Relationship between the Prenatal Diagnosis of Placenta Acreta Spectrum and Lower Use of Blood Components / Relação entre o diagnóstico prenatal de espectro da placenta acreta e menor uso de hemoderivados

Abstract Objective To describe the clinical results of patients admitted and managed as cases of placenta accreta spectrum (PAS) at a Central American public hospital and the influence of the prenatal diagnosis on the condition. Materials and Methods A retrospective analysis of PAS patients treated at Hospital Bertha Calderón Roque, in Managua, Nicaragua, between June 2017 and September 2021. The diagnostic criteria used were those of the International Federation of Gynecology and Obstetrics (Fédération Internationale de Gynécologie et d'Obstétrique, FIGO, in French). The population was divided into patients with a prenatal ultrasonographic diagnosis of PAS (group 1) and those whose the diagnosis of PAS was established at the time of the caesarean section (group 2). Results During the search, we found 103 cases with a histological and/or clinical diagnosis of PAS; groups 1 and 2 were composed of 51 and 52 patients respectively. Regarding the clinical results of both groups, the patients in group 1 presented a lower frequency of transfusions (56.9% versus 96.1% in group 2), use of a lower number of red blood cell units (RBCUs) among those undergoing transfusions (median: 1; interquartile range: [IQR]: 0-4 versus median: 3; [IQR]: 2-4] in group 2), and lower frequency of 4 or more RBCU transfusions (29.4% versus 46.1% in group 2). Group 1 also exhibited a non-significant trend toward a lower volume of blood loss (1,000 mL [IQR]: 750-2,000 mL versus 1,500 mL [IQR]: 1,200-1,800 mL in group 2), and lower requirement of pelvic packing (1.9% versus 7.7% in group 2). Conclusion Establishing a prenatal diagnosis of PAS is related to a lower frequency of transfusions. We observed a high frequency of prenatal diagnostic failures of PAS. It is a priority to improve prenatal detection of this disease.

Prenatal ultrasonographic diagnosis of Fetus in Fetu at 2nd trimester: A case report / 대한산부인과학회지

Fetus in fetu is an very rare condition in which a vertebrate fetus is incorporated within its twin. Although a number of cases were reported at 3rd trimester of gestation or postnatally, the authors present a retroperitoneal fetus in fetu with 9 x 7 x 6 cm sized cystic mass that was diagnosed at 2nd trimester using ultrasonography and confirmed on a computed tomography scan after birth. The mass was successfully excised postnatally and consistent with a fetus in fetu by pathological confirmation. Solid mass was surrounded by a fluid-containing sac and showed highly ordered organogenesis around an axial vertebral column.

Prenatal Ultrasonographic and Molecular Diagnosis of Apert Syndrome: A case report / 대한산부인과학회지

Apert Syndrome is a kind of developmental disorder characterized by the craniosynostosis by synostosis of the coronal suture, bilateral symmetric syndactyly of the limbs (mitten-like hands and feet), midfacial hypoplasia, and variable degree of mental retardation. In 1894, Wheaton did the first description, and in 1906, it was named by Apert. Apert Syndrome is a rare autosomal dominent disorder and the prevalance at birth is estimated from 1:100000 to 160000. This syndrome is developed by the result of a mutation in the fibroblast growth factor receptor 2 gene (FGFR 2) located at 10q25.3-26. In familial cases, diagnosis in the first trimester sometimes has been made. But In sporadic cases, mostly it has been diagnosed in the second or third trimester by ultrasonography. In Korea, Apert syndrome is so rare, and it has not yet been reported that Apert syndrome is defined by prenatal molecular diagnosis with ultrasonographic detection. We present a case of prenatal molecular definitive diagnosis of Apert syndrome suspected strongly by ultrasonographic finding with a brief review of literature. Mother of affected fetus was transferred to our hospital at 31(2) weeks' gestation due to abnormal fetal ultrasound finding of severe polyhydroamnios and bilateral syndactyly of hands detected at 26(3) weeks' gestation. We suspected Apert syndrome by fetal ultrasonographic finding, and then confirmed Apert syndrome by DNA analysis of fetal amniocyte from therapeutic amnioredution at 31(4) weeks' gestation.

Avaliação ultra-sonográfica da apendicite aguda / Ultrasonographic evaluation of acute appendicitis

OBJETIVO: A apendicite aguda é a mais comum urgência cirúrgica abdominal. Na tentativa de aumentar a acurácia diagnóstica a ultra-sonografia abdominal tem sido observada como método sensível e específico. O presente estudo tem por objetivo avaliar a ultra-sonografia do abdome no diagnóstico de apendicite aguda. MÉTODO: Um total de 138 pacientes submetidos a tratamento cirúrgico com suspeita diagnóstica admitidos no Hospital Municipal Djalma Marques foi estudado no período de janeiro de 1997 a dezembro de 1998. Todos os exames foram realizados na mesma instituição e havia 87 pacientes do sexo masculino (63,0 por cento) e 51 do sexo feminino (37,0 por cento) com idade variando de 11 a 81 anos (média de 28,4 anos). RESULTADOS: Dos 134 casos com diagnóstico comprovado cirurgicamente, o estudo ultra-sonográfico foi positivo em 114 (sensibilidade de 85,0 por cento). O apêndice foi visualizado como imagem longitudinal ou transversal maior do que 7mm em 75 dos 114 achados positivos (65,8 por cento). CONCLUSÕES: Os autores concluem que a ultra-sonografia abdominal é um instrumento valioso no diagnóstico de apendicite aguda.

BACKGROUND: Acute appendicitis is the most common disease leading to emergency abdominal surgery. Many diagnostic tools have been evaluated. Abdominal ultrasonography is sensitive and specific which increase diagnostic accuracy in acute appendicitis. The aim of the present study is to evaluate the abdominal ultrasonography in the diagnosis of acute appendicitis. METHOD: A total of 138 patients underwent surgical treatment for suspected appendicitis admitted to the Hospital Municipal Djalma Marques from January 1997 to December 1998. All abdominal ultrasonography examinations were performed at same hospital. There were 87 male (63.0 percent) and 51 female (37.0 percent), and their ages ranged from 11 to 81 years (mean 28.4 years). RESULTS: Of the 134 patients with proved appendicitis at surgery the ultrasonographic diagnosis was positive in 114 (sensitivity of 85.0 percent). The appendix was visualized on a longitudinal or transverse image > 7mm in 75 patients of the 114 positive findings (65.8 percent). CONCLUSIONS: It can be concluded that abdominal ultrasonography examination is a valuable tool in diagnosis of acute appendicitis.

Comparative Study on the Results of Ultrasonography and Pathological examination for Polyp-like Cystic Lesions / 中国微创外科杂志

Objective To study the proportion and sonographic features of various kinds of diseases in the polypoid lesions of the gallbladder (PLG) diagnosed by ultrasonography, and to explore the reliability of ultrasonography for the diagnosis of PLG. Methods A total of 556 cases of PLG diagnosed by ultrasonography were classified basing on the results of pathological examination. And the accordance rate between ultrasonography and pathological examination in the PLG with different size was analyzed. Results Among the 556 cases of PLG, 446 (80.2%) had cholesterol polyps, 86 (15.5%) adenomatous polyps, 18 (3.2%) inflammatory polyps, and 6 (1.1%) myoadenoma. In 97.3% of the cholesterol polyps, the diameter was less than 1.0 cm, and 64.6% of the cases had multiple polyps. In the cholesterol polyps, the accordance rate between ultrasonography and pathological examination was 91.3%. Of the adenomatous polyps, 61.6% had a diameter over 1.0 cm, and 34.0% showed atypical hyperplasia or malignancy. However, 25% of the malignancies were found in the adenomatous polyps with a diameter less than 1.0 cm. Conclusions More than 80% of PLG are cholesterol polyps and 15.5% are adenomatous polyps. Most of the PLG with malignant transformation sized over 1.0 cm in diameter. However, the adenomatous polyps with a diameter ranged from 0.7 to 0.9 cm also have malignant tendency. In the cholesterol polyps, the accordance rate between ultrasonography and pathological examination is 91.3%, showing that ultrasonography is reliable for the diagnosis of the disease.

The Ultrasonographic Diagnosis of the Complications in Mammoplasty by Different Operation Methods / 中国医师杂志

Objective To evaluate the clinical value of highfrequency ultrasonography in diagnosis of the complications in mammoplasty.Methods One hundred and one cases of mammoplasty with complications were examined.They were divided into implanted group and injected group,and the prosthetic position,shape,internal echo and capsula were observed.Results Among the cases,91 breasts were capsular contraction and hardening,24 were asymmetry,38 were rupture,4 were infection and 1 was bleed.All cases were proved by operation.Conclusion High-frequency ultrasonography was easy and effective to diagnose the complications of mammoplasty.

Application of Ultrasonographic Diagnosis and Color Doppler Blood Flow Image in Bone and Soft Tissue Tumors / 中华超声影像学杂志

This report emphasizes on US diagnostic characteristics of partly BSTT,including OSteogenic sarcotma in 57 cases,chondrosarcoma in 25 cases, fibrosarcoma in 18 cases, synovial sarcoma in 14 cases, myelogenous neoplasm in 21 cases.metastatic bone ttmlor in 67 cases,giant cell turnor of bone in 52 cases, chordoma in 25 cases,hemangioma In 32 cases,desmoplastic fibroma in 10 cases. Pigrnenled villonodular synovius in 10 cases,and aneurysmal bone cyst in 8 cases, altogether 563 cases. The study firstly presents the application and specific menifestation of US diagnosis in BSTI. In many aspects,US is superor to X-ray, CT and MRI in diagnosing BSTT. It provides a great deal of reliable basis for clinical diagnosis and. Treatment.