Efficacy of shear wave elastography in predicting preeclampsia in the first trimester.

OBJECTIVE: This study aimed to investigate the predictive value of shear wave elastography (SWE) for preeclampsia (PE) in first-trimester pregnancies. METHODS: Singleton pregnant women aged 18-45 years, who underwent routine first-trimester prenatal examinations (11-13 weeks+6 days) were enrolled. Pregnancies with anterior placenta and normal first-trimester screening test results were included in the study group. The SWE measurements of six areas of the placenta were performed, and the mean value was estimated. The perinatal outcomes and the demographic data were also collected. The receiver operating characteristic curve analysis was used for the accuracy of predicting PE. RESULTS: This study consisted of 84 patients, of which 9 were diagnosed with PE during the follow-up. The mean SWE value of the PE patients was higher than that of patients with normal pregnancies (p=0.002). The analysis showed that the optimal cutoff value was 7.43 kPa to predict PE in the placentas of first-trimester pregnancies, with 88% sensitivity and 78% specificity. CONCLUSIONS: The SWE values of the placenta in the first trimester were different between normal patients and those who are subsequently developing PE. SWE may be a suitable tool for predicting PE in pregnant women.

Laparoscopic sacral uteropexy with cravat technique--experience and results.

OBJECTIVE: The aim of the present study was to evaluate the safety and efficacy of a ″Cravat″ technique for the management of uterine prolapse in patients who want to preserve uterus, involving suspension of the uterus from the sacral promontory by using polypropylene mesh. MATERIALS AND METHODS: A prospective observational study between January 2011 and September 2013 was conducted. Prior to surgery, prolapse assessment was undertaken with Baden-Walker halfway system to grade the degree of prolapse at all sites. Patients with severe uterine prolapse (stage II-IV) who want to preserve uterus, were operated with Cravat technique. All patients were evaluated at 2 weeks and 6 weeks after surgery and followed for 6 months. Outcomes were evaluated objectively by vaginal examination using Baden-Walker halfway classification, and subjectively classifying patients as 'very satisfied', 'satisfied' and 'not satisfied' at the 6th month postoperatively. RESULTS: Sacral uteropexy was successfully performed by laparoscopy in 32/33 patients (one needed to be converted to laparotomy). Nine patients also had a concurrent procedure as colporaphy anterior, colporaphy posterior or transobturator tape. Postoperative recovery has been uneventful with subjective and objective cure rates were 96.9% and 93.9%, respectively at six month. One recurrence of total prolapse needed to be reoperated and two patients with sacrouteropexy still remained at stage 2 prolapse. There have been no cases of graft exposure, rejection or infection with a median follow-up of 23.9 months. CONCLUSIONS: Laparoscopic sacral uteropexy with "Cravat technique" was found to be safe and simple procedure.

Laparoscopic Sacral Uteropexy with Cravat Technique--Experience and Results

Objective The aim of the present study was to evaluate the safety and efficacy of a “Cravat’’ technique for the management of uterine prolapse in patients who want to preserve uterus, involving suspension of the uterus from the sacral promontory by using polypropylene mesh. Materials and Methods A prospective observational study between January 2011 and September 2013 was conducted. Prior to surgery, prolapse assessment was undertaken with Baden-Walker halfway system to grade the degree of prolapse at all sites. Patients with severe uterine prolapse (stage II-IV) who want to preserve uterus, were operated with Cravat technique. All patients were evaluated at 2 weeks and 6 weeks after surgery and followed for 6 months. Outcomes were evaluated objectively by vaginal examination using Baden-Walker halfway classification, and subjectively classifying patients as ‘very satisfied’, ‘satisfied’ and ‘not satisfied’ at the 6th month postoperatively. Results Sacral uteropexy was successfully performed by laparoscopy in 32/33 patients (one needed to be converted to laparotomy). Nine patients also had a concurrent procedure as colporaphy anterior, colporaphy posterior or transobturator tape. Postoperative recovery has been uneventful with subjective and objective cure rates were 96.9% and 93.9%, respectively at six month. One recurrence of total prolapse needed to be reoperated and two patients with sacrouteropexy still remained at stage 2 prolapse. There have been no cases of graft exposure, rejection or infection with a median follow-up of 23.9 months. Conclusions Laparoscopic sacral uteropexy with “Cravat technique” was found to be safe and simple procedure. .