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An inverse association between the use of a LHA in patients with PPH due to bleeding of the placental bed and the need to perform an emergency obstetric hysterectomy was observed. Additionally there was a significant reduction in the mean duration of hospital stay, use of hemoderivatives and admission to the ICU.

Body stalk anomaly is a rare and severe malformation syndrome in which the exact pathophysiology and trigger factors are still unknown. This is a case of a 30-year-old patient who underwent ultrasound at 9 weeks of gestation. It revealed an abnormal location of the inferior body of the embryo in the coelomic space. The findings suggested a short umbilical cord syndrome. In order to confirm the diagnosis, the patient was scheduled for a second ultrasonography at 11 weeks of gestation. The obtained images, confirmed the location of the inferior body in the coelomic space with no visible bladder, absence of the right leg, severe abdominal wall defect, consistent with an omphalocele, and a short 5 mm umbilical cord. These last ultrasonographic findings were consistent with body stalk anomaly. Because of severe malformation incompatible with life, the patient was offered termination of pregnancy. Pathologic examination confirmed the suspected pathology of body stalk anomaly.

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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.

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.

Poster abstracts 88.7%, 86.8% and 92.5% for CD, PD and e-flow, respectively. Negative and positive predictive values for e-flow estimation were 97.4% and 78.6%, respectively. Prognostic values of analyzed methods in our group of patients based on the area under ROC was: 0.940, 0.945 and 0.960 respectively. Conclusion: E-flow technology applied in ultrasonographic Doppler index is useful to make a prognosis of ovarian tumor malignancy.

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