic injections and 31 patients had extra-amniotic injections following an intramuscular injection for priming of the cervix the night before. In 103 women the pregnancy was terminated within the first 24 hours after the administration of sulprostone (90.3%). 8 patients (7.0 %) had a cervical dilatation over 2 cm. In 3 women no effect was noted. In 1 patient the prostaglandin application was stopped because of severe vomiting. The mean administration abortion interval was 12 hours and 54 minutes following extra amniotic application and 10 hours and 30 minutes with extra amniotic application and following intramuscular priming. In 5 patients the abortion was completed after the priming administration. More than 90% of the patient's required analgesia. There were 32.4% side effects of mild character. The results and the methods are described and compared to other methods.
<b><i>Introduction:</i></b> Pregnancies conceived through assisted reproductive techniques (ARTs) are on the rise worldwide and have been associated with a higher risk of placental-related disease in the third trimester. <b><i>Methods:</i></b> A cohort was created of singleton pregnancies after assisted reproduction, admitted at our institution for delivery, between January 2020 and August 2022. Fetal growth velocity from the second trimester to delivery was compared against a gestational-age-matched group of pregnancies spontaneously conceived according to the origin of the selected oocyte (i.e., autologous vs. donated). <b><i>Results:</i></b> 125 singleton pregnancies conceived through ART were compared to 315 singleton spontaneous conceptions. Overall, after adjusting for possible confounders, multivariate analysis demonstrated that ART pregnancies had a significantly lower estimated fetal weight (EFW) z-velocity from the second trimester to delivery (adjusted mean difference = −0.002; <i>p</i> = 0.035) and a higher frequency of EFW z-velocity in the lowest decile (adjusted OR = 2.32 [95% CI, 1.15–4.68]). Also, when ART pregnancies were compared according to the type of oocyte, those conceived with donated oocytes showed a significantly lower EFW z-velocity from the second trimester to delivery (adjusted mean difference = −0.008; <i>p</i> = 0.001) and a higher frequency of EFW z-velocity in the lowest decile (adjusted OR = 5.33 [95% CI, 1.34–21.5]). <b><i>Conclusions:</i></b> Pregnancies achieved through ART exhibit a pattern of lower growth velocity across the third trimester, especially those conceived with donated oocytes. The former represents a sub-group at the highest risk of placental dysfunction that may warrant closer follow-up.
Electronic poster abstractsConclusions: The detection of PIm uterines > p95 in second trimester does not demonstrate a strong association with PE and adverse outcomes in a population with a low prevalence of pre-eclampsia. P14.04 Examination of placental vascularisation with 3-dimensional ultrasound technology in pregnant women with hypertensiońObjectives: The pathological fetomaternal circulation can lead to elevated resistance in the uterine circulation, which can cause placental insufficiency, and decreased fetal oxygenation. The pathological development of the placenta, because of the uteroplacental insufficiency, can result in IUGR, premature birth, intrauterine hypoxia, or even intrauterine death. The aim of this study was to analyze the placental vascularization by three-dimensional power Doppler technique, made with the help of VOCAL methods. Methods: Three-dimensional power Doppler indices, vascularization (VI), flow (FI) and vascularization flow index (VFI), were measured in cases of pregnancies with normal (N = 316) and elevated blood pressure (N = 52) using VOCAL technique (Voluson 730, 4DView program). We analysed the correlation among the above mentioned indices and the outcome of pregnancy, the place of placental implantation, the maternal pre-gestational BMI, and the weight-gain during pregnancy. Results: In case of pregnancies with hypertension the 3-DPD indices (VI, FI, VFI) were significantly lower than pregnancies with normal blood pressure ( p < 0,001, Levene's test for equality of variances). The variation of z-scores compared to the control group were: VI:-3,9; FI: -6,38; VFI:-5,83. We fond that maternal blood pressure and pre-gestational BMI has great effect, but other factors has no significant effect on placental circulation. Conclusions: The direct three-dimensional measurement of placental vascularization should gather more and more ground because anomalies of uteroplacental and fetal vascularization appears too late, when complications are already developed. We suggest to apply FI in screening examinations, this index appears to be the most reliable index because of its low intra-placental variability. Lower placental vascularization indices seems to be a good ultrasound indicator for early diagnosis and prevention of complications in pregnancies with high blood pressure. P14.05 Abstract withdrawn P14.06Worst vs mean uterine artery PI in prediction of adverse pregnancy outcome
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