Electronic poster abstractsrelation to IO and position of centre of GS relative to midpoint axis of uterus had the highest diagnostic value. EP24.07Medical termination of pregnancy up until the 7th week of gestation in the Czech Republic: the role of ultrasound in diagnosis and follow-up P. Strasilova, M. Tozzi, V. Durdova, T. Kratochvilova, E. Hostinska, M. Lubusky Obstetrics and Gynecology, Palacky University Hospital, Olomouc, Czech RepublicObjectives: According to SmPC (Summary of Product Characteristic) and Czech National Guidelines (Recommendation of National OB/GYN Society), medical termination of pregnancy (MToP) in the 1st trimester can be carried out solely based on the woman's request up until the 7th week of gestation if the pregnancy is confirmed by ultrasound as an intrauterine singleton prosperous pregnancy, between day 42 and 49 of gestation, Crown-rump length (CRL) 2-9 mm. In addition, only ultrasound is able to diagnose ongoing pregnancy or missed abortion in MToP follow up. Methods: Prospective cohort study. In the years 2015-2016, a total of 194 pregnant women came to our medical facility and requested MToP, the women were 16-44 years of age (average 29.6, median 29), the diagnosis of intrauterine singleton prosperous pregnancy was set by transvaginal ultrasound, gestational age was 42-49 days (average 6.0, median 5). MToP was carried out by combination of mifepriston (600 mg orally) and misoprostol (400 mcg orally) within 48 hours. Follow up (verification of successful MToP) after 2-3 weeks was evaluated by transvaginal ultrasound as well. Results: In 11 women (5.7%) who requested MToP, an unprosperous pregnancy or CRL >9 mm was diagnosed, in the remaining 183 women MToP was carried out, but in 55 cases (30.1%) at least one additional Pre-First visit was needed before the diagnosis of intrauterine singleton prosperous pregnancy CRL 2-9 mm could be established, in 4 cases (2.2%) two Pre-First visits and in 1 case (0.5%) even three. In 16 women (8.7%) MToP follow up was missed and of the remaining 167 women, complete abortion (success) was diagnosed in 94.6% (158/167), incomplete abortion in 0.6% (1/167), missed abortion in 1.2% (2/167) and ongoing pregnancy (failure) in 3.6% (6/167). Conclusions: The role of ultrasound in the diagnosis of intrauterine singleton prosperous pregnancy is crucial and even MToP follow up cannot be fully replaced by assessment of hCG levels in serum or urine. SMI significantly reduces motion artefacts and can visualise low-velocity blood flow in small vessels. At 6 weeks' gestation from last menstrual period, ultrasonography showed an echoic cystic lesion in the uterine cervical mucosa without embryo instead of gestational sac in the uterine endometrium, therefore diagnosis of uterine cervical pregnancy was made. Power Doppler could not detect any blood flows around the cystic lesion, but SMI shows small vessels branched uterine artery via decidua (figures a and c). On the 7th day after administration of systemic MTX, reduced blood flow around gestational sac in th...
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