OC20.01: Preoperative mapping of deep infiltrating endometriosis in the posterior compartment using transvaginal strain elastography and IDEA classification

Abstract

Objectives: Severe neonatal hypoglycemia (SNH) can cause brain injury and long-term neurodevelopmental impairment. The aim of this study was to investigate the diagnostic effectiveness of ultrasound markers measured in the third trimester as predictors of SNH and determine if current practice can be improved. Methods: An unselected cohort of 6250 singleton fetuses had a universal 36 week scan in a single tertiary referral centre (2016)(2017). The variables included in the analysis were the criteria used in current practice to predict SNH (birthweight (BW) < 10 th centile, pre-existing diabetes, gestational diabetes, gestational age at delivery) and cerebro-placental ratio (CPR), AC growth velocity (ACGV), maternal body mass index (BMI) and fetal gender. The ACGV was defined as the Z-score AC difference between 20 and 36 weeks. Our outcome was SNH defined as glycemia < 2.0 mmol/l within 4 hours of delivery and requiring admission to neonatal unit. Univariate and multivariate logistic regression analyses were used to assess the association between these variables and SNH. The receiver-operating characteristics curve (ROC) analysis was used to investigate the predictive accuracy of the current practice model and determine if adding new markers could improve the detection of SNH. Results: A total of 143 (2.3%) neonates had SNH. The current practice model showed an area under the curve (AUC) of 0.69 (95% confidence interval (CI), 0.68-0.71). Our predictive model (AUC, 0.77; 95% CI, 0.76-0.78) included the current practice variables and CPR (odds ratio (OR) 0.44; 95% CI, 0.28-0.69), ACGV (OR 1.43; 95% CI, 1.19-1.72), BMI (OR 1.01; 95% CI, 1.001-1.015) and male gender (OR 1.90; 95% CI, 1.28-2.82). Adding CPR < 5 th centile (OR 3.42; 95% CI, 2.01-5.82) and ACGV > 90 th centile (OR 2.30; 95% CI, to the current practice model showed AUC 0.73 (95% CI, 0.72-0.74). Conclusions: Using CPR and ACGV in addition to the predictive criteria currently used in clinical practice improves the identification of neonates at risk of SNH. axial or anteverted/retroflexed uterus was associated with a negative sliding sign (p < 0.001). Conclusions:We have shown that the prevalence of POD obliteration on ultrasound evaluation in the general population

Transvaginal Strain Elastosonography May Help in the Differential Diagnosis of Endometriosis?

“…Due to scarring, they show with color Doppler only a minimal signalling. We have previously reported that infiltrating lesions of rectal endometriosis appear to be stiffer than sections of healthy intestinal wall by transvaginal strain elastosonographic examination [ 2 ] ( Figure 1 A). A strain ratio (SR) of 2.0 serves as a cut-off value for the optimal distinction.…”