No abstract

The 3-dimensional transperineal ultrasound is helpful in determining the primary repair of the anal sphincter during the immediate post-partum, with no discomfort for patients, as well as for establishing those early sphincter injuries that go unnoticed during vaginal delivery.

Oral communication abstractsultrasound data (n = 12), leaving 538 data sets for analysis. The mean age was 53 years . Prolapse symptoms were reported by 263 (49%). On PFUS mean bladder descent was −6.5mm (32 to −63.8), mean uterine descent +14.3mm (56.1 to −51.1), mean enterocele descent −0.92mm (0 to −48.6) and mean rectal descent was −7.26mm (39 to −54.1). ROC statistics suggested a cut-off 15mm above the symphysis pubis for diagnosing an abnormal degree of uterine descent on Valsalva, giving a sensitivity of 70% and a specificity of 57% for the prediction of symptoms of prolapse. The area under the curve was 0.68 (0.63−0.72). Conclusions:In this large retrospective study, the optimal cut-off for defining abnormal descent of the uterus was defined as 15 mm above the SP. This is much more cranial than previously defined cutoffs for bladder prolapse (10 mm below the SP) and rectal descent (15 mm below the SP). Clearly, a given degree of uterine descent is much more likely to lead to symptoms of prolapse than the same degree of bladder or rectal descent. OC09.04Determination of levator ani muscle lesions in instrumental delivery with vacuum using transperineal 3D-4D ultrasonography

Were analyzed the following data: reason for of MRI, GA at MRI, position of the stomach and jejunum in T2. Position of the jejunum was defined as normal if in the left flank below the stomach and abnormal otherwise, therefore classified into 3 groups : intra-thoracic (A), extra-fetal (B) and abnormal intrafetal (C). The position of the jejunum was studied by two independent operators. Antenatal data were correlated to postnatal imaging, surgical or autopsy findings. Results: 709 fetal MRI were performed during this period. The mean GA at MRI was 30 WG (22 min-37 max). In 64 cases (9%) jejunum was absent from the sub gastric area in the left flank on T2-weighted images. Forty-one fetuses (64 %) had a left diaphragmatic hernia with intrathoracic position of the proximal jejunum (group A). In 11 cases (17%), jejunum was extrafetal due to gastroschisis (group B). In 12 cases (19%) intra-abdominal proximal jejunum was in an abnormal position, i.e. in the middle or right flank, with a normally positioned stomach (group C). In only 2 cases of group C (16.6%), gastrointestinal abnormality was suspected on ultrasound. The two operators were concordant in 100 % of cases. All diagnoses of groups A and B (52 cases) were confirmed postnatally or at autopsy. In 10 cases (83%) of group C, malposition was also confirmed postnatally while it had not been suspected during prenatal ultrasounds. One case had a right jejunal deviation caused by a large duplication cyst but bowel position was normal at surgery. In the other one, jejunal position proved normal postnatally. Conclusions: due to T2-weighted sequences high contrast resolution, fetal MRI is a useful tool for prenatal diagnosis of digestive malposition, including in cases where fetal ultrasound did not suspect this diagnosis. P22.14 Early fetal morphological evaluation (12-14 weeks): abdominal ultrasonography approach