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Electronic poster abstractsfrom both sides of the bladder. The presence of SUA was also checked at the second (18-21 weeks) scan and after delivery by visual assessment of placenta. Concordance between first and second trimester findings was compared. Results: Prevalence of SUA was 0.92%. In 8.7% of cases the number of vessels in the cord was not possible to assess. Sensitivity, specificity, positive and negative predictive value for the finding in the first trimester were 92, 99.8, 79 and 99.9% respectively. In 31% of cases the fetus had associated malformations. With an ultrasound at 12-14 weeks most of the cases with significant fetal malformation were diagnosed. There was high concordance between the findings in the first and second trimester scan (coefficient of correlation 0.89). Conclusions: SUA is a useful marker for fetal malformation in the first trimester. It allows detection of a large number of cases with malformations before 20 weeks of gestation.The diagnosis of SUA at the first trimester scan is accurate and reproducible in the second trimester, so we could recommend to include its assessment into the protocol of 11-13 weeks scan. EP08.07Estimation of gestational age at 11 to 13 + 6 weeks of gestation using fetal biparietal diameter in a Korean population Objectives: To evaluate fetal biparietal diameter (BPD) between 11 and 13 + 6 weeks' gestation in pregnant Korean women after in vitro fertilisation (IVF), to construct reference charts for estimation of gestational age and to compare these charts with well-established standards. Methods: Data were retrospectively collected on 536 singleton Korean pregnancies conceived after IVF that underwent sonography between 11 and 13 + 6 weeks' gestation. The BPD was measured from the outer to the inner edge of the parietal bone in a transverse plane. Gestational age was calculated by adding 14 to the number of days between the date of oocyte retrieval and the date of the ultrasound scan. Results: We developed a new chart of BPD for the Korean population to estimate gestational age between 11 and 13 + 6 weeks. The BPD of Korean pregnancies was similar to previously described estimations at 11 weeks of gestation, but tended to be greater with advancing gestational age than those predicted by the formulas of Selbing and Kjessler. The best-fit equation for estimation of gestational age from BPD was GA (day) = 83.3571 − (0.8742 × BPD) + (0.0498 × BPD 2 ); and SD = −0.09850 + (0.08659 × BPD). Conclusions:The described chart may improve the accuracy of estimating GA in Korean pregnant women in the late first trimester.Supporting information can be found in the online version of this abstract Objectives: Assessing the angiogenic factors levels and the Doppler parameters in healthy controls and fetal growth restriction (FGR). Methods: This case-control study included 66 patients with diagnosis of FGR and 64 healthy pregnancies at 24-41 weeks of gestation. For both groups, maternal circulating concentrations of angiogenic factors of soluble fms-like tyrosine kinase-...

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The maldevelopment of the spiral arteries in the placental bed reduces uteroplacental blood flow and results in diseases later in the pregnancy. These diseases are here called the uteroplacental vascular syndromes. These syndromes have serious consequence for both the infant and the mother. These pregnancies with a maldeveloped uteroplacental circulation can be detected in the first twenty weeks of pregnancy with uteroplacental Doppler studies. This predictive ability can be improved with addition of maternal biophysical and historical data and biochemical testing of the maternal blood. Prophylactic therapy with aspirin and other antioxidants improves outcomes in some if not all of these syndromes. The potential for these syndromes is probably 15% to 20% of nulliparous pregnancies. Further research needs to be done to clarify the above facts and thus better detect these pregnancies and improve interventions and outcomes. The research into the early detection and improving the outcomes of these pregnancies, with otherwise normal mothers and infants, takes a much lower financial profile than the early detection of abnormal foetuses.

From December 1996 to March 2004, 27 consecutive patients (both private and public) presented with large uterine fibroid masses to be removed, which subsequently weighed 500 g or more. All were scheduled for a laparoscopic hysterectomy procedure where the uterine vessels are secured laparoscopically using a linear cutterstapling device. The data from these cases was collected prospectively. Twenty-six of the large uterine fibroid masses were successfully removed by planned laparoscopic hysterectomy without major complication. One case had to be opened because of dense pelvic adhesion, and it was the case with the largest mass in the series (1,280 g). The mean weight of the removed masses was 704.6 g (range: 500-1,280 g). Operating times were long (mean 220 min), but the postoperative stay was short (mean 2.26 days). Laparoscopic hysterectomy a using linear cutter-stapling device to secure the uterine vessel pedicles for large uterine fibroid masses is a useful and effective procedure in most cases with fast patient recovery.

is a valid perspective. We agree with the analogy of an automobile recall, which is appropriate if something is defective, but this doesn't work in the health care world where there is little money to fix needed changes in design or recover from mistakes. Unfortunately, we muddle through with worn brakes, broken turn signals, low fuel mileage, loose steering, and try to get through our required inspections, while preserving a quality driving and safe passenger experience.

We retrospectively analysed our first 1,275 laparoscopic hysterectomies for ureteric injuries. All patients scheduled for hysterectomy in two private gynaecological practices in Sydney and Adelaide over the past decade were offered laparoscopic hysterectomy using a linear cutter stapling device for securing uterine vascular pedicles. The stapling of the uterine vascular pedicles resulted in the injury of four ureters in the first 275 cases (1.45%), whereas in the subsequent 1,000 cases there was only one such injury (0.1%). In light of our data and the reviewed literature, we conclude regarding ureteric injury at laparoscopic hysterectomy that: in the early days it was probably more the result of surgical inexperience and technique development rather than instrument failure; in experienced hands and with a perfected technique the rate is probably no higher than for abdominal hysterectomy; in experienced hands the rate is probably similar whether stapling or bipolar diathermy is used to secure the uterine vascular pedicles.

Obesity is an increasingly prevalent condition in our society. The majority of hysterectomies are still being undertaken abdominally. Obese patients have a high rate of complications from abdominal surgery. Laparo-vaginal hysterectomy has a faster recovery than abdominal hysterectomy. If the uterine vessels are ligated laparoscopically at laparo-vaginal hysterectomy, there is a low conversion rate to abdominal hysterectomy. The aim of this study was to establish whether laparoscopic hysterectomy is a feasible alternative in obese patients. A 7-year audit of patients requiring a hysterectomy identified 27 women weighing 100 kg or more. All patients gave informed consent to an initial laparoscopic procedure, having been assessed as suitable for such, and then had a laparoscopic hysterectomy performed. Data regarding their operation was prospectively collected and retrospec-tively reviewed. All patients had successful laparoscopic hysterectomies with none requiring conversion to open operation, reoperation or readmission. There were no major complications. The postoperative stay was short (mean 2.4 days), but operation times were long (mean 175 min). Laparoscopic hysterectomy is a feasible alternative to abdominal hysterectomy in obese patients weighing 100 kg or more with low morbidity and fast recovery with short hospital stay.