Although severe hemolytic disease in patients with partial D is rare, this neonatal death illustrates the need for a change in management of women with weak D.
The qualitative and quantitative effects of bladder and vaginal balloon volumes on the sonographic diagnosis of paravaginal defects were evaluated. Transabdominal ultrasound measurements were performed on patients with stage 4 prolapse and coexisting paravaginal defects (study group) as well as on nulliparous patients without prolapse or paravaginal defects (control group). Paravaginal defects were measured, first without a water-filled condom in the vagina, and then sequentially with a 30, 60 and 90 ml water-filled balloon in the vagina at bladder volumes of 150 and 300 ml. Paravaginal defects were detected on transabdominal ultrasound in both groups. In both the study and the control groups the size of the paravaginal defect was directly related to the size of the balloon placed in the vagina (P<0.0001). There were no significant differences in the size of the paravaginal defects measured at a bladder volume of 150 ml compared to those measured at 300 ml. We conclude that transabdominal ultrasound is not useful in detecting paravaginal defects.
point based risk score based only on the presence of model variables (0-1 low, 2-3 medium, and 4-5 high risk). RESULTS: Among 36,188 delivery admissions, there were 869 cases of SMM (2.4%). Gestational age was the best single variable predictor for SMM (AUC 0.62). Using our development sample, our final model was saturated at 4 variables: gestational age, obesity, preeclampsia, and a composite for bleeding risk (Table 1). This model performed moderately well at predicting risk for SMM (AUC 0.74). In our test sample, both probability and point based risk stratification discriminated SMM risk across low, medium, and high risk categories (Table 2, p< 0.001). CONCLUSION: Predicting delivery admissions at highest risk for SMM is feasible using a parsimonious point based risk stratification model. This model is practical to implement, can be used to inform hospital resource allocation, and is comparable in accuracy to existing risk tools for other obstetric outcomes.
Virtual poster abstractsthe cervix allowed us to perform correctly a cerclage, delay delivery and prevent extreme prematurity.
VP44.08Silent rupture of myometrium scar in pregnancy
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