Infants with ankyloglossia experiencing persistent breastfeeding difficulties showed less compression of the nipple by the tongue postfrenulotomy, which was associated with improved breastfeeding defined as better attachment, increased milk transfer, and less maternal pain. In the assessment of breastfeeding difficulties, ankyloglossia should be considered as a potential cause.

Nipple position is believed to influence breastfeeding success. To investigate this belief, submental ultrasound images were obtained during breastfeeding of normal term infants. This study measured nipple to hard-soft palate distance (NHSPD) in 18 mother-infant pairs during the first and fourth weeks of life. Median NHSPD was 5 mm (interquartile: 4, 6 mm). There were no significant differences in median NHSPD between first, second, and fifth minutes of feeding (P = .675) or between week 1 and week 4 (P = .320). The nipple was not stationary during feeding, with mean nipple movement of 4.0 -/+ 1.3 mm. Further research is required with more infants to confirm the boundaries of normality for ultrasound measurements of nipple position during successful breastfeeding.

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...