Improvement in uterine artery doppler indices via hysteroscopic metroplasty

Objective: the objective of our research was to study uterine artery doppler indices and their evolution over time after metroplasty and subsequent pregnancy in patients whose septate uterus was the only explanation for infertility. Materials and Methods: a retrospective study. The uterine arteries of 78 patients with septate uteri were evaluated using endovaginal color doppler ultrasound before and after metroplasty. Fifty-one patients became pregnant after metroplasty and were selected as study group, pregnancy occurred within 17 months. By comparing uterine artery doppler indices before and after metroplasty, we observed that the resistive index (RI) and pulsatility index (PI) post surgery were significantly lower compared to pre-metroplasty levels. Results: all pregnant women in the study Group showed uterine resistive indexes within normal ranges, they all underwent scheduled cesarean intervention. Gestational evolution was normal in all patients (mean score of Apgar and birth weight); no neonatal complications were observed. Conclusion: metroplastic intervention in women with septate uterus as the sole cause of infertility may be a plausible alternative for patients wishing to carry a pregnancy

Conjoined twins: what ultrasound may add to management

Introduction: Conjoined twins occur in approximately 0.2:10,000 births; the obstetrician and sonographer only rarely examine them. In Western countries, discovery of conjoined twins is often made by the end of the first trimester; however, in the third world, conjoined twins are often discovered only at birth. Objective: To evaluate how ultrasound techniques, when possibly available, may improve management and counseling when conjoined twins are confirmed. Material and Methods: The authors report two different cases of union of two equal twins with sole umbilical cord. Results: The two cases presented with non contributive medical history and no prior teratogen exposure and an unfavorable prognosis. Early discovery of viable conjoined twins permits assessment of the best route of delivery and a planning for serial sonography and fast MRI to plan eventual separation surgery or fetus after-birth surviving possibilities