249 RESUMOIntrodução: Nos últimos anos, vários autores evidenciaram a morbilidade associada aos partos ocorridos entre as 34 e 36 semanas (pré-termo tardio) e entre as 37 e 38 semanas de gestação (termo precoce). Neste sentido, pretendemos realizar um estudo epidemiológico dos partos que ocorrem nestas idades gestacionais, em Portugal. Material e Métodos: Realizámos um inquérito, que foi aplicado a todos os hospitais públicos de Portugal, acerca da prevalência e via de parto nos partos pré-termo tardios e de termo precoce, e morbilidade e mortalidade neonatal associada. As questões referiam-se apenas a gestações de feto único e a partos ocorridos em 2013. Resultados: Incluímos 14 hospitais, correspondendo a 33,5% dos partos ocorridos em Portugal, em 2013. Verificámos que 5,4% dos partos ocorreram no período pré-termo tardio e 27% no termo precoce. Aproximadamente dois terços dos partos pré-termo tardio e três quartos dos partos de termo precoce foram espontâneos. A taxa de cesariana foi mais elevada entre as 34 e 36 semanas de gestação (39,1%) do que entre as 37 e 38 semanas (26,4%). As complicações neonatais foram mais frequentes após um parto pré-termo tardio (34,2%), quando comparadas com os de termo precoce (14,2%). Discussão: Na nossa amostra, a prevalência de parto pré-termo tardio e de termo precoce, ainda que ligeiramente inferior, é comparável à publicada em estudos anteriores. Conclusão: É importante que a comunidade obstétrica nacional adote atitudes no sentido de limitar os partos antes das 39 semanas de gestação. Assim, nestas idades gestacionais os partos devem possuir uma indicação médica válida. Palavras-chave: Mortalidade Infantil; Nascimento Prematuro; Portugal; Prematuro; Prevalência; Questionários. Prevalence of Late Preterm and Early Term Birth in PortugalParto Pré-Termo Tardio e de Termo Precoce em Portugal The prevalence of late preterm and early term birth in our cohort is comparable, although slightly reduced, to other published series. Conclusion:The obstetric community should raise efforts to limit deliveries below 39 weeks' gestation to the ones with a valid medical indication.

This study demonstrates a poor correlation between actual birth weight and the estimated fetal weight using a formula based on femur length and mid-thigh soft-tissue thickness, both linear parameters. Although avoidance of circumferential ultrasound measurements might prove to be beneficial, it is still yet to be found a fetal estimation formula that can be both accurate and simple to perform.

Objective: To evaluate the effect of maternal weight on the intra-and inter-observer reproducibility of third-trimester ultrasonography fetal measurements. Methods:The present prospective study, performed at a tertiary hospital, enrolled patients at between 35 +0 weeks and 36 +6 weeks of singleton pregnancies between January 1, 2015, and July 1, 2016. Fetal ultrasonography measurements were evaluated twice by a first observer and a third time by a second observer. Intra-and interobserver consistency were analyzed using the Cronbach α reliability coefficient, and measurement reproducibility was compared with patients stratified by a body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) of below 25 or at least 25. Results:The study included 197 patients (133 with BMI <25 and 64 with BMI ≥25).Among patients with a BMI below 25, the reliability coefficients for bi-parietal diameter, head circumference, abdominal circumference, and femur length measurements were 0.97, 0.95, 0.98, and 0.96, respectively, for intra-observer consistency, and were 0.97, 0.93, 0.98, and 0.95, respectively, for inter-observer consistency. Among patients with a BMI of at least 25, these values were 0. 97, 0.96, 0.98, and 0.97, respectively, for intra-observed consistency, and 0.97, 0.94, 0.98, and 0.96, respectively, for inter-observer consistency. Conclusion:High intra-and inter-observer reproducibility was observed for third-trimester fetal ultrasonography measurements, including for patients who were overweight. K E Y W O R D SFetal biometry; Intra-and inter-observer reproducibility; Obesity; Third trimester ultrasound

Introduction:The role of intrapartum ultrasound as an ancillary method to instrumental vaginal delivery is yet to be determined. This study aimed to compare the use of transabdominal and transperineal ultrasound with routine clinical care before performing an instrumental vaginal delivery, regarding the incidence of adverse maternal and neonatal outcomes. How to cite this article: Barros JG, Afonso M, Martins AT, et al. Transabdominal and transperineal ultrasound vs routine care before instrumental vaginal delivery -A randomized controlled trial.

Transabdominal suprapubic ultrasound improved the accuracy of the evaluation of fetal head position, namely when transvaginal digital examination was performed by residents. This may be important especially when instrumental deliveries are considered.