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M525 AMNIOTIC FLUID INDEX VERSUS SINGLE DEEPEST VERTICAL POCKET AS A SCREENING TEST FOR PREVENTING ADVERSE PREGNANCY OUTCOME
S700
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
during 4 minutes, curantyl (50 mg t.i.d.), medical food product – polisol (1 tbsp t.i.d.), tivortin (4.2% infusion solution), phenibut. Intrapartum epidural anesthesia was carried out. Methods: The study of uterine pressure was held by the biomonitoring BMT 9141 RFT Biomonitor (Germany). The serotonin concentration in blood was examined by the method of S. Udenfriend (1965). The fetus state evaluation was held by the method of Fisher (in points). Results: The serotonin concentration at the beginning of the first period of the pregnant women delivery was: for the 3-d group of women – (0.600±0.01) mmol/L; for the 2-nd group of women – (0.618±0.01) mmol/L; and for the 1-st group of women – (0.672±0.02) mmol/L. At the end of the first period of delivery the serotonin concentration was: (0.696±0.02) mmol/L, (0.649±0.01) mmol/L and (0.850±0.01) mmol/L respectively. An increase of serotonin concentration in blood is accompanied by the uterine contractile activity. The fetus state rating of pregnant women in the dynamics of delivery by Fisher was as follows: healthy women – (8.7±0.12) points, the 2-nd group – (6.743±0.11) points, and the 1-st group – (7.9±0.3) points. Conclusions: Thus, the developed complex of therapy helped to improve the uterine contractile activity and the fetus state during delivery, which contributed to the reduction of perinatal complications frequency. M524 PRENATAL SCREENING EXPERIENCE OF A TUNISIAN DEPARTMENT OF OBSTETRICS D. Zeghal1 , W. Fatah1 , R. Ben hmid1 , F. Zouari1 , S. Mahjoub1 . 1 C, Maternity Center of Tunis, Tunis, Tunisia Objectives: Prenatal screening is searching for conditions in a fetus or embryo before birth. The aim is to find diseases or malformations early during pregnancy to avoid handicap. The indications of tests for screening are getting larger in our department. Materials: The study was done over a period of 8 years from January 2004 to December 2011. The study concerns 47440 fetal scans, 1897 fetal sampling and 275 serum marker testing. Methods: It is a retrospective study held in the Department “C” of Gynecology and Obstetrics in the Center of maternity and neonatology of Tunis. Results: The mean age of our patients is 35 years old with extremes varying from 18 to 47. The mean gestity and parity are 3 and 2 respectively. Consanguinity was noted in 1.3% of the cases among which 62.5% of first degree. During the study, we accomplished 47440 fetal scans and 275 serum marker testing. The total number of fetal samplings was 1897: 1503 amnicentesis, 104 third quarter amniocentesis with FISH technique, 24 cordocentesis and 266 chorionic villus sampling. The principal indication was advanced maternal age (>35): 56%. The other indications are: fetal scan anomalies (16%), positive serum markers (7%), sickle cell anemia and thalassemia (6.5%), toxoplasmosis (6.5%) and genetic diseases (2.3%) The prenatal diagnosis determined 58 chromosomic anomalies, 3 genetic diseases, 12 fetal toxoplasmosis, 7 cases of thalassemia and sickle cell disease. We have realized 186 medical interruptions of pregnancies for fetal anomalies detected mainly by ultrasonography. Conclusions: Prenatal diagnosis has gained a large place in obstetrics as it helps to detect during pregnancies anomalies which can determine if the fetus will be aborted; or to diagnose high risk pregnancies in order to schedule delivery in the appropriate maternities.
M525 AMNIOTIC FLUID INDEX VERSUS SINGLE DEEPEST VERTICAL POCKET AS A SCREENING TEST FOR PREVENTING ADVERSE PREGNANCY OUTCOME Y. He1 , Q. Chen1 . 1 First hospital of Peking University, Beijing, China Objectives: The purpose of this study was to compare the use of the amniotic fluid index (AFI) with the single deepest vertical pocket (DVP) measurement as a screening tool for decreased amniotic fluid volume in preventing adverse pregnancy outcome. Materials: Between January of 2000 and December of 2010, 708 patients were diagnosised with oligohydromnios (AFI less than 8 cm) in the Department of Obstetrics and Gynecology First hospital of Peking University. Twin pregnancies, patients complicated with premature repture of membrane were excluded. Methods: This was a retrospective cohort study from 2000 to 2010. Patients with an AFI less than 5 cm and those with a DVP less than 2 cm were compared. The primary outcome measure included an umbilical artery pH of less than 7.1; the presence of meconium; an Apgar score of less than 7 at 5 minutes; cesarean delivery rate and neonatal intensive care unit (NICU) admission. Results: Between January of 2000 and December of 2010, 708 patients were diagnosised with oligohydromnios (AFI less than 8 cm). According to different diagnostic criteria, the patients were divided into four groups: AFI less than 5 cm: 160cases;DVP less than 2 cm: 126cases; AFI less than 5 cm but DVP more than 2 cm: 94cases; AFI more than 5 cm but less than 8 cm: 548 cases. In all groups, the cesarean scetion rate was very high. When the amniotic fluid index was used, significantly more cases of oligohydramnios were diagnosed. There is no evidence that one method is superior to the other in the prevention of poor peripartum outcomes including: prevalence of cesarean section (AFI less than 5 cm vs DVP less than 2 cm: 97.5% vs 95.2%), neonatal asphyxia (1.3% vs 1.6%), the presence of meconium (11.3% vs 15.9%) and admission to neonatal intensive care unit (31.3% vs 34.9%). Conclusions: During antepartum fetal surveillance, use of single deepest pocket compared with amniotic fluid index is associated with a significantly lower rate of suspected oligohydramnios. Single deepest vertical pocket measurement is the method of choice for the assessment of amniotic fluid volume. M526 MANAGEMENT OF PREGNANCY COMPLICATED BY HEPATITIS B AND C IN MALTA D. Azzopardi Micallef1 , N. Mamo2 , A. Micallef Fava1 , J. Mamo1 . 1 Mater Dei Hospital, Msida, Malta; 2 University of Malta Medical School, Qawra, Malta Objectives: The prevalence of hepatitis B in Malta has been estimated at 1–2%. There is the impression that the incidence of hepatitis C is increasing. All pregnant women in Malta are screened for hepatitis B and C. Chronically infected pregnant patients are not started on active medication but are monitored throughout the pregnancy. Materials: All patients attending antenatal clinic are routinely screened for hepatits B and C. Data from the laboratory records was assessed and the management plan set up. Methods: Women with chronic HCV infection have a 3% risk of transmitting the virus to the fetus. Antiviral regimes for hepatitis C are highly teratogenic and should be avoided in the first trimester. There is no indication that changing the mode of delivery will alter the rate of transmission. Results: HBeAg positive mothers who are not on any treatment have a 90% rate of transmission of HBV to the neonate. All pregnant women are screened for HBV in Malta using an enzyme immunoassay for the HBV surface antigen. HIV positive patients should be screened for HBV using both HBsAg and HBV core antibody. Chronically infected pregnant women who are treated
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
during 4 minutes, curantyl (50 mg t.i.d.), medical food product – polisol (1 tbsp t.i.d.), tivortin (4.2% infusion solution), phenibut. Intrapartum epidural anesthesia was carried out. Methods: The study of uterine pressure was held by the biomonitoring BMT 9141 RFT Biomonitor (Germany). The serotonin concentration in blood was examined by the method of S. Udenfriend (1965). The fetus state evaluation was held by the method of Fisher (in points). Results: The serotonin concentration at the beginning of the first period of the pregnant women delivery was: for the 3-d group of women – (0.600±0.01) mmol/L; for the 2-nd group of women – (0.618±0.01) mmol/L; and for the 1-st group of women – (0.672±0.02) mmol/L. At the end of the first period of delivery the serotonin concentration was: (0.696±0.02) mmol/L, (0.649±0.01) mmol/L and (0.850±0.01) mmol/L respectively. An increase of serotonin concentration in blood is accompanied by the uterine contractile activity. The fetus state rating of pregnant women in the dynamics of delivery by Fisher was as follows: healthy women – (8.7±0.12) points, the 2-nd group – (6.743±0.11) points, and the 1-st group – (7.9±0.3) points. Conclusions: Thus, the developed complex of therapy helped to improve the uterine contractile activity and the fetus state during delivery, which contributed to the reduction of perinatal complications frequency. M524 PRENATAL SCREENING EXPERIENCE OF A TUNISIAN DEPARTMENT OF OBSTETRICS D. Zeghal1 , W. Fatah1 , R. Ben hmid1 , F. Zouari1 , S. Mahjoub1 . 1 C, Maternity Center of Tunis, Tunis, Tunisia Objectives: Prenatal screening is searching for conditions in a fetus or embryo before birth. The aim is to find diseases or malformations early during pregnancy to avoid handicap. The indications of tests for screening are getting larger in our department. Materials: The study was done over a period of 8 years from January 2004 to December 2011. The study concerns 47440 fetal scans, 1897 fetal sampling and 275 serum marker testing. Methods: It is a retrospective study held in the Department “C” of Gynecology and Obstetrics in the Center of maternity and neonatology of Tunis. Results: The mean age of our patients is 35 years old with extremes varying from 18 to 47. The mean gestity and parity are 3 and 2 respectively. Consanguinity was noted in 1.3% of the cases among which 62.5% of first degree. During the study, we accomplished 47440 fetal scans and 275 serum marker testing. The total number of fetal samplings was 1897: 1503 amnicentesis, 104 third quarter amniocentesis with FISH technique, 24 cordocentesis and 266 chorionic villus sampling. The principal indication was advanced maternal age (>35): 56%. The other indications are: fetal scan anomalies (16%), positive serum markers (7%), sickle cell anemia and thalassemia (6.5%), toxoplasmosis (6.5%) and genetic diseases (2.3%) The prenatal diagnosis determined 58 chromosomic anomalies, 3 genetic diseases, 12 fetal toxoplasmosis, 7 cases of thalassemia and sickle cell disease. We have realized 186 medical interruptions of pregnancies for fetal anomalies detected mainly by ultrasonography. Conclusions: Prenatal diagnosis has gained a large place in obstetrics as it helps to detect during pregnancies anomalies which can determine if the fetus will be aborted; or to diagnose high risk pregnancies in order to schedule delivery in the appropriate maternities.
M525 AMNIOTIC FLUID INDEX VERSUS SINGLE DEEPEST VERTICAL POCKET AS A SCREENING TEST FOR PREVENTING ADVERSE PREGNANCY OUTCOME Y. He1 , Q. Chen1 . 1 First hospital of Peking University, Beijing, China Objectives: The purpose of this study was to compare the use of the amniotic fluid index (AFI) with the single deepest vertical pocket (DVP) measurement as a screening tool for decreased amniotic fluid volume in preventing adverse pregnancy outcome. Materials: Between January of 2000 and December of 2010, 708 patients were diagnosised with oligohydromnios (AFI less than 8 cm) in the Department of Obstetrics and Gynecology First hospital of Peking University. Twin pregnancies, patients complicated with premature repture of membrane were excluded. Methods: This was a retrospective cohort study from 2000 to 2010. Patients with an AFI less than 5 cm and those with a DVP less than 2 cm were compared. The primary outcome measure included an umbilical artery pH of less than 7.1; the presence of meconium; an Apgar score of less than 7 at 5 minutes; cesarean delivery rate and neonatal intensive care unit (NICU) admission. Results: Between January of 2000 and December of 2010, 708 patients were diagnosised with oligohydromnios (AFI less than 8 cm). According to different diagnostic criteria, the patients were divided into four groups: AFI less than 5 cm: 160cases;DVP less than 2 cm: 126cases; AFI less than 5 cm but DVP more than 2 cm: 94cases; AFI more than 5 cm but less than 8 cm: 548 cases. In all groups, the cesarean scetion rate was very high. When the amniotic fluid index was used, significantly more cases of oligohydramnios were diagnosed. There is no evidence that one method is superior to the other in the prevention of poor peripartum outcomes including: prevalence of cesarean section (AFI less than 5 cm vs DVP less than 2 cm: 97.5% vs 95.2%), neonatal asphyxia (1.3% vs 1.6%), the presence of meconium (11.3% vs 15.9%) and admission to neonatal intensive care unit (31.3% vs 34.9%). Conclusions: During antepartum fetal surveillance, use of single deepest pocket compared with amniotic fluid index is associated with a significantly lower rate of suspected oligohydramnios. Single deepest vertical pocket measurement is the method of choice for the assessment of amniotic fluid volume. M526 MANAGEMENT OF PREGNANCY COMPLICATED BY HEPATITIS B AND C IN MALTA D. Azzopardi Micallef1 , N. Mamo2 , A. Micallef Fava1 , J. Mamo1 . 1 Mater Dei Hospital, Msida, Malta; 2 University of Malta Medical School, Qawra, Malta Objectives: The prevalence of hepatitis B in Malta has been estimated at 1–2%. There is the impression that the incidence of hepatitis C is increasing. All pregnant women in Malta are screened for hepatitis B and C. Chronically infected pregnant patients are not started on active medication but are monitored throughout the pregnancy. Materials: All patients attending antenatal clinic are routinely screened for hepatits B and C. Data from the laboratory records was assessed and the management plan set up. Methods: Women with chronic HCV infection have a 3% risk of transmitting the virus to the fetus. Antiviral regimes for hepatitis C are highly teratogenic and should be avoided in the first trimester. There is no indication that changing the mode of delivery will alter the rate of transmission. Results: HBeAg positive mothers who are not on any treatment have a 90% rate of transmission of HBV to the neonate. All pregnant women are screened for HBV in Malta using an enzyme immunoassay for the HBV surface antigen. HIV positive patients should be screened for HBV using both HBsAg and HBV core antibody. Chronically infected pregnant women who are treated