Cerebellar alterations are a hallmark of Fetal Alcohol Spectrum Disorders and are thought to be responsible for deficits in fine motor control, motor learning, balance, and higher cognitive functions. These deficits are, in part, a consequence of dysfunction of cerebellar circuits. Although the effect of developmental ethanol exposure on Purkinje and granule cells has been previously characterized, its actions on other cerebellar neuronal populations are not fully understood. Here, we assessed the impact of repeated ethanol exposure on the number of inhibitory neurons in the cerebellar vermis. We exposed pregnant mice to ethanol in vapor inhalation chambers during gestational days 12–19 and offspring during postnatal days 2–9. We used transgenic mice expressing the fluorescent protein, Venus, in GABAergic/glycinergic neurons. Using unbiased stereology techniques, we detected a reduction in Venus positive neurons in the molecular and granule cell layers of lobule II in the ethanol exposed group at postnatal day 16. In contrast, ethanol produced a more widespread reduction in Purkinje cell numbers that involved lobules II, IV–V and IX. We also found a reduction in the volume of lobules II, IV–V, VI–VII, IX and X in ethanol-exposed pups. These findings indicate that second and third trimester ethanol exposure has a greater impact on Purkinje cells than interneurons in the developing cerebellar vermis. The decrease in the volume of most lobules could be a consequence of a reduction in cell numbers, dendritic arborizations, or axonal projections.

Objective We compared the sensitivity and specificity of abdominal circumference (AC) alone versus estimated fetal weight (EFW) to predict small for gestational age (SGA) or large for gestational age (LGA) at birth. Study Design We searched the literature for studies assessing an ultrasonographic AC or EFW after 24 weeks to predict SGA or LGA at birth. Case series or studies including anomalous fetuses or multiple gestations were excluded. We computed the sensitivity, specificity, and positive and negative predictive values of any AC or EFW cutoff analyzed by at least two studies. Results We identified 2,460 studies, of which 40 met inclusion criteria (n = 36,519). Four studies assessed AC alone to predict SGA (n = 5,119), and six assessed AC to predict LGA (n = 6,110). Sixteen assessed EFW to predict SGA (n = 13,825), and 22 evaluated EFW to predict LGA (n = 18,896). To predict SGA, AC and EFW < 10th percentile have similar ability to predict SGA. To predict LGA, AC cutoffs were comparable to all EFW cutoffs, except that AC > 35 cm had better sensitivity. Conclusion After 24 weeks, AC is comparable to EFW to predict both SGA and LGA. In settings where serial EFWs are inaccessible, a simpler screening method with AC alone may suffice.

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Objectives:The angle of progression (AOP), as measured by transperineal ultrasound (TPUS), has been suggested as a tool for monitoring labour progress as well as predicting the mode of delivery in nulliparous women before the onset of labour at term. The AOP is defined as the angle between the long line of the symphysis pubis bone and a line extended from the most leading part of the fetal skull. The aim of this study was to assess whether the AOP measurement before the onset of labour can predict a successful vaginal birth after a Caesarean section (VBAC). Methods: A prospective, observational study including women at term with a single previous birth by Caesarean section (CS), without prior vaginal births and who desire a trial of labour was performed. TPUS was used to measure the AOP in consenting woman before active labour. Only women delivering within one week of TPUS were included. The staff in the labour ward was blinded to the AOP measurements. Clinical data and delivery outcome were retrieved from computerized medical records. Results: Forty-seven women were included. A successful VBAC was achieved in 51.1% (n = 24) of women. The median AOP was significantly narrower in women who eventually delivered by CS than in those who had a successful VBAC (88 • , IQR 77-97 vs. 99 • , IQR 90-111, respectively; p = 0.002). An AOP >98 • (derived from an ROC curve) was associated with a successful VBAC in 82% of women. Of the three women with an AOP > 98 • who underwent a repeat CS, two were operated owing to maternal request before active labour, and the third had a CS in an early stage of labour due to fever and prolonged ruptured membranes with no contractions. Conclusions: This study suggests that the AOP may be a useful sonographic tool for predicting the success of VBAC and can assist in consulting women with a prior Caesarean section regarding the preferred mode of delivery. P17.02Fetal thymus and steroid treatment: the effect of prenatal therapy on sonographic measurements L. Guariglia, S. Buongiorno, P. Ciliberti, I. Mappa, V. Catzola, M. De Vita, M. Viggiano, A. Cavaliere, A. Fattorossi, P. Rosati Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, ItalyObjectives: Ultrasound (US) studies of fetal thymus size in utero are reported in physiological and in complicated pregnancies. In literature, the effect of prenatal steroid treatment on the fetal immune system and thymus size is demonstrated. The aim of the study is to determine if there is an US anatomical change in fetal thymus correlated to administration of prenatal steroids. Methods: The study population [n = 6 pregnant women attending for programmed Caesarean section (CS) near term] was compared to a control group (n = 7) with similar maternal and fetal characteristics [gestational age (±1 week), maternal age, body mass index (BMI), parity and mean percentile of estimated fetal weight (EFW)]. In the study group two doses of 12 mg of betamethasone were administered at 24 hours intervals within 7 days before delivery. The patients ...

Use of transvaginal ultrasonography for cervical length measurement at the 20-week anatomic examination has been suggested as a screening method to predict the risk of preterm birth. This article describes a three-dimensional ultrasonographic multiplanar imaging method of cervical length measurement by manipulating the center reference point and volume axes. This methodology should yield a more consistent, accurate measurement of the cervical length compared to conventional two-dimensional ultrasonographic methods. Also described are additional software image manipulation techniques to enhance visualization of the relational anatomy of the cervix. Precise utilization of the center reference point and available image reconstruction software augment current two-dimensional morphologic information of the lower genital tract.