The fetal renal anteroposterior diameter on second- and third-trimester sonography is predictive of an increased risk for neonatal urologic surgery. Surgical risk is best predicted by a third-trimester renal anteroposterior diameter threshold of 15 mm.
INTRODUCTION:In an effort to decrease cesarean delivery rates, an institutional review of inductions performed at or beyond 39 weeks of gestation was designed to identify potential risk factors. METHODS:A retrospective chart review of patients undergoing an induction of labor between 39 and 42 weeks of gestation was performed at a single institution over a 7-month time period. Information abstracted included gestational age, parity, and Bishop score. Records were reviewed to determine induction agents, delivery route, and neonatal outcomes. RESULTS:A total of 236 patients was identified. Of these patients, 104 (44.1%) underwent induction for a medical indication compared with 132 (55.9%) for elective reasons. Overall the cesarean delivery rate was 18.6% (n544) with 75% secondary to a failed induction. Cesarean delivery rates between medical and elective inductions did not vary. When comparing elective inductions, multiparous women presented at a slightly earlier gestation (40.2 compared with 40.8 weeks, P,.005) yet the average Bishop score did not vary. Nulliparous patients who underwent elective induction were 2.3 times more likely to have a cesarean delivery than multiparous patients (26.2% compared with 9.0%, P,.05). The risk of a vacuum-assisted vaginal delivery for nulliparous women was 13.9 times more likely as compared with multiparous patients with elective induction (17% compared with 1.5%, P,.01). Despite no difference in the average Bishop's score, the risk of cervical ripening as a nulliparous patient was 3.09 as compared with multiparous patients (P,.001).CONCLUSIONS: Nulliparity is an independent risk factor for cesarean delivery and operative vaginal delivery in women undergoing elective induction of labor.
Oral communication abstractsduring treatment (T1, T2). We characterized change patterns that differentiate between responsive and non-responsive groups. Results: The overall response rate for 45 patients was 67%. Before chemotherapy, FI was significantly higher in responders than non-responders (P < 0.05). Receiver-operating characteristics curve analysis suggested that a sensitivity of 80% and a specificity of 73% can be achieved with an optimum FI threshold of 35.8. During treatment, we observed a dramatic change (increment or decrement) of VI at T1 stage in the responsive group, but not the non-responsive group. When the VI change was more than 42%, we could predict the final response to chemotherapy with a sensitivity of 84% and a specificity of 79%. Patients with VI change more than 42% had a response rate of 96% (26/27), in contrast, the remaining patients has a response rate of 22% (4/18) only (P < 0.001). Conclusions: By using 3D power Doppler, the initial FI and the VI change can be used as early predictors of patient response to neoadjuvant chemotherapy. OC24.04Ultrasound presurgical endometrial cancerGyn/Obs, University of Bari -Italy, Bari, Italy Objectives: The aim of this study was to assess the accuracy of transvaginal sonography (TVS) in the preoperative staging of endometrial carcinoma, because accurate preoperative staging of the disease would assist in planning the optimal course of treatment. We investigated the ability to distinguish between cases with < 50% and > 50% myometrial invasion (FIGO Stage Ia -Ib vs. Stage Ic), and tumor extension to the cervical stroma (Stage IIb) according to the old FIGO classification. Methods: 140 women with pathologically-proven of endometrial cancer, referred to our institution between 2007 and 2010, were included in this study. All underwent TVS examination about seven days before the surgical staging. Histological findings of myometrial and cervical stroma invasion were used as the reference standard. Results: The histological subtypes comprised 75% endometrioid adenocarcinoma, 9% serous papillary, 6% endometrioid villoglandular, 4% villoglandular, 3% adenosquamous and 3% clear cells; there were 60% well differentiate, 15% moderately differentiate and 25% poorly differentiate cancers. The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for TSV in the evaluation of < 50% myometrial infiltration were 82%, 77%, 79%, 80% and 48%; of > 50% myometrial infiltration were 86%, 90%, 86%, 90%, and 57%; for cervical invasion were 80%, 100%, 100%, 89% and 63% respectively. Conclusions: The transvaginal sonography shows good accuracy in the staging of endometrial carcinoma. Our results support a potential role of TVS for the prediction of strome cervix infiltration of endometrial cancer.Supporting information can be found in the online version of this abstract. Objectives: Previous studies have found an increased rate of malformations in pregnancies conceived via assisted reproductive technologies. The goal of this study was...
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