ABSTRACT
AIM: Analyze if the evaluation of aberrant right subclavian artery in the prenatal echography has improved the detection of chromosomal, genetic and/or morphological abnormalities in our population. METHODS: Descriptive, observational, cross-sectional study of the cases of aberrant right subclavian artery diagnosed in our Prenatal Diagnosis Unit between January of 2011 and December of 2018. RESULTS: Two hundred and fifty-seven cases of aberrant right subclavian artery were diagnosed and among them, 179 were considered isolated cases and thus were confirmed after birth. The detection of aberrant right subclavian artery did not improve itself neither the diagnosis of trisomy 21 in the second trimester of pregnancy nor other chromosomal or genetic abnormalities, including the not isolated cases. There were two cases of trisomy 21 diagnosed in the second trimester that presented major sonographic disorders and an inadequate examination during the first trimester. When aberrant right subclavian artery was associated with soft markers of aneuploidy in the second trimester, any case was a trisomy 21. Aberrant right subclavian artery seems to be associated with some minor and major heart defects, especially ventriculoseptal defect and aneurismatic ductus, and in some cases, also with clubfeet. CONCLUSION: When an adequate screening of aneuploidies and a thorough ultrasound have been performed during the first trimester, aberrant right subclavian artery hardly helps to perform other diagnosis in the second trimester.
Subject(s)
Aneurysm , Aneurysm/diagnostic imaging , Cardiovascular Abnormalities , Cross-Sectional Studies , Female , Humans , Pregnancy , Prenatal Diagnosis , Subclavian Artery/abnormalities , Ultrasonography, PrenatalABSTRACT
Introducción: La simulación es un elemento que ya se utiliza de manera profusa en el entrenamiento de obstetras y ginecólogos. Permite entrenarse en situaciones complejas con seguridad para la paciente. Presentamos un programa piloto con la aplicación de distintas técnicas de simulación al entrenamiento en ecografía obstétrica. Sujetos y métodos: Diseñamos un programa con parte presencial y no presencial destinado a 12 médicos internos residentes de ginecología y obstetricia. La parte no presencial consistió en el acceso a unos documentos en una página web. La parte presencial consistió en tres talleres con una duración total de cuatro horas: taller de ecografía en la semana 20 mediante realidad virtual, taller de técnicas invasivas con simuladores de tareas y taller de habilidades comunicativas en dar malas noticias mediante paciente estandarizado. Se les pasó a los alumnos una encuesta de satisfacción anónima (con escala de 1 a 10) al final del programa. Resultados: El resultado de la experiencia de aprendizaje fue muy satisfactorio, como así lo reflejaron los alumnos en la puntuación media global del curso, que fue de 9,1. Conclusión: En este trabajo mostramos que la simulación en el aprendizaje de la ecografía obstétrica ha sido satisfactoria para los residentes
Introduction: Simulation is an useful tool widely used among obstetrician and gynaecologist, as it allows training in complex situations increasing patients safety. We are introducing a brand-new simulation program based on obstetric ultrasound. Subjects and methods: It is designed half face-to-face for 12 gynecology and obstetrics residents. The non presence part of the course was online, with access to several documents at a website. The on-site modality consisted of 3 workshops that lasted 4 hours in total: the 20 th week ultrasound workshop implementing virtual reality, the invasive techniques course using mannequin simulation, and the development of bad news communicative skills with standardized patients workshop. All participants were required to fill an anonymous satisfaction survey (scale 1 to 10) at the end of the programme. Results: The learning experience was very satisfactory and the learners gave their inputs in the feedback survey. The final score was 9.1 over 10. Conclusion: In this paper we show that the use of simulation to learn obstetrical ultrasound was rewarding for the residents
Subject(s)
Humans , Ultrasonic Therapy/methods , Ultrasonic Surgical Procedures/education , Ultrasonography, Prenatal/methods , Simulation Training/methods , Amniocentesis/methods , Internship and Residency/methodsABSTRACT
INTRODUCTION: The value of a single umbilical artery (SUA) in first trimester ultrasound is not well established. The aim of our study was to determinate the relevance of diagnosis of single umbilical artery in first trimester ultrasound as an early marker suggesting the presence of malformations or associated chromosomopathies. MATERIAL AND METHODS: Retrospective study of clinical cases of SUA diagnosed at the University Hospital Puerta de Hierro in Madrid (Spain) during the first trimester ultrasound between September 2008 and September 2012. RESULTS: Prevalence of SUA was 1.1% in single pregnancies and 3.3% in twin pregnancies. Sensitivity, specificity, false positive rate, and false negative rate for the finding in the first trimester were 84.2, 99.8, 0.2, and 15.7%, respectively. 17.6% of cases had associated malformations. With an ultrasound in the 16th week most of the cases with significant fetal malformation were diagnosed. DISCUSSION: SUA is a useful marker in the first trimester for fetal malformation pathology, as it will allow detecting a large number of cases with malformations before 20 weeks of gestation.
