External cephalic version: Predictors of success and influence on caesarean rates.

OBJECTIVE: To evaluate the success rate of external cephalic version, predictive factors for success of this maneuver and to examine how it affects mode of delivery, pregnancy and neonatal outcome rates. STUDY DESIGN: Retrospective cross-sectional study performed in a tertiary care university hospital between January 2002 and June 2018. A total of 324 ECVs were performed in 321 pregnancies. Maternal and ultrasound data, procedure-related factors, birth characteristics and neonatal data were collected. Absolute and relative frequencies were used for descriptive analysis and the chi-square test for comparative analysis. Odds ratios with 95 % confidence intervals were calculated. RESULTS: The overall success rate of the procedure was 33,3%. Multiparity, transverse lie, unengaged breech presentation, low body mass index, soft uterus and palpable fetal head were independent risk factors for success. No statistically significant association was found with other variables. Routine use of ECV allowed a reduction in cesarean delivery rates for breech presentation, with no increase in maternal or neonatal morbidity. Operative delivery rates after successful ECV were similar to those of the general population. DISCUSSION AND CONCLUSION: Despite a relatively low overall success rate, routine use of ECV can result in reduced cesarean delivery rates with similar perinatal outcomes. Conveyed information on the success rate of ECV can be adapted to individual patient characteristics.

Prenatal sonographic diagnosis of isolated fetal ascites in cri-du-chat (5p-) syndrome: A case report.

Isolated fetal ascites and cri-du-chat syndrome (CdCS; OMIM #123450) are two very rare conditions that, to our best knowledge, have never been reported together. Here, we describe a case of isolated fetal ascites detected in the first trimester ultrasound, with no other remarkable signs. After an extensive work-up (fetal ultrasound, serologies, Coombs test, and NIPT), an amniocentesis was performed and revealed an abnormal karyotype of 46,XX,del(5)(p15.2), characteristic of CdCS. We hypothesize that isolated fetal ascites has to be considered an antenatal ultrasonographic marker for CdCS, a finding that should be confirmed in further cases.

Benign Metastasizing Leiomyoma of the Uterus: Rare Manifestation of a Frequent Pathology.

Benign Metastasizing Leiomyoma (BML) is a rare condition with few cases reported in the literature. It is usually incidentally diagnosed several years after a primary gynecological surgery for uterine leiomyoma. Differential diagnosis of BML is complex requiring an extensive work-up and exclusion of malignancy. Here, we report two cases of BML based on similarity of histopathological, immunohistochemical, and genetic patterns between lung nodules and uterine leiomyoma previously resected, evidencing the variability of clinical and radiological features of BML. We highlight the importance of 19q and 22q deletions as highly suggestive of BML. These findings are particularly relevant when there is no uterine sample for review.

Obstetric Management of Delayed-Interval Delivery.

The delayed-interval delivery is a rare, flexible and complex procedure. In light of these facts, there is no consensus on the best approach to achieve it successfully. This case report is of an asynchronous delivery, in a twin pregnancy, with a 32-day interval between births of siblings. Our obstetric management at a critical gestational age improved the outcome of the second newborn. The probability of success of delayed-interval delivery depends on the proper selection of the candidates, the appropriate active management and the continuous monitoring for early detection of complications.