The usefulness of volume NT software in measuring the fetal nasal bone at 11 to 13 + 6 weeks of gestation.

OBJECTIVE: The objective of this study is to investigate the reproducibility of 3D ultrasound to measure the fetal nasal bone (NB) at first trimester. METHODS: A group of singleton viable pregnancies attending the 11 to 13 + 6 weeks aneuploidy screening at the University of Bologna were prospectively selected. For each patient, fetal NB was measured by 2D ultrasound. Subsequently, a 3D ultrasound of the fetal head was acquired, and fetal NB was measured by offline analysis using the volume nuchal translucency software. The correlation between 2D and 3D ultrasounds and the reproducibility of fetal NB measurement at 3D ultrasound were assessed. RESULTS: Overall, 161 Caucasian women were included in the study. At 3D ultrasound, NB measurement showed an excellent intraobserver [Oper 1, intraclass correlation coefficient (ICC) = 0.98; Oper 2, ICC = 0.921] and interobserver agreement (rc = 0.92). The agreement between 2D and 3D measurements was moderate (rc = 0.77). CONCLUSIONS: A 3D ultrasound supported by the volume nuchal translucency software may provide reliable measurements of the fetal NB in the first trimester.

A rare immature teratoma of the tela chorioidea of the third ventricle: late-onset, intrapartum ultrasound diagnosis and postnatal outcome.

We describe a previously unreported case of immature teratoma originating from the tela chorioidea of the third ventricle diagnosed during labor at term of pregnancy. Postnatal MR imaging and pediatric neurosurgery with postnatal outcome at 6 months of age are reported.

Neonatal respiratory morbidity in twins versus singletons after elective prelabor caesarean section.

OBJECTIVE: To compare the rate of neonatal respiratory morbidity in singletons versus twins delivered by pre-labour caesarean section. STUDY DESIGN: Uncomplicated pregnancies delivered by prelabor caesarean section at 34+0 to 37+6 weeks' gestation were retrospectively selected. For both singletons and twins caesarean delivery was undertaken electively only after amniocentesis and if the lecithin/sphingomyelin ratio was ≥2. Neonatal respiratory morbidity was compared in twins versus singletons. RESULTS: 241 singletons and 100 twin neonates were included. Overall neonatal respiratory morbidity was comparable between the two groups (25/241 (11.7%) versus 7/100 (7%), p=.331). Between 34+0 and 36+6 weeks, however, the risk was higher among singleton than twins (15/46 (32.6%) versus 6/72 (8.3%), p<.001). At multiple regression, dichorionicity, gestational age at delivery ≥37 weeks and female sex independently decreased the risk of neonatal respiratory morbidity. CONCLUSION: The risk of neonatal respiratory morbidity after elective caesarean section seems lower among twins, especially prior to 37+0 weeks.

Menopause affects pain depending on pain type and characteristics.

OBJECTIVE: Women are more affected than men by many chronic pain conditions, suggesting the effect of sex-related mechanisms in their occurrence. The role of gonadal hormones has been studied but with contrasting results depending on the pain syndrome, reproductive status, and hormone considered. The aim of the present study was to evaluate the pain changes related to the menopausal transition period. METHODS: In this observational study, postmenopausal women were asked to evaluate the presence of pain in their life during the premenopausal and postmenopausal periods and its modification with menopause. RESULTS: One hundred one women were enrolled and completed questionnaires on their sociodemographic status, pain characteristics, and evolution. The most common pain syndromes were headache (38%), osteoarticular pain (31%), and cervical/lumbar pain (21%). Pain was present before menopause in 66 women, ceased with menopause in 17, and started after menopause in 18. Data were used for cluster analysis, which allowed the division of participants into four groups. In the first, all women experienced headaches that disappeared or improved with menopause. The second group included osteoarticular pain; the pain improved in half of these women and remained stable in the other half. The third group had cervical/lumbar pain, which disappeared or improved with menopause in all. The fourth group presented different kinds of moderate pain, which worsened in all. CONCLUSIONS: The present study provides preliminary data suggesting that menopause can affect pain depending on the painful condition experienced by the woman. This underlines the different interactions of menopause-related events with body structures involved in pain.