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2077360 Physiological Changes in Fetal and Neonatal Splanchnic Circulations During Perinatal Period
Abstracts Objectives: The Japan Society of Ultrasonics in Medicine（JSUM） wrote and published ‘Recommendations for equipment and working environment to prevent work-related musculoskeletal disorders （WRMSD） and eye disorders’ to assist Japanese sonographers. These recommendations (guidelines) for the ergonomics of ultrasonography exist in Europe ,America and Australia. Systematic guideline for preventing work-related disorders of sonographers taking into account the situation in Japan is needed. Methods: The Ultrasound Equipment and Safety Committee（JSUM） produced the committee for ergonomics of ultrasonography in 2010. The committee for ergonomics of ultrasonography is composed of the members stated below. Doctors,sonographers, researchers of diagnostic ultrasound system constructors and researchers of ergonomics in Japan. The committee for ergonomics of ultrasonography carried out the following. ・A questionnaire about Diagnostic Ultrasound System and working environment for members and specialist training facilities of Japan Society of Ultrasonics in Medicine. ・Investigated sonographers’ physical stress during abdominal and cardiac ultrasonic diagnosis by each joint angle measurement. ・Examine the equipment for ultrasonography and work environment from an ergonomic standpoint. Results: ・One of four Japanese sonographer had diagnosis of the workrelated musculoskeletal disorders ・As for the Japanese sonography, The sonographer inspected it with at risk posture to become the factor of the work-related musculoskeletal disorders. ・Clarified the specifications of the apparatus and the optimum of the work environment to become the most suitable work posture for Japanese. Specifically for Equipment, clarified the desirable the operation panel height and moving range, monitor height, the height of the chair and couch etc. Conclusions: ‘Recommendations for Equipment and working environment to prevent work-related musculoskeletal disorders and eye disorders’ were written and published by The Japan Society of Ultrasonics in Medicine（JSUM）to assist Japanese sonographers, manager of sonography’s facilities and diagnostic ultrasound system constructors in 2012.
2077353 Nuchal Umbilical Cord: The Impact on Perinatal Outcome in Term Jozef Visnovsky, Karol Dokus, Erik Kudela, Marcela Nachajova, Jan Danko Obstetrics and Gynecology, Jessenius Faculty of Medicine, Martin, Slovakia Objectives: Nuchal umbilical cord is a common complication in pregnancy and could be associated with peripartal complications and adverse perinatal outcome. A prospective clinical study was conducted to evaluate the validity of ultrasound in detection of nuchal umbilcal cord as well as its impact on perinatal morbidity and mortality. Methods: This study enrolled pregnant women sonographically diagnosed with the nuchal umbilcal cord following 38 weeks of gestation. The result of ultrasound examination was not known to a pregnant woman and obstetrician. Results: During the 3-year period there was a total of 4132 births, of which 1,472 (35.6%) were terminated by caesarean section and 58 by forceps (1.4%). The number of births after 37 week of gestation was 3539 (85.6%). Ultrasound examination of the umbilical cord was performed in a total of 923 pregnant women (26.1%), while the incidence of nuchal umbilical cord was diagnosed in 121 pregnant women (13.1%). The analysis of data showed that there was no significant difference in the incidence of nuchal umbilical cord in all patients who gave birth after 37 week of gestation (387 to 10.9%) and in patients in control group. False negative results were obtained in 32 pregnant and false positive results in 24 pregnant women in this group, so that the accuracy of ultrasound was as followed: sensitivity 75.2%, specificity 96.9%, and negative predictive value 93.9%. There was no significant difference between the frequency of vaginal and cesarean births and fetal outcome
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measured by Apgar scoring system according to the presence of nuchal umbilical cord. In our dataset, there was no perinatal death. Conclusions: Based on the presented results, nuchal umbilical cord is not associated with an increased number of surgical procedures during delivery (caesarean section ,forceps) The authors found no difference in perinatal morbidity and mortality in the group of patients with a confirmed diagnosis of nuchal umbilical cord compared to the group without it. Acknowledgement: This work was supported by project ‘‘Virtual and Simulation Tuition as a New Form of Education at JFM CU in Martin’’, ITMS: 26110230071, co-funded from EU sources and European Social Fund.
2077360 Physiological Changes in Fetal and Neonatal Splanchnic Circulations During Perinatal Period Karol Dokus,1 Katarina Matasova,2 Silvia Dokusova,3 Jozef Visnovsky,1 Mirko Zibolen,2 Jan Danko1 1 Obstetrics and Gynecology, Jessenius Faculty of Medicine, Martin, Slovakia, Slovakia, 2Neonatology, Jessenius Faculty of Medicine, Martin, Slovakia, Slovakia, 3Diabetology, National Endocrinology and Diabetology Institute, Martin, Slovakia, Slovakia Objectives: The aim was to study the course of physiological changes in coeliac artery (CA) and superior mesenteric artery (SMA) blood flow velocities (BFVs) during the perinatal period in healthy term fetuses and neonates. Methods: The prospective Doppler sonography study included 50 healthy fetuses at 36 – 41 weeks of pregnancy and then newborns. The Doppler examinations of CA and SMA arteries in fetuses were performed before the onset of labor and those in newborns at 2, 24, and 72 hours of life. All data were statistically analyzed using MedCalc 14.8.1 software (MedCalc Inc., Ostend, Belgium). Results: The end-diastolic velocity (EDV) in CA was generally higher during the perinatal period compared to SMA (p , 0.001). The EDV in SMA decreased postnatally (8.4 +- 3.2 vs. -7.2 +- 5.3 cm/s, p , 0.001) and showed negative values in 92% of the newborns. At 24 h of postnatal life, EDV of SMA had subsequently become positive in all of the newborns (13.8 +- 4.8 cm/s, p , 0.001). The EDV in CA had always a positive value. The changes in EDV of the both vessels were reflected by inverse changes in the resistive and pulsatility indexes. Conclusions: Blood flow velocities in CA increase from fetal period (. 36 weeks) up until 24 hours post partum while velocities in SMA drop with a negative diastolic flow occurring within the first 24 hours of life. Keywords: Doppler sonography, splanchnic circulation, fetus, newborn Acknowledgement: This work was supported by project ‘‘Virtual and Simulation Tuition as a New Form of Education at JFM CU in Martin’’, ITMS: 26110230071, co-funded from EU sources and European Social Fund.
2077416 Skene’s Gland Duct Cysts: the Utility of Vaginal/ Transperineal Imaging In Diagnosis And Mapping For Surgery. a Case Series And Review of The Literature Petrus Frans Kruger,1 Rose Rahmani,2 Rose Kung1 1 Obstetrics and Gynecology, Division Urogynecology, University of Toronto, Toronto, ON, Canada, 2Radiology, University of Toronto, Toronto, ON, Canada Objectives: We aim to demonstrate that with the advent of improved high frequency probes pelvic floor imaging is a useful diagnostic tool and aids in preoperative surgical mapping. Methods: Three consecutive patients with periurethral cysts that presented to a women’s ultrasound imaging center in Toronto between June 2012 and February 2014 were included in this study. Patient information was extracted from the office database of transvaginal
2077353 Nuchal Umbilical Cord: The Impact on Perinatal Outcome in Term Jozef Visnovsky, Karol Dokus, Erik Kudela, Marcela Nachajova, Jan Danko Obstetrics and Gynecology, Jessenius Faculty of Medicine, Martin, Slovakia Objectives: Nuchal umbilical cord is a common complication in pregnancy and could be associated with peripartal complications and adverse perinatal outcome. A prospective clinical study was conducted to evaluate the validity of ultrasound in detection of nuchal umbilcal cord as well as its impact on perinatal morbidity and mortality. Methods: This study enrolled pregnant women sonographically diagnosed with the nuchal umbilcal cord following 38 weeks of gestation. The result of ultrasound examination was not known to a pregnant woman and obstetrician. Results: During the 3-year period there was a total of 4132 births, of which 1,472 (35.6%) were terminated by caesarean section and 58 by forceps (1.4%). The number of births after 37 week of gestation was 3539 (85.6%). Ultrasound examination of the umbilical cord was performed in a total of 923 pregnant women (26.1%), while the incidence of nuchal umbilical cord was diagnosed in 121 pregnant women (13.1%). The analysis of data showed that there was no significant difference in the incidence of nuchal umbilical cord in all patients who gave birth after 37 week of gestation (387 to 10.9%) and in patients in control group. False negative results were obtained in 32 pregnant and false positive results in 24 pregnant women in this group, so that the accuracy of ultrasound was as followed: sensitivity 75.2%, specificity 96.9%, and negative predictive value 93.9%. There was no significant difference between the frequency of vaginal and cesarean births and fetal outcome
S119
measured by Apgar scoring system according to the presence of nuchal umbilical cord. In our dataset, there was no perinatal death. Conclusions: Based on the presented results, nuchal umbilical cord is not associated with an increased number of surgical procedures during delivery (caesarean section ,forceps) The authors found no difference in perinatal morbidity and mortality in the group of patients with a confirmed diagnosis of nuchal umbilical cord compared to the group without it. Acknowledgement: This work was supported by project ‘‘Virtual and Simulation Tuition as a New Form of Education at JFM CU in Martin’’, ITMS: 26110230071, co-funded from EU sources and European Social Fund.
2077360 Physiological Changes in Fetal and Neonatal Splanchnic Circulations During Perinatal Period Karol Dokus,1 Katarina Matasova,2 Silvia Dokusova,3 Jozef Visnovsky,1 Mirko Zibolen,2 Jan Danko1 1 Obstetrics and Gynecology, Jessenius Faculty of Medicine, Martin, Slovakia, Slovakia, 2Neonatology, Jessenius Faculty of Medicine, Martin, Slovakia, Slovakia, 3Diabetology, National Endocrinology and Diabetology Institute, Martin, Slovakia, Slovakia Objectives: The aim was to study the course of physiological changes in coeliac artery (CA) and superior mesenteric artery (SMA) blood flow velocities (BFVs) during the perinatal period in healthy term fetuses and neonates. Methods: The prospective Doppler sonography study included 50 healthy fetuses at 36 – 41 weeks of pregnancy and then newborns. The Doppler examinations of CA and SMA arteries in fetuses were performed before the onset of labor and those in newborns at 2, 24, and 72 hours of life. All data were statistically analyzed using MedCalc 14.8.1 software (MedCalc Inc., Ostend, Belgium). Results: The end-diastolic velocity (EDV) in CA was generally higher during the perinatal period compared to SMA (p , 0.001). The EDV in SMA decreased postnatally (8.4 +- 3.2 vs. -7.2 +- 5.3 cm/s, p , 0.001) and showed negative values in 92% of the newborns. At 24 h of postnatal life, EDV of SMA had subsequently become positive in all of the newborns (13.8 +- 4.8 cm/s, p , 0.001). The EDV in CA had always a positive value. The changes in EDV of the both vessels were reflected by inverse changes in the resistive and pulsatility indexes. Conclusions: Blood flow velocities in CA increase from fetal period (. 36 weeks) up until 24 hours post partum while velocities in SMA drop with a negative diastolic flow occurring within the first 24 hours of life. Keywords: Doppler sonography, splanchnic circulation, fetus, newborn Acknowledgement: This work was supported by project ‘‘Virtual and Simulation Tuition as a New Form of Education at JFM CU in Martin’’, ITMS: 26110230071, co-funded from EU sources and European Social Fund.
2077416 Skene’s Gland Duct Cysts: the Utility of Vaginal/ Transperineal Imaging In Diagnosis And Mapping For Surgery. a Case Series And Review of The Literature Petrus Frans Kruger,1 Rose Rahmani,2 Rose Kung1 1 Obstetrics and Gynecology, Division Urogynecology, University of Toronto, Toronto, ON, Canada, 2Radiology, University of Toronto, Toronto, ON, Canada Objectives: We aim to demonstrate that with the advent of improved high frequency probes pelvic floor imaging is a useful diagnostic tool and aids in preoperative surgical mapping. Methods: Three consecutive patients with periurethral cysts that presented to a women’s ultrasound imaging center in Toronto between June 2012 and February 2014 were included in this study. Patient information was extracted from the office database of transvaginal