Oral poster abstracts (UtR), and estimate the fraction of CO distributed to the uteroplacental circulation during the second half of pregnancy. Methods: Fifty-three low risk-pregnancies were evaluated longitudinally at approximately 4-weekly intervals from 22 weeks until term (a total of 253 observations). Mean arterial blood pressure (MAP), CO and SVR were measured using impedance cardiography, and the uterine artery blood flow velocities and diameter using Doppler and B-mode ultrasonography, respectively. Quta of both uterine arteries was estimated as the product of time-averaged intensity weighted mean velocity and cross-sectional area of the uterine artery. UtR was calculated as: MAP/sum of right and left Quta. Results: CO increased from 5.5 to 5.8 L/min (p = 0.006) despite a significant increase in SVR from 1046 to 1135 dyne s cm-5 (p = 0.0077) during 22-40 weeks. The UtR decreased from 0.26 to 0.13 mmHg/mL/min (p < 0.00001) and the total utero-placental blood flow more than doubled during the same period increasing from 299 ml/min to 673 ml/min which represented 5.6% to 11.7% of the maternal CO. Conclusion: We have established longitudinal reference intervals for the fraction of maternal CO distributed to the utero-placental circulation at 22-40 weeks of gestation. Increments in uteroplacental blood flow are relatively higher than that of the CO in the second half of pregnancy suggesting redistribution of maternal circulation due to continuous reduction in UtR.
In summary a combined therapeutic approach employing local and subsequent parenteral injection of MTX with close follow up of the gradually diminishing vascularization around the chorionic sac is a reasonable therapeutic approach for the increasing number of first trimester CSPs. Determination of vascularity seems to be an important measure of healing in addition of the βhCG.Patients after Cesarean deliveries, should be encouraged to present between 6-8 weeks of a subsequent pregnancy for possible and early detection of this threatening entity.
P08.02The role of ultrasound in prenatal diagnoss of the pathological invasion of placenta into the myometrium M. Kotori, F. Muhaxhiri, S. Lulaj
Department of Gynecology and Obstetric, University Clinical Center, Prishtina, AlbaniaIntroduction: The placenta accreta, increta and percreta are the pathological features of the placenta insertion in myometrium. They are present in 1 : 2500 of pregnancies, in 4-10% of the cases with placenta praevia. Based on the serious obstetric complications which can appear from the pathological insertion of the placenta such as massive bleeding, hemorrhagic shock, the need for transfusion, for hysterectomy, infections, intraoperative lesions of the urinary bowel, and maternal death, this is the main need and interest of the prenatal diagnosing of this pathology. Objective: To investigate the possibility of prenatal diagnosing of this pathology with the ultrasound. Material and methods: In the study are included 84 pregnant women with the low insertion of placenta and with bleeding in the second and third trimester. They were examined with ultrasound with abdominal probe 3.5 MHz for searching of the characteristic signs of the pathological insertion of placenta in the depth of myometrium such as: the absent of the hypoehogenic retroplacentar-myometrial zone, the absent of the smooth surface with urinary bowel, the presence of the vascular lacunas (''Swiss cheese''). Results: From the 6 cases with placenta praevia accreta and increta, 5 (83.3%) were diagnosed in prenatal period with the ultrasound. Conclusions: The ultrasound examinations enable the prenatal diagnosing of the pathological invasion of the placenta in the myometrium and help us in preoperative preparation and intraoperative management.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.