Objectives

Fetal stomach dimensions in normal pregnancy correlate with gestational age and nomogram of fetal gastric development appears to be useful in assessment of normal fetal growth.

In this report, two conjoined twin cases that were diagnosed at the 19th and 25th week of gestational age are reported. In the first case the pregnancy was terminated because of the very poor prognosis. In the second case the decision was made to continue the pregnancy after counseling explaining the possibility of a separation procedure with good prognosis being carried out after birth. The babies were delivered at 38 weeks of gestation and the separation procedure was carried out at ten months of age without any complications. In selected cases, there is no need to abort, because of the possibility of a separation procedure after birth with good prognosis. Color Doppler ultrasound examination in an early stage of pregnancy in cases of conjoined twin can make it possible to decide which cases are candidates for a separation procedure after birth.

Purpose: To evaluate the efficiency of transvaginal ultrasound in the early diagnosis of ovarian cancer. Methods: Screening transvaginal ultrasound has been annually performed during the last 2 years in asymptomatic women without familial history of ovarian cancer. When abnormalities were detected, the procedure was repeated after 4-6 weeks. If the findings disappeared, the study was repeated after 1 year. If the abnormality persisted, study was complemented with tumor markers, computed tomography and laparoscopic surgery. The findings were compared with a control group of women in whom ovarian transvaginal ultrasonography was formally indicated. Results: A total of 26007 transvaginal ultrasound were performed: 8813 (33.8%) belonged to the screening group and 17194 (66.2%) to the control group. In 14 patients of the screening group, a malignant tumor was diagnosed and histologically confirmed. The mean age of these patients was 45 years old (SD 12). Eleven of these tumors were stage I (seven Ia, and four Ic), two stage IIIc and one was a metastatic melanoma in both ovaries. Six lesions were borderline tumors (five serous and one mucinous). In the control group, 27 ovarian cancers were diagnosed in patients with a mean age of 48 years (SD 17). In this group, 11 tumors were in stage I, and six were borderline. Conclusions: Although consensus about the benefits of using transvaginal ultrasound as a screening procedure is not conclusive, our data reveals that tumors detected in patients screened with transvaginal ultrasound are in earlier stages when compared with those diagnosed in the control group. No differences were found in age and number of borderline tumors between both groups. Additional studies are needed to support this preliminary findings. P02Endometrial sampling during sonohysterography (SHGes) E. Ferrazzi, C. Lanzani, N. Ciminera & V. Conserva Purpose: To assess the diagnostic accuracy of sonohysterography (SHG) and endometrial sampling during SHG (SHGes) compared to traditional hysteroscopy and biopsy. Methods: Seventy-two consecutive patients with irregular bleeding and/or intracavitary abnormalities underwent transvaginal sonography (TVS) and SHG. SHG was performed with a 4.7-mm intrauterine catheter. In all patients, an endometrial biopsy was performed by a syringe vacuum aspiration at the end of SHG. Procedure-related pain was assessed. Sonographic findings at SHG were defined as normal, focal lesions or diffuse endometrial abnormality. In patients with diffuse endometrial abnormality, hysteroscopy and hysteroscopic guided biopsy were performed. In patients with focal lesions, an operative hysteroscopy was performed. Pathologic report was the gold standard. Results: Mean age was 48 years (interquartile range 38-54). At SHG, no pain, mild, and severe discomfort was reported by 75, 18 and 7% of patients, respectively. Fifty patients underwent hysteroscopic guided biopsy, 22 operative hysteroscopy. Hysteroscopic findings were compared to SHG-SHGes finding. (A) Benign lesions: in 56 cases SHG and SHG...

The incidence of conjoined twins is extremely small and ranges between 1:30 000 and 1:100 000 live births. Recent years, the prenatal diagnosis is possible in very early pregnancy and also detailed USG gives us an opportunity for making differential diagnosis in the case of well or poor prognosis. We present two cases with thoracophagus which were diagnosed at 19th and 25th week of gestation. First case was terminated because of severely conjoined (Shared hearth with single ventricule, two atrium, single aorta under the diaphragm. Second one was diagnosed at 25th week of gestation whom had just conjoined liver, attached pericardium on the ventricular walls and no other anomaly. After given counseling, the family opted to continue the pregnancy and the follow up of the pregnancy was uneventful and delivered at 38th week by cesarean section. They well tolerated in the neonatal period. The babies have gone operation at 10th months of age. They recovered after separation procedure and the outcome was uneventful. In recent years, defining the anatomical relationship of conjoined twins is greatly simplified by new technologies like 2D and/or 3D ultrasonography. Differential diagnosis of the cases with good or bad outcome in terms of shared organ and anomalies is important in clinical making decision for the termination or continuation of pregnancy.