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Conclusions:Transvaginal sonography for CL measurement can be helpful for predicting emergent Caesarean delivery. EP01.10 Cervical measurement are useful predictor of success of TOLAC Objectives: To evaluate whether measurement of cervix is helpful in predicting vaginal delivery in patients whose indication of previous Caesarean section was protraction disorder. Methods:We studied retrospectively about pregnant women who were admitted for trial of labour after Caesarean delivery (TOLAC) from . Among them, women whose indication of previous Caesarean section was protraction disorder were enrolled. Exclusion criteria were premature rupture of membrane (PPROM), suspicious macrosomia, pregnancy with diseases affecting labour course (ex.gestational diabetes, pre-eclampsia etc). Total 94 patients were studied. At 39 weeks of gestation, we checked cervical volume, cervical length and Bishop score. Success of TOLAC defined vaginal delivery (VBAC). After delivery we compared the outcome between VBAC (n = 62) and failed group (n = 32). Results: VBAC rate was 66%. It was significantly lower rate compared with group of another previous Caesarean indications. In VBAC group, Cervical length was significantly shorter than failed group (3.0 ± 0.3 cm vs. 4.1 ± 0.5 cm, P < 0.001). Cervical volume and Bishop score were not significant in both group. Conclusions: Measuring cervical length is useful marker in predicting VBAC among TOLAC with previous protraction disorder history.

Results: The evidence from 10 studies examining 3,056 women showed a small benefit on live birth/ongoing pregnancy and on clinical pregnancy despite the heterogeneity observed. Subgroup analyses separating the studies by single/multiple doses of GnRH agonists or by ovarian stimulation with GnRH agonist/antagonist did not explained the heterogeneity. Conclusions: Adding GnRH agonist during luteal phase improves ongoing pregnancy. However, this evidence is of very low quality and there is no evidence about adverse perinatal outcomes and congenital malformations. We therefore believe that including this intervention in clinical practice would still be premature. OP19.03The evaluation and clinical value of the tubal patency through the application of real-time three dimensional hysterosalpingo-contrast sonography (HyCoSy) The difference between the evaluation of tubal patency under two modes was not statistically significant (P > 0.05). However, there was significant statistical disparity between the outcomes of the fallopian tube lines under the two modes (P < 0.05), which was assessed better with 3D HyCoSy rather than 2D HyCoSy. Conclusions:The method of TVS 3D HyCoSy with SonoVue has obvious advantages in evaluating the tubal patency and the fallopian tube line, a high value in clinical application and could be further expanded.Supporting information can be found in the online version of this abstract Objectives: To assess the efficacy of intramuscular pethidine in the reduction of pain during hysterocontrast sonography (HyCoSy). Methods: Six hundred and six patients undergoing HyCoSy were randomised to receive either 0.75 mg/kg intramuscular pethidine with NSAID or NSAID alone, 30 minutes before the procedure. Visual analogue pain scoring was carried out immediately after the procedure to ascertain the degree of pain felt during the procedure. The effect of tubal patency status on pain score was also ascertained. Results: There was a significant pain reduction with intramuscular pethidine compared to the group without pethidine administration (mild or less pain 44.9% versus 13.0%). In both treatment group, tubal patency was associated with reduced pain scores.

Methods: All medical articles and congress abstracts are included in the national review system, similar to PubMed. We searched this system using the terms ''abdominal pregnancy'' and identified 69 articles, including 95 cases of AP with sufficient clinical information, including our previously reported case. There were 86 early (E) APs and 9 advanced (A) APs. There were eight MTX-indispensable EAPs. Results: Among the EAPs, MTX was administered after primary surgery in eight (9%, 8/86). The patient's background, pregnancy weeks, implantation site, operation, blood loss, blood transfusion, reason for MTX therapy and MTX schedule are examined. Pregnancy weeks were documented in six cases and were 5 (2 cases), 6, 7, 8 and 10 weeks respectively. Implantation sites varied. Blood loss ranged from 225-2,000 g in five of the eight cases and blood transfusion was performed in one case. MTX was administered to one patient (12.5%) who did not undergo surgical extraction because of liver pregnancy, one patient (12.5%) without tumor extraction for fear of massive bleeding and to the remaining six patients (75%) because of incomplete extraction or residual pathological changes. MTX was mostly administered according to the usual regimen for trophoblastic disease. Conclusions: MTX-indispensable EAPs should be regarded as dangerous. Some EAPs cannot be managed only by operative dissections but MTX administration are required for additional therapy. P16.09Psychological acceptability of transvaginal scan among Nigerians attending for early pregnancy ultrasound

Diffusion-weighted MRI was performed with a 1.5 T MRI and axial echoplanar diffusion sequence with 4 and 11 b-values respectively. Three different region of interest (ROI) were selected manually on the placenta, on 3 successive slides close to the cord insertion. These ROIs were analysed with different post processing algorithm: ADC (mono-exponential least square fitting), IVIM sequential approach (bi-exponential least square fitting). We analysed the changes in parameters (ADC, f, D* and D) across GA and according to z-score of fetal birthweight and placental weight. Results: A total of 55 patients were analysed using diffusion-weighted MRI. There was a significant linear correlation between ADC and z-score of fetal birthweight (p = 0.004) and a significant quadratic correlation between ADC and GA (p = 0,001). On the IVIM sequential approach, there was also a significant linear correlation between f (perfusion fraction) and z-score of fetal birthweight (p = 0.008) and placental weight (p = 0.05) as well as a significant quadratic correlation with GA (p = 0.04). Conclusions: Our study suggests that placental function can be studied in vivo based on MRI diffusion weighed imaging. IVIM may provide an interesting method to evaluate placental perfusion in humans, without using contrast agent nor radiation. The linear relationship between the perfusion fraction and z-score of the fetal weight suggests this might be a suitable tool to detect placental insufficiency and monitor patients at risk of IUGR. OP09.02Whatsapps ultrasound teleconsultation in a low-resource setting: feasibility, accuracy and patient's psychological acceptability