improvements in delivery of screening can be made with few additional resources in the absence of an organized system. We promoted linkages between detection and diagnosis through enhancement of teamwork and functional coordination, which improved follow-up rates. We restored links between screening and reading processes through minor adjustments, which improved the turnaround time of samples. Trained outreach workers created new links between community and health services, identifying women who had never been screened before in their lives and facilitating their access to regular clinic services.

Hydranencephaly and fetal death was diagnosed in two of three fetuses during the abdominal sonographic examination of a 2.5-year-old, intact female Chihuahua that had clinical signs of dystocia 63 days after mating. A cesarean section was performed and one live normal puppy was present. Two dead puppies, each with a markedly enlarged and fluid filled skull were removed.