Objective To assess the neurodevelopmental outcome of children with prenatally diagnosed isolated microcephaly defined as head circumference more than 2 SD below the gestational mean. Methods
Oral communication abstractsEP in women with an IMLE in combination with HCG levels were calculated. Results: The prevalence of EP was 3.7% in this population of women who attended our early pregnancy unit. A total of 1627 women were scanned, of which 134 (8%) were classified as PUL. Of the PUL group, 27 women were subsequently diagnosed with EP or persistent PUL requiring treatment (20%), 89 women with failing PULs (66%) and 18 women with IUPs (14%). Of the 134 women with a diagnosis of PUL, 37 had an IMLE and 97 had a disrupted MLE on ultrasound. The incidence of EP in those with IMLE was significantly higher than those with a disrupted MLE {13(35%) v 14(14%) (p<0.01), RR 2.05 (95% confidence interval 1.2-3.5)}. An IMLE alone to predict EP had a sensitivity of 49%, specificity of 78% and a positive LR of 2.13. Combining an IMLE and HCG 48hr/0hr ratio 0.67-1.66 (plateau) predicted EP with a sensitivity of 41%, specificity of 93% and a positive LR of 5.4. Conclusions:In combination with the HCG ratio, the sonographic appearance of an IMLE may be a useful predictor of EP in women with a PUL. Methods: Prospective observational study. Pregnant women presenting to our EPU in the study period underwent transvaginal scan (TVS). Women with TVS diagnosis of an ectopic pregnancy (tubal or non-tubal) were offered either conservative (expectant or medical) or surgical management depending on her clinical state, ultrasound findings and pre-treatment hCG ratio (hCG 48 h/hCG 0 h). Expectant management was offered to clinically stable women with hCG ratio < 1; medical management was offered to clinically stable women with hCG ratio > 1. If a woman was clinically unstable, and/or fetal cardiac activity was noted on TVS and/or there was significant haemoperitoneum was noted on TVS, then surgery (salpingectomy) was performed. More than 30 historical, clinical, TVS and biochemical variables were recorded for analysis. TVS measurements included endometrial thickness (ET), type of EP, blood in POD/Morison's pouch & subjective power Doppler colour scores (PDCS). Serum hCG 0 h & hCG ratio underwent logarithmic (log) transformation for comparison. These recorded variables were analysed to determine presence of significance between three groups. P-values < 0.05 represented statistical significance. Results: 1395 consecutive women presented to EPU. 5.3% (75/1395) were diagnosed EP. Complete data available on 73 EPs. The three management groups were compared: the most significant variables were ET (p=0.0086), vaginal bleeding with clots (p=0.0110), PDCS 1 (p=0.0241) and log serum hCG 0 h (p=0.0012) were all significant variables. Conclusions: These preliminary results demonstrate only a few variables were significantly different between non-surgical and surgical management arms. We are now developing a new model to predict successful conservative management. Objective: Microcephaly is defined as a head circumference smaller than 2 or 3 standard deviations. The prenatal counseling for fetuses with isolated microcephaly is complex as there ...
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