Objectives First, to validate a previously developed model for screening for pre‐eclampsia (PE) by maternal characteristics and medical history in twin pregnancies; second, to compare the distributions of mean arterial pressure (MAP), uterine artery pulsatility index (UtA‐PI), serum placental growth factor (PlGF) and serum pregnancy‐associated plasma protein‐A (PAPP‐A) in twin pregnancies that delivered with PE to those in singleton pregnancies and to develop new models based on these results; and, third, to examine the predictive performance of these models in screening for PE with delivery at < 32 and < 37 weeks' gestation. Methods Two datasets of prospective non‐intervention multicenter screening studies for PE in twin pregnancies at 11 + 0 to 13 + 6 weeks' gestation were used. The first dataset was from the EVENTS (Early vaginal progesterone for the preVention of spontaneous prEterm birth iN TwinS) trial and the second was from a previously reported study that examined the distributions of biomarkers in twin pregnancies. Maternal demographic characteristics and medical history from the EVENTS‐trial dataset were used to assess the validity of risks from our previously developed model. The combined data from the first and second datasets were used to compare the distributional properties of log10 multiples of the median (MoM) values of UtA‐PI, MAP, PlGF and PAPP‐A in twin pregnancies that delivered with PE to those in singleton pregnancies and develop new models based on these results. The competing‐risks model was used to estimate the individual patient‐specific risks of delivery with PE at < 32 and < 37 weeks' gestation. Screening performance was measured by detection rates (DR) and areas under the receiver‐operating‐characteristics curve. RESULTS The EVENTS‐trial dataset comprised 1798 pregnancies, including 168 (9.3%) that developed PE. In the validation of the prior model based on maternal characteristics and medical history, calibration plots demonstrated very good agreement between the predicted risks and the observed incidence of PE (calibration slope and intercept for PE < 32 weeks were 0.827 and 0.009, respectively, and for PE < 37 weeks they were 0.942 and −0.207, respectively). In the combined data, there were 3938 pregnancies, including 339 (8.6%) that developed PE and 253 (6.4%) that delivered with PE at < 37 weeks' gestation. In twin pregnancies that delivered with PE, MAP, UtA‐PI and PlGF were, at earlier gestational ages, more discriminative than in singleton pregnancies and at later gestational ages they were less so. For PAPP‐A, there was little difference between PE and unaffected pregnancies. The best performance of screening for PE was achieved by a combination of maternal factors, MAP, UtA‐PI and PlGF. In screening by maternal factors alone, the DR, at a 10% false‐positive rate, was 30.6% for delivery with PE at < 32 weeks' gestation and this increased to 86.4% when screening by the combined test; the respective values for PE < 37 weeks were 24.9% and 41.1%. Conclusions In the as...

<p><strong>Objective</strong>. The objective of the current study was to describe the anatomical variations of vessels observed in patients with Meckel’s Diverticulum.</p><p><strong>Methods</strong>. A narrative review of the literature was undertaken by means of the PubMed database, using the terms: “Meckel’s Diverticulum AND vessels”, “Meckel’s Diverticulum AND anatomical variation” and “Meckel’s Diverticulum variation”. Classical anatomical textbooks were also used for normal anatomy. Additional articles provided useful information in relation to the aim of this review. Hence, the articles that met the inclusion criteria were included in this review, and the collected data were categorized into a single table.</p><p><strong>Results</strong>. The majority of studies indicated the presence of an abnormal vitelline artery. Other angiographic findings concerned variations of the ileal and the iliac arteries. However, the literature revealed the presence of vascular variations without the existence of Meckel’s Diverticulum, whereas a remnant of the vitelline vein may be present, but it is very rare.</p><p><strong>Conclusion</strong>. The detection of vascular variations accompanying Meckel’s Diverticulum is not always easy and requires the correct choice of imaging method to prevent misdiagnosis.</p>

Anatomic variations can be an additional challenge for any surgeon, especially in complicated surgical procedures, and they could lead to complications if not identified timely. We present a case report of an incidental intraoperative finding of unilateral duplicated ureter, identified during pelvic lymphadenectomy for a patient who underwent surgical treatment for ovarian cancer. Also, we include an update on this anatomic variation following the literature review. The importance of a systematic approach in the identification of the relevant anatomy and landmarks, taking into consideration the variation of the duplicated ureter, is emphasized in this paper and may contribute beneficially to the experience of surgeons operating in this field.

Levonorgestrel-releasing intrauterine devices are considered to be a reliable contraceptive option with a low failure rate. The risk of ectopic pregnancy, however, if an unintended pregnancy occurs is significantly higher.In this study, we present a case of a tubal ectopic pregnancy in a woman with a levonorgestrel-releasing intrauterine device in situ for one year. Our case emphasises the importance of having a high index of suspicion in women who have an intrauterine device in situ, presenting with a positive pregnancy test. We also discuss the importance of timely ultrasound examination and the management considerations of similar cases. The importance of urgent review and investigation of women with positive pregnancy test and intrauterine contraceptive device in situ, given the higher possibility of ectopic pregnancy, is highlighted by this case.