[PREVENTION OF PRETERM BIRTH IN TWINS WITH SHORT MID-TRIMESTER CERVICAL LENGTH LESS THAN 25MM -COMBINED TREATMENT WITH ARABIN'S CERCLAGE PESSARY AND INTRAVAGINAL MICRONIZED PROGESTERONE COMPARED WITH CONSERVATIVE TREATMENT].

Background: Twin pregnancies with short mid-trimester cervical length have a high rate of preterm births.

Objectives: To compare combined treatment of Arabin cerclage pessary, and intravaginal micronized progesterone to conservative treatment for the prevention of preterm births in twins pregnancies with short cervical length in second trimester of pregnancy.

Methods: A retrospective study that compared twin pregnancies with short ≤25mm cervix in second trimester 16-28 gestational weeks treated with combined treatment of Arabin cervical pessary and intravaginal micronized progesterone 200mg TID to a control group with conservative treatment for the prevention of preterm.

Prenatal ultrasound charts of orbital total axial length measurement (TAL): a valuable data for correct fetal eye malformation assessment.

Objective: To construct prenatal age-specific reference intervals using ultrasound measurement of total axial length (TAL) in normal fetuses for assessing microphthalmia.

Method: Prospective cross-sectional study of fetuses assessed at a prenatal ultrasound unit between 2011 and 2014. The study cohort comprised 309 pregnant women attending for routine fetal biometry, viability, or anomaly scan between 14 and 41 weeks of gestation.

[First year experience using arabin cervical pessary with intravaginal micronized progesterone for the prevention of preterm birth in patients with mid-trimester short cervix].

Background: Arabin cervical pessary is a silicone ring pessary for the prevention of preterm birth (PTB] for pregnant women at risk with second trimester short uterine cervix. Progesterone supplementation has been found to prevent PTB.

Objective: To review our first year of experience using Arabin cervical pessary with intravaginal micronized progesterone in the prevention PTB.

Assessment of the accuracy of multiple sonographic fetal weight estimation formulas: a 10-year experience from a single center.

Objectives: The primary aim of this study was to compare the accuracy of sonographic fetal weight estimation models. The secondary aim was to define the most accurate time (4-7 or 3 days before delivery) for evaluating fetal weight.

Methods: In this retrospective cohort study, a total of 12,798 sonographic fetal weight estimations were analyzed, of which 9459 were performed within 3 days of delivery and 3339 within 4 to 7 days.

[The findings and sequence of events leading to termination of pregnancy due to Down's syndrome--before and after the verge of viability: 10 years experience at a single medical center].

Objective: To assess the differences in the sequence of events, leading to termination of pregnancy (TOP) due to diagnosis of Down syndrome (DS). The study compared women who were referred to institutional abortion committees (< 23 weeks) to those who were referred to supreme regional abortion committees (> 23 weeks).

Methods: Cases of singleton pregnancy ending in TOP due to DS in our institute during the period January 2000-December 2010 were retrospectively reviewed.

[Non-indicated cesarean section--does the "Golem" counteract?].

Cesarean section rate is steadily increasing and in Israel it has risen to 20%. MultipLe and different reasons have led to this phenomenon, among them are non-indicated cesarean sections. Although health care providers disagree whether this development is medically, ethically and publically justified, national associations allow it, while respecting those obstetricians who decline to do so.

Model predicted Down syndrome detection rates for nuchal translucency screening in twin pregnancies.

Objective: To estimate the Down syndrome detection rate for nuchal translucency (NT) screening in twins when fetus-specific risk allows for between-fetus NT correlation.

Methods: The between-fetus correlation coefficient of log NT, in multiples of the median (MoM), was estimated from a series of 977 unaffected twins scanned at a single centre. Results were expressed in multiples of the normal median using a curve derived from 515 unaffected singleton pregnancies at the same centre.

Twin tubal pregnancy: a rising complication?

Objective: To present four cases of twin tubal pregnancies and discuss possible etiologies. Twin tubal pregnancies are a rare event, with incidence rates estimated as 1 out of 725-1,580 of tubal pregnancies.

Design: Case series.

Is neonatal risk from vasa previa preventable? The 20-year experience from a single medical center.

Background: Vasa previa is a rare condition associated with neonatal morbidity and mortality that may be diagnosed prenatally using transvaginal sonography. The aim of this study was to assess the prenatal detection of vasa previa and its subsequent impact on neonatal outcomes in two 10-year periods (1988-1997 versus 1998-2007).

Method: Retrospective review of all cases of vasa previa.

Termination of pregnancy due to fetal abnormalities performed after 23 weeks' gestation: analysis of indications in 144 cases from a single medical center.

Background/aims: To assess the indications for late termination (> or =23 weeks' gestation) of pregnancy (LTOP), and to evaluate the rate of cases potentially diagnosable earlier.

Methods: Cases of singleton pregnancy ending in LTOP due to fetal abnormalities in our institute between 1/1998 and 12/2005 were retrospectively reviewed. The women were divided into two groups according to the sequence of events that led to LTOP: Group 1 - the first test indicating an abnormal finding was performed < or =23 weeks' gestation, but LTOP was performed >23 weeks; Group 2 - the first test indicating an abnormal finding was performed > or =23 weeks of gestation, or the fetal prognosis was not certain at the time of diagnosis and there was a medical recommendation to continue investigation.

Paraovarian cysts of neoplastic origin are underreported.

Introduction: We suspected that paraovarian cysts of neoplastic origin may be underreported. This study was designed to evaluate our data on the pathologic characteristics of cystic lesions located in the paraovarian area and compare them with previous studies that claimed the vast majority of these lesions were simple paraovarian cysts and only few (1.69% to 5%) were neoplastic ones.

Pelvic splenosis--a gynaecological challenge.

Pelvic splenosis is a post-traumatic spleen autotransplantation, which can mimic various gynaecological diseases. A case of a 39-year-old woman, who underwent partial splenectomy because of a road accident in her childhood, currently presenting with abdominal pain and suspected corpus luteus torsion. Diagnostic laparoscopy was conducted which ruled out twisted ovary.

Fetal abnormalities leading to third trimester abortion: nine-year experience from a single medical center.

Objective: To assess fetal abnormalities and events leading to third-trimester abortion.

Methods: The study population included all parturient women with singleton pregnancy that underwent termination of pregnancy (TOP) in the third trimester in our institute because of fetal indications between 1998 and 2006.

Results: There were 777 cases of TOP due to fetal anomalies in our center during the study period, and 52 terminations were carried out in the third trimester.

The clinical characteristics and sonographic findings of maternal ovarian torsion in pregnancy.

Objective: To investigate the incidence, risk factors, and sonographic findings of maternal ovarian torsion in pregnancy.

Design: Retrospective study.

Setting: Department of Obstetrics/Gynecology of a tertiary referral center.

Combined local and systemic methotrexate treatment of viable ectopic pregnancy: outcomes of 31 cases.

Purpose: Medical treatment of viable unruptured ectopic pregnancies by systemic methotrexate (MTX) is controversial due to elevated failure rates. This study describes a combined local and systemic MTX administration and compares the outcomes between viable ectopics in different locations.

Methods: This retrospective study evaluated 31 patients treated with combined local (sonographically guided) and systemic MTX for viable, unruptured ectopic pregnancies.

Uterine-preserving emergency surgery for cesarean scar pregnancies: another medical solution to an iatrogenic problem.

Objective: To supplement existing cases of cesarean scar pregnancy presenting as acute conditions. All of the study women had been treated by a conservative surgical approach.

Design: Retrospective study.

Clinical, sonographic, and epidemiologic features of second- and early third-trimester spontaneous antepartum uterine rupture: a cohort study.

Objective: To present prenatal findings and maternal and neonatal outcomes following second- and early third-trimester spontaneous antepartum uterine rupture events in our institute.

Method: Charts of patients with full-thickness second- or early third-trimester symptomatic uterine ruptures locally treated between 1984 and 2007 were evaluated.

Results: There were seven events involving six women, all requiring emergency laparotomy, and cesarean section (CS).

[Adnexal masses: understanding and management].

Asymptomatic adnexal masses have become common findings due to the widespread use of the transvaginal ultrasound. Most asymptomatic adnexal masses are benign, but malignancy should still be excluded. The assessment of women with adnexal masses, intended to detect the ones suspicious for malignancy, includes the medical history, physical examination, ultrasound scan with Doppler flows, and, in some cases, the CA-125 levels.

Prenatal diagnosis of sex chromosome abnormalities: the 8-year experience of a single medical center.

Objective: To assess the indications for prenatal karyotyping of sex chromosomal abnormalities (SCAs) during pregnancy.

Methods: All singleton pregnancies interrupted in our institute because of SCAs (1998-2005) were categorized into subgroups of 45,XO (Turner syndrome), 47,XXY (Klinefelter syndrome), 47,XXX and 47,XYY. The indications for prenatal diagnostic testing were recorded.

Arteriovenous malformation after uterine curettage: a report of 3 cases.

Background: Acquired uterine arteriovenous malformation is a rare but potentially life threatening condition and, as such, must be considered in the differential diagnosis of cases of abrupt, profuse vaginal bleeding following uterine curettage. The condition can easily be confused with retained products of conception and gestational trophoblastic disease.

Cases: One case was managed surgically, while 2 others were treated with selective embolization.

Simultaneous bilateral torsion and entanglement of the adnexa.

We report the first case of bilateral adnexal torsion complicated by concomitant entanglement of both adnexas. The clinical presenting symptoms and signs were similar to those described in unilateral adnexal torsion without adnexal entanglement. The final diagnosis was established by diagnostic laparoscopy, and aspiration of one of the ovarian cysts was required to disentangle the adnexas.

Prenatal thrombosis of the inferior vena cava and the renal veins.

Objective: This manuscript discusses the clinical presentation, diagnosis, pathophysiology and possible etiologies of prenatal thrombosis of the inferior vena cava and renal veins.

Methods: Eleven cases were identified through a Medline search of the English literature. These cases were reviewed, together with a recent case that was treated in our medical center.