Congenital hypoplasia of the femur is a principal sign in four uncommon malformations: proximal femoral focal deficiency (PFFD), femurfibula-ulna (FFU) complex, femoral hypoplasia-unusual facies syndrome, and limb/pelvishypoplasidaplasia syndrome. To the best of our knowledge, few reports of ultrasonographic prenatal diagnosis of PFFD,lP3 of FFU ~o m p l e x ,~ or of limb/pelvis-hypoplasia/aplasia syndrome5 have been described. The aim of this report is to present a new case of antenatal ultrasound diagnosis of severe hypoplasia of the left femur associated with ipsilateral absent fibula, anterior bowed tibia, and agenesis of two toes. CASE REPORTA 29-year-old woman, in her second pregnancy, was referred to the Maternity Care Unit of Galliera Hospital at 23 weeks, menstrual age (MA). Her first pregnancy resulted in a full-term spontaneous vaginal delivery of a healthy infant. There was no family history of congenital malformations. The present pregnancy was uncomplicated.A routine real-time ultrasound examination showed a very short left femur and ipsilateral absent fibula with bowed tibia (Figures 1A and 1B). The upper limbs and right lower limb had a length at 50th centile [according to the standard growth curves by Romero et a16 (19SS)l; the biparietal diameter was 55 mm (50th centile). No ecographic evidence of defects of internal organs was present. By amniocentesis, karyotype revealed a 46 XY fetus, and alpha-fetoprotein was within the normal range.

The aim of the study was to analyse the dynamic anatomical supports of the posterior vaginal wall from the perspective of rectocele and rectal intussusception repair. Two groups of patients were studied. Group 1 (n = 24) with genuine stress incontinence but no major vault prolapse had vagino/proctomyograms and transperineal ultrasound examinations. Group 2 with vaginal vault prolapse, clinical rectoceles and obstructive defecation symptoms (n = 19 had single-contrast defecating proctography before and after posterior-sling surgery. The posterior vaginal wall is suspended between perineal body, which underlies half its length, and uterosacral ligaments, which also support the anterior wall of rectum. Muscle forces stretch the vagina and rectum against the perineal body and uterosacral ligaments, creating shape and strength, like a suspension bridge. Postoperative proctogram studies indicated that anterior rectal wall intussusception has the same etiology as rectocele, deficient recto-vaginal ligamentous support. Repair to uterosacral ligaments and perineal body should be considered with large rectoceles, anterior rectal wall intussusception and obstructive defecation disorders.

This large cross-sectional study suggests that postmenopausal women are at higher risk of type 2 diabetes after allowance for the effect of age. Other main determinants of risk of type 2 diabetes in women around menopause were low socioeconomic status and being overweight. Diabetes was found less frequently in those taking hormone replacement therapy.

Background: Genitourinary syndrome of menopause (GSM) is the new term for vulvovaginal atrophy (VVA). The condition is relevant in more than 50% of women, having an adverse impact on quality of life and sexual relationships. Objective: To assess the efficacy and safety of a new type of non-ablative laser, Solid State Vaginal Laser (SSVL), for vaginal tissue regeneration and rejuvenation. Method: Eighty participants with GSM symptoms were treated with a total of 4 treatments in about two months (every 15 -20 days) of a nonablative SSVL (LASEmaR 1500™-EUFOTON). A cumulative intensity of GSM symptoms using a 10-cm VAS (dryness and/or burning and/or dyspareunia), the vaginal health index (VHI), the Female Sexual Function Index (FSFI) were evaluated. Urinary Incontinence Short Form (ICIQ-UI SF) and vaginal bioptic samples were also collected. Results: Improvement following the SSVL was observed on VHIS, VVA symptoms and sexual female function. This finding was also ratified by the improvement of vaginal histological features. After the SSVL treatment, almost all patients (91%) affected by urinary incontinence obtained the complete remission of symptoms. Conclusion: The objective evaluation of VHIS, FSFI and ICIQ-UI SF scores and the histological results indicates a real favorable effect of SSVL on GSM and on urinary incontinence.

Nulliparity and lifelong irregular menstrual cycles are associated with an increased risk of preterm ovarian failure.