To compare the pre-surgical ability of a multivariate predictive algorithm combining CA 125, HE4 and menopausal status (ROMA) vs. ultrasound (US) imaging performed by an experienced examiner, for estimation of the risk of malignancy in patients with adnexal masses. Methods: Prospective multi-center, double blind, clinical trial enrolling patients presenting with adnexal masses and candidate for surgical treatment. Blood samples for HE4 and CA 125 measurements and US were performed within 30 days prior to surgery. Masses were classified by US according to IOTA criteria: the examiner classified each mass as certainly or probably benign, difficult to classify, or probably or certainly malignant. A separate self impression of presumed histological diagnosis was given. Separate logistic regression algorithms for pre-and post-menopausal women were utilized to categorize patients into low and high risk group for ovarian cancer (ROMA). Outcome measures were sensitivity (Sens), specificity (Spec), positive predictive value (PPV) and negative predictive value (NPV) of ROMA, CA 125 and HE4 and US in discriminating adnexal masses. Results: To date 51 patients entered in the study. At final pathology there were 23 malignancies, 3 borderline tumors and 25 benign diseases. The different tests performed as follow: US (Sens 100%,

Introduction No research has examined the impact of any physical-artistic-cognitive activity on foetal neurodevelopment. The aim of the study was to investigate the efficacy of a unique prenatal dance activity in pre- and postnatal cognitive and motor development as a complementary health care practice. Methods 26 clinically uncomplicated primiparas and multiparas with singleton pregnancies and their later born children were examined in this prospective study at the University of Pécs, Hungary. The activity group participated in supervised, 60-min, twice-weekly, moderate-intensity prenatal dance classes for 19.56 ± 3.97 weeks, whereas the control group did not. We determined the developmental ages of their children with the Bayley Scales of Infant and Toddler Development in both groups at 5 weeks of age and in the activity group at 33 months of age. Results Prenatal dance activity did not cause any adverse outcomes. Infants in the activity group had significantly higher mean developmental ages than the control group regarding cognitive skills (P < 0.001), receptive (P < 0.001) and expressive communication (P = 0.007), fine (P < 0.001) and gross motor (P = 0.001). As toddlers their mean developmental ages were significantly higher than their mean calendar age regarding cognitive skills (P = 0.001), receptive (P = 0.001) and expressive communication (P = 0.001), fine (P = 0.002) and gross motor (P = 0.001). Conclusions Our results confirm the safe implementation of this prenatal dance activity and the more advanced cognitive and motor development of children in the activity group as infants compared to the control group and as toddlers compared to the norm. These results offer a novel approach to dance in pre- and postnatal clinical practice.

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Placental insufficiency and fetal growth restriction may lead to fetal hypoxia and acidemia, which result in fetal cardiac injury. The aim was to compare the levels of fetal cardiac troponin T (cTnT) at birth according to fetal gender in pregnancies complicated by placental insufficiency before 34 weeks gestation. Methods: Between March 2007 and Feb 2010, 45 singleton pregnancies with placental insufficiency characterized by abnormal umbilical artery Doppler were prospectively studied. All the patients delivered by Cesarean section and the Doppler exams were performed at the same day. Immediately after delivery, UA blood samples were obtained for fetal cTNT measurements. Fetal cardiac injury was characterized by abnormal level of fetal cTnT at birth (>=0.10 ng/mL). Results: Fetal cardiac TnT at birth was significantly higher in the group of male fetuses (n = 20, 44.4%) when compared with female fetuses (mean = 0.137, SD = 0.095 ng/mL vs. mean = 0.082, SD = 0.077 ng/mL, P = 0.041). In the group of male fetuses, Doppler results of ductus venosus (DV) showed values of DV PIV > 1.0 in 14 cases (70%), and in the group of female fetuses 12 cases (48%, P = 0.237). Conclusions: Fetal gender was associated with cTnT level at birth in pregnancies complicated by placental insufficiency before 34 th weeks gestation. The fetal cardiac compromise and cardiac injury may be influenced by fetal gender, suggesting differences in the cardiovascular response to fetal hypoxia.

Objective: Postoperative urinary retention may develop after radical gynecologic operations. Dysfunction of the urinary bladder may cause urinary retention and increases the incidence of urinary tract infection. Sonographic (US) assessment of the postvoid residual volume (PRV) of the bladder is a non-invasive, reproducible method. Methods:The authors report on a 6-month prospective study of patients with cervical cancer who have undergone radical abdominal hysterectomy (n = 17) at the Department of Obstetrics and Gynecology, University of Pécs. They estimated the amount of postoperative PRV with two methods of three-dimensional (3D) US volumetry (VOCAL and XI VOCAL, n = 35) and with exact measurement of the PRV by the catheter. The authors compared the feasibility and accuracy of the two US-methods in in-vivo organvolume estimation and first validated the XI VOCAL method in an in-vivo setting. Results: Three-dimensional US volume determination of postoperative PRV with the application of the VOCAL and XI VOCAL methods correlated significantly with the actual amount of the PRV measured by catheterization (correlation coefficient 0.985 for VOCAL and 0.990 for XI VOCAL, respectively, p < 0.001). If the amount of PRV did not exceed 350 mls, the accuracy of the XI VOCAL method was superior to that of the VOCAL (correlation coefficient 0.980 for VOCAL and 0.994 for XI VOCAL, respectively, p < 0.001). Using a cutoff value of PRV ≥ 100 mls to eliminate the necessity of catheterization, both 3D-US methods had a specificity, sensitivity, positive and negative predictive values of 100%, respectively. Conclusions: In case of postoperative urinary retention following radical hysterectomy both non-invasive 3D-US methods are appropriate for the correct volume determination of PRV. Thus we may decrease the number of unnecessary urinary bladder catheterization, reduce the incidence of iatrogenic urinary tract infection, and permit a better postoperative comfort for patients. Objective: Last version of 4Dview software (7.0.3) allows the calculation of 3D vascular indexes using HDF. Reportedly this new Doppler technique is more sensitive than conventional PD. We aimed to determine whether there are differences in three-dimensional vascular indexes when calculated using HDF and PD. Methods: Twenty consecutive asymptomatic premenopausal women (mean age: 31 years) without past history of gynecological disease who attended for routine gynecological check-up were included in the study. All women had regular menstrual cycles and none had uterine or myometrial pathology detected at basal transvaginal ultrasound. All women underwent three-dimensional transvaginal ultrasound using a GE Voluson 730E. In each patient two consecutive 3D volumes from the uterus were obtained. First one volume was obtained using conventional PD (settings: power 96%, gain: 0.8, frequency: medium, quality normal, filter low 1, PRF 0.6 KHz) and immediately after this other one with HDF (settings: power 96%, gain 0.2, frequency medium, quality normal, filter low 1,...