Reference ranges and distribution of placental volume by 3-dimensional virtual organ computer-aided analysis between 11 weeks and 13 weeks 6 days.

OBJECTIVES: The purpose of this study was to determine the feasibility, reproducibility, and distribution of placental volume measurements according to the crown-rump length between 11 weeks and 13 weeks 6 days. METHODS: Images were acquired in 128 pregnancies followed in Burgundy during first-trimester screening sonography using an abdominal 3-dimensional transducer. The placental volume was then calculated by the virtual organ computer-aided analysis method with a rotation angle of 30° by a single operator. RESULTS: Placental volumes ranged from 33.3 to 107.6 cm(3) with a mean ± SD of 62.3 ± 14.8 cm(3); the 5th and 10th percentiles were 38.0 and 44.20 cm(3), respectively, whereas the 90th and 95th percentiles were 80.25 and 86.68 cm(3). An exponential relationship was found between placental volume and crown-rump length: ln placental volume = 0.018 × crown-rump length + 2.93425; ln SD = 0.15; r(2) = 0.58. Finally, the mean placental quotient, defined as the ratio of placental volume to crown-rump length, was 1 ± 0.1 cm(3)/mm; the respective percentile values were 0.74, 0.81, 1.18, and 1.29 cm(3)/mm. No associations were found between parity or smoking and the placental quotient or between obesity and the placental quotient. Intraobserver reproducibility was good, with a mean difference of 0.2 cm(3). CONCLUSIONS: Measurement of placental volume between 11 weeks and 13 weeks 6 days is reliable and reproducible and correlates strongly with crown-rump length.

Transvaginal treatment of anterior or central urogenital prolapse using six tension-free straps and light mesh.

OBJECTIVE: To evaluate the feasibility, efficacy, complications, and outcomes of treatment of anterior or central compartment urogenital prolapse by placement of an anteroposterior 22-g/m(2) mesh with six straps through one anterior vaginal incision. METHODS: In a prospective study, patients treated for urogenital prolapse at a center in France between February 2008 and June 2011 were enrolled. Previous treatments, related interventions, intraoperative and postoperative complications, and anatomic outcomes were recorded during 3years of follow-up. Failure was defined as recurrence of prolapse of stage II or higher according to the Pelvic Organ Prolapse Quantification system. RESULTS: Overall, 74 patients were included. Preoperatively, 55 (74%) patients had stage III cystocele, 13 (18%) had stage IV cystocele, and 44 (59%) had associated uterine prolapse of at least stage II. Postoperative hematoma occurred in three patients and vaginal exposure in two patients. There were no cases of visceral injury. Vaginal comfort improved postoperatively: 68 (92%) patients were satisfied with the outcome and there were no cases of de novo dyspareunia. Seventeen (23%) patients subsequently had stress urinary incontinence that was treated by placement of suburethral tape. The anatomic outcomes were satisfactory for 72 (97%) women, including sexually active patients. CONCLUSION: Transvaginal prolapse repair by placement of an anteroposterior six-strap 22-g/m(2) mesh was feasible and effective with satisfactory 3-year outcomes.

Loading and release of small hydrophobic molecules in multilayer films based on amphiphilic polysaccharides.

We report on the loading and release behaviors of polyelectrolyte multilayers based on hydrophobically modified carboxymethylpullulan (CMP) derivatives and poly(ethyleneimine) (PEI) toward hydrophobic dye. The dye-loaded films are obtained according to two different protocols: (i) the postdiffusion approach, which involves the diffusion of the dye within preassembled self-assemblies, and (ii) the precomplexation method, which requires the formation of a water-soluble amphiphilic CMP derivative-dye complex before the multilayer buildup. In both cases, we provide clear evidence for the entrapment of the dye in hydrophobic nanoreservoirs resulting from the aggregation of decyl pendent groups grafted on CMP chains. We show that the loading capacity of the multilayers, as well as their release behavior, can be tuned by varying the grafting degree of CMP chains. Moreover, we demonstrate the possibility to trigger the subsequent release of the loaded dye molecules by varying the composition of the surrounding solution.