Fetal sex determination: obstetricians' attitudes in antenatal screening units in Finland.

AIM: To study obstetricians' attitudes in Finnish antenatal screening units concerning fetal sex determination without medical indication. METHODS: A structured questionnaire to all delivery units (n = 37) and the main outpatient screening units (n = 18) in the country. RESULTS: The majority of units made fetal sex determination without medical indication at patient's request during the second-trimester ultrasonographic screening. This examination was seen to have consequences for maternal-fetal attachment, but it was also considered medically useless and sometimes harmful. Only three out of the responding 32 units maintained quality control of the examination. A false diagnosis resulted extremely seldom in any litigation process. CONCLUSIONS: More precise guidelines are needed for fetal sex determination in healthcare organisation.

Myometrial inflammation in human delivery and its association with labor and infection.

The presence of inflammation in decidual and myometrial samples as defined by histopathologic examination and the association between the myometrial inflammation and different maternal infectious morbidity and labor-related clinical variables were evaluated in 648 consecutive women who underwent cesarean section at various gestational periods. Altogether, 1,205 histologic (559 decidual and 646 myometrial) samples were studied. In normal pregnancies, myometrial inflammatory lesions were detected rarely before parturition, indicating their abnormality in these cases. After ruptured fetal membranes with advanced cervical dilatation and in patients with clinical chorioamnionitis, myometrial samples commonly were infiltrated by leukocytes, up to moderate and marked densities. Moderate to marked myometrial inflammation showed no diagnostic value in high-risk term parturients for the prediction of postoperative endometritis. Our study is the first to show the frequency of myometrial inflammation in nonselected consecutive pregnant women and, thus, is important for better understanding the myometrial inflammatory response during human parturition.

Kinetics of a US contrast agent in benign and malignant adnexal tumors.

PURPOSE: To evaluate the effects of a microbubble contrast agent on the power Doppler ultrasonographic (US) examination of adnexal tumors, with a special focus on the timing of the transit of the microbubble bolus. MATERIALS AND METHODS: Seventy patients who were suspected of having ovarian tumors were examined preoperatively with contrast material-enhanced US. Images obtained during a 5-minute examination were stored digitally, and the behavior of the contrast agent was evaluated objectively with measurement of the time-dependent image intensity at the region of interest with a computer program. A time-intensity curve in each case was derived and analyzed. The Mann-Whitney U test was used to compare intensity changes and tumor parameters in benign and malignant adnexal tumors. RESULTS: Both the baseline and maximum power Doppler intensities, as well as the absolute and relative (percent) rise in intensity, were significantly higher (P <.001) in malignant as compared with benign tumors. The arrival time was shorter (17.5 vs 22.5 seconds; P =.005) and the duration of contrast agent effect was longer (190.4 vs 103.6 seconds; P <.001) in malignant tumors than they were in benign tumors. The area under the time-intensity curve was significantly greater in malignant tumors compared with that in benign tumors (P <.001). CONCLUSION: After microbubble contrast agent injection, malignant and benign adnexal lesions behave differently in degree, onset, and duration of Doppler US enhancement.