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32 участника, 114 тем

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  • The guidelines contain special information regarding the diagnosis of PCOS among adolescents and postmenopausal women. Anovulatory symptoms and the presence of polycystic ovaries alone are insufficient to make the diagnosis of PCOS among adolescents. Hyperandrogenism needs to be present.
  • The diagnosis of PCOS is difficult after menopause, but a history of menstrual irregularities and hirsutism helps. The presence of polycystic ovaries is less likely after menopause.
  • Women diagnosed with PCOS should undergo screening tests for diabetes using an oral glucose tolerance test and should be screened for depression. Diabetes screening should occur every 3 to 5 years after a normal result.
  • Overweight and obese women with PCOS should be evaluated for possible obstructive sleep apnea symptoms and tested with polysomnography for suspected disease.
  • However, women with PCOS do not need to be routinely screened for endometrial cancer or nonalcoholic fatty liver disease.
  • Hormonal contraceptives are the first-line treatment of anovulatory symptoms and hirsutism in PCOS. There is no recommendation for one form of contraceptive vs another.
  • Weight loss likely improves reproductive and metabolic outcomes of PCOS, but it is unlikely to be effective among women at a normal body weight.
  • Metformin should be used in cases of PCOS featuring diabetes or glucose intolerance. It is a second-line drug for women with menstrual irregularities who cannot tolerate hormonal contraceptives.
  • Clomiphene citrate or comparable estrogen modulators are the first-line treatment of anovulatory infertility among women with PCOS.
  • Thiazolidinediones are not recommended for the treatment of PCOS because of safety concerns. More research is required before a strong recommendation is made regarding the use of statins in PCOS.
  • There is limited difference in the treatment recommendations for adolescents and adults. The optimal duration of treatment with either hormonal contraceptives or metformin is unknown.
  • http://www.medscape.org/viewarticle/813644?src=cmemp
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The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) wrote a joint opinion published in the November issue ofObstetrics & Gynecology discouraging use of the general label "term pregnancy" and replacing it with these categories:

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Increased nuchal lucency, video-clip 1

Philippe Jeanty, MD, PhD, Chaitali Shah, MD, Cerine Jeanty
Tennessee Women"s Care, Nashville TN

This video clip shows a fetus with a 5.6 mm nuchal lucency. Chromosomal testing and anatomical scans were normal The baby was normal at birth.

These are the ultrasound images demonstrating the same pathology.

http://www.sonoworld.com/TheFetus/page.aspx?id=1389

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Succenturiate & bilobate placenta

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Placenta circumvallate

Gloria Valero de Madrid, MD, Philippe Jeanty, MD, PhD

Also called circumvallata (= surrounded by a wall).  These are placenta that are a form of placenta extrachorialis, unusual in humans but common in chimpanzee and orang-utan. They are usually benign condition requiring no alteration of management and simply have to be differentiated from other type of bands and membranes in the uterine cavity.

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Ultrasound examination in the second & third trimester

Aleksandra Mikic Novakov, MD, PhD

Novi Sad, Yugoslavia

Normal fetal morphology

http://www.sonoworld.com/TheFetus/page.aspx?id=449

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Trisomy 21

Emmanuel Julien, MD.

Case report:

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Trisomy 21, 12 weeks

Francesco Contarin, MD.

Clinica Sanatrix, Caracas, Venezuela.

 

Case report

http://www.sonoworld.com/TheFetus/page.aspx?id=3055

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Trisomy 18

S. Manohar, MD, DMRD

Madurai, India 

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Trisomy 18 


Albana Cerekja
, MD, PhD*, Flavia Ventriglia, MD**, Vanessa Martucci, MD**, Francesco Cecinato, MD***, Juan Piazze MD, PhD****.


*     Ultrasound Division, ASL Roma B, Rome, Italy.
**    Pediatric Cardiology. Policlinico Umberto I. University “La Sapienza” Rome, Italy.
***   Obstetrics Department. Policlinico Umberto I. University “La Sapienza” Rome, Italy.
****  Ultrasound Division, Ceprano Hospital, Ceprano, Italy.

http://www.sonoworld.com/TheFetus/page.aspx?id=2954

 

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