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Background: Detection of placental mRNA in maternal plasma has been reported in high-risk pregnancies. We attempted to investigate the concentrations of plasminogen activator inhibitor-1 (PAI-1) and tissue-type plasminogen activator (tPA) mRNA in maternal plasma in preeclampsia. Methods: Peripheral blood samples were obtained from healthy pregnant women before and after delivery and also from women with or without preeclampsia. Plasma was isolated from these samples, and RNA was extracted. Plasma PAI-1 and tPA mRNA concentrations were then measured by use of reverse transcription PCR assays. The concentrations were converted into multiples of the median (MoM) of the controls adjusted for gestational age. Data were stratified and analyzed according to the clinical severity of preeclampsia and quantitative distribution of blood pressure and proteinuria. Results: The median (minimum-maximum) PAI-1 mRNA MoM values for women with preeclampsia and controls were 2.48 (0.82-8.53) and 1.00 (0.41-2.33), respectively, whereas the median (minimum-maximum) tPA mRNA MoM values were 3.33 (1.01-10.58) and 1.00

Fetal tumors are sporadic entities and in some cases can be diagnosed prenatally. A team approach, incorporating the skills of obstetricians, radiation therapists, pediatric medical oncologists and hematologists, neonatal surgeons, rehabilitation specialists, and social workers, is imperative to ensure that the patient receives the best treatment. Retinoblastoma is a relatively uncommon tumor of childhood that arises in the retina. The estimated annual incidence is between 1 in 15,000 and 1 in 34,000. Although it may occur at any age, it most often arises in younger children, with 80% of cases diagnosed before the age of 5 years. We report a case of prenatally diagnosed fetal retinoblastoma.

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The role of sexual transmission of microorganisms in bacterial vaginosis (BV) is controversial. If sexual intercourse were a risk factor for BV, then we would expect that women with BV would also be coinfected with other sexually transmitted diseases (STD). We investigated the prevalence of STD among pregnant women a low socio-economic status with bacterial vaginosis in Indonesia. Among these women, 23.3% had at least one STD (chlamydia, gonorrhoea, syphilis or trichomoniasis). Chlamydial infection was the most prevalent (19.5%), followed by trichomoniasis (3.8%), gonorrhoea (3.2%) and syphilis (0.4%). Compared to the rates of STD observed in a previous study of all pregnant women (with or without BV) in Indonesia, pregnant women with BV have more than a 2-fold increase in chlamydia (19.5% vs 8.2%) and a 6-fold increase in gonorrhoea (3.2% vs 0.5%). Because detection of BV by Gram stain is easy to perform and economical, detection of BV has potential as a prescreening marker for chlamydia and gonorrhoea among asymptomatic pregnant women of low socio-economic status in Indonesia. Further work is needed to evaluate the usefulness of BV as a prescreening marker for chlamydia and gonorrhoea.

Although three-dimensional ultrasound (3DUS) has been available for more than 10 years in Indonesia, there was no publishing article from our region which systematically evaluates our experiences in this most recent ultrasound technologies and its application to obstetric. 3DUS is revolving into a technology with various range of applications in numerous fields because it helps overcome some of the key limitations related to two-dimensional imaging. It is through this review that we attempt to develop a continuous line of understanding the current diagnostic benefits of 3D and 4DUS in diagnosis of fetal abnormalities and consider the utility and role of this type of imaging in the routine clinical practice.

Purpose: To evaluate the efficiency of transvaginal ultrasound in the early diagnosis of ovarian cancer. Methods: Screening transvaginal ultrasound has been annually performed during the last 2 years in asymptomatic women without familial history of ovarian cancer. When abnormalities were detected, the procedure was repeated after 4-6 weeks. If the findings disappeared, the study was repeated after 1 year. If the abnormality persisted, study was complemented with tumor markers, computed tomography and laparoscopic surgery. The findings were compared with a control group of women in whom ovarian transvaginal ultrasonography was formally indicated. Results: A total of 26007 transvaginal ultrasound were performed: 8813 (33.8%) belonged to the screening group and 17194 (66.2%) to the control group. In 14 patients of the screening group, a malignant tumor was diagnosed and histologically confirmed. The mean age of these patients was 45 years old (SD 12). Eleven of these tumors were stage I (seven Ia, and four Ic), two stage IIIc and one was a metastatic melanoma in both ovaries. Six lesions were borderline tumors (five serous and one mucinous). In the control group, 27 ovarian cancers were diagnosed in patients with a mean age of 48 years (SD 17). In this group, 11 tumors were in stage I, and six were borderline. Conclusions: Although consensus about the benefits of using transvaginal ultrasound as a screening procedure is not conclusive, our data reveals that tumors detected in patients screened with transvaginal ultrasound are in earlier stages when compared with those diagnosed in the control group. No differences were found in age and number of borderline tumors between both groups. Additional studies are needed to support this preliminary findings. P02Endometrial sampling during sonohysterography (SHGes) E. Ferrazzi, C. Lanzani, N. Ciminera & V. Conserva Purpose: To assess the diagnostic accuracy of sonohysterography (SHG) and endometrial sampling during SHG (SHGes) compared to traditional hysteroscopy and biopsy. Methods: Seventy-two consecutive patients with irregular bleeding and/or intracavitary abnormalities underwent transvaginal sonography (TVS) and SHG. SHG was performed with a 4.7-mm intrauterine catheter. In all patients, an endometrial biopsy was performed by a syringe vacuum aspiration at the end of SHG. Procedure-related pain was assessed. Sonographic findings at SHG were defined as normal, focal lesions or diffuse endometrial abnormality. In patients with diffuse endometrial abnormality, hysteroscopy and hysteroscopic guided biopsy were performed. In patients with focal lesions, an operative hysteroscopy was performed. Pathologic report was the gold standard. Results: Mean age was 48 years (interquartile range 38-54). At SHG, no pain, mild, and severe discomfort was reported by 75, 18 and 7% of patients, respectively. Fifty patients underwent hysteroscopic guided biopsy, 22 operative hysteroscopy. Hysteroscopic findings were compared to SHG-SHGes finding. (A) Benign lesions: in 56 cases SHG and SHG...