Objective To ascertain the prevalence and clinical significance of small hyperechogenic foci detected in the fetal left ventricle in routine ultrasound screening of pregnant women attending our hospital. Population and methods From April 1994 to April 1995, 1135 consecutive pregnant women examined at the obstetric ultrasound unit of our hospital were studied prospectively. A postnatal cardiologic examination was performed when signs of cardiopathy were observed at the prenatal ultrasound investigation or the neonatal examination. Results Congenital heart disease was detected in 10/1148 infants born (0.9%); eight diagnoses were made prenatally (detection rate 80%). The prevalence of left ventricular hyperechogenic foci was 3.2% (37/1148 fetuses). In 35 cases (94.6%) the foci were no longer observed at the routine third trimester examination. Only in two cases (5.4%) did foci persist at the postnatal examination but without clinical signs of cardiopathy or karyotype anomalies. No association was observed between foci and major structural abnormalities. The foci were single in 32 cases (86.5%). Four foci (10.8%) were located at the interventricular septum, five (13.5%) bilaterally at the papillary apparatus of the mitral valve, and the others at the ventricular wall. No focus was associated with incompetence of the affected valve, whereas five (13.5%) were associated with a fetal disorder. Conclusions The prevalence of intracardiac hyperechogenic foci in our general population considered at low risk was more than five times greater than that reported in the literature. Foci were not associated with structural heart defects or chromosomal abnormalities. Persistence during the third trimester and postnatal life was rare and without evident signs of heart disease.

Ruff'iW and M.P. Canalek 9ml"rnrnrr efohnt-,,io mnd ovnpeo,opr md~irobiolonv. s. oemrdo Hmp;m/, ""!"e/s~~Y 0,Mil.R MO"Z,? ,md%Iwi&l, safety &I efficacy of sulbactam/amp~icil[in w&v compared to that of cefotetan in 95 hospital pa&ts with gy&&ogic or obstetric infeckws. Sulbackun/ampiciUin (I g:2 sl. iyys admiGsierea* i.Wrwxx& evc,~ ,D h to 46patients, and c&Man (2 g) was administered intravenously every 12 h to 49patients. Ail 23 patients with obstetric infections and 18 of the 23 patients with gynecologic infections vented iuith sulbactam/ampiciilinwere evahroizd ascured. All 21 palien& with obstetric infections and 23 of the 28 patients with gyneckgic infecakwzs treated with cefotetari were evaluated as cured. No side effects requiring discontinuation of rherapy or reduction of the dose administered, were observed.

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The vaginal administration of 2.0 mg of PGE2 gel seems to be equally effective as 3.0 mg in terms of labor success rate with a significant lower incidence of side effects.