The objective of this study was to investigate the effect of lying and sitting positions on urodynamic parameters and diagnoses. This prospective study was carried out on 96 women with urinary incontinence who underwent urodynamic assessment. Cystometry was performed both in the lying and sitting positions. For filling cystometry, we infused normal saline at a rate of 50 ml/min. All the results were entered on the urodynamic database and were analysed using Minitab software release 13.30. Mean age was 49 (20-84) years. Sixty-four (67%) women complained of mixed incontinence, 16 (17%) of urgency alone, eight (8%) of stress incontinence and eight (8%) of urgency and urge incontinence. Two (2%) showed stress incontinence by lying cystometry, and 53 (55%) by sitting cystometry. During lying nine (9%) demonstrated detrusor overactivity, while 53 (55%) demonstrated detrusor overactivity in sitting position. No case of mixed incontinence was diagnosed by lying cystometry but 17 (18%) cases were detected by sitting cystometry. This study explains the higher detection rate of stress incontinence, detrusor overactivity and mixed incontinence by cystometry in sitting position. Therefore, we recommend that sitting posture is preferred over lying position for performing cystometry.

We report a case of vesicocervical fistula secondary to caesarean section. This is a rare complication of caesarean section, which was not recognised intraoperatively. Diagnosis was made clinically, radiologically and endoscopically during the post-operative period. Conservative management with indwelling catheterisation for 3 weeks failed. Hence the fistula was repaired surgically by an abdominal approach.

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th World Congress on Ultrasound in Obstetrics and GynecologyPoster abstracts anomaly scans are performed on all obstetric patients at twenty weeks gestation by obstetric sonographers and all suspected cases reviewed by fetal medicine consultants. Cases were identified from a departmental logbook, delivery suite register and the regional anomaly registry. Information was obtained regarding antenatal diagnosis, follow-up, postnatal confirmation and fetal outcome. Results: One hundred and three confirmed anomalies were diagnosed antenatally and twenty-one resolved spontaneously. Of the eightytwo that persisted sixty-eight were confirmed postnatal. Eight cases were initially diagnosed postnatal. The overall detection rate was eighty-nine percent, false positive rate -14% and the false negative rate -8.2%. Common anomalies were renal (20%), gastrointestinal (20%) and central nervous system (16%). There was a 331/3% mortality associated with gastrointestinal anomalies compared to 7% with renal cases although the latter had double the intensity of follow-up. Conclusions:The detection rates met generally accepted standards. Gastrointestinal anomalies had a higher rate of poor fetal outcome prompting a need for increased surveillance when diagnosed and patient counselling. The findings should lead to the development of a more accurate patient information booklet based on local data. P061 Antenatally diagnosed malformations in a Perinatology Hacettepe University Hospital, TurkeyObjective: To investigate the results of prenatally suspected malformations in a tertiary referral center and study their impact on perinatal mortality. Methods: Obstetric ultrasonography records of the Perinatology Unit between 1998-2002 were retrospectively reviewed. Follow-up data was obtained from hospital charts in the Neonatology and Pediatric Pathology Units. Results: 379 cases were referred to the unit for ultrasonography were suspected to have fetal malformations. Urinary system malformations were most commonly encountered (25.6%), followed by CNS malformations (21.1%). Mean gestational age at the time of referral was 25.7 weeks ranging between 12-41 weeks. Termination of pregnancy was performed in 64 patients (16.8%). Ten cases of chromosomal aneuploidies were detected in the fetal anomaly group (2.6%). Total number of births during this period was 7417. Perinatal mortality rate was 31 per thousand, and the rate of perinatal mortality attributable to major malformations was 33.9% during the last 5 years. Conclusion: Gestational age at the time of referral and diagnosis is important in order to reduce perinatal mortality rate that is attributable to fetal anomalies. Objective: Evaluate and document improvement in clinical obstetric practice based on the use of routine second trimester ultrasound for all pregnancies followed. Methods: All pregnancies delivered at Mayo Medical Center during a 2 year period were evaluated for clinical outcomes and compared with ultrasound results. Routine obstetric ultrasound was done at 18-20 weeks gestatio...