22nd World Congress on Ultrasound in Obstetrics and Gynecology Oral communication abstracts OC12.07 The impact of placental insufficiency on cardiovascular function in early infancy: a prospective longitudinal study K. Makikallio 1 , J. Shah 2 , C. Slorach 1 , J. Kingdom 2 , A. Redington 1 , E. Jaeggi 1 1 Pediatrics, Division of Cardiology, The Hospital for Sick Children / University of Toronto, Toronto, ON, Canada; 2 Obstetrics and Gynecology, Mount Sinai Hospital / University of Toronto, Toronto, ON, Canada Objectives: The association between low birth weight and early cardiovascular events has led to fetal programming- hypothesis. We therefore postulated that fetal growth restriction (FGR) is associated with detectable cardiovascular changes in infants. Methods: 52 appropriately grown fetuses (AGA), 40 FGR fetuses with continuous end-diastolic umbilical artery (UA) flow (FGR) and 20 fetuses with absent/reversed end-diastolic UA flow (ARED) were examined prospectively during fetal life, at 1 week and 6 months of life. We studied the impact of gestational age/weight on cardiac function, blood pressure (BP), heart rate (HR) and central and vascular stiffness. Results: Postnatal indices of cardiovascular function (adjusted for gestational age) and dimensions (adjusted for body surface area, BSA) were comparable during infancy with physiological, age- dependent changes between birth and 6 months. At 6 months, diastolic BP was still the lowest and HR the highest in the ARED group. Conclusions: Placental insufficiency caused significant blood flow redistribution in utero but this did not impact postnatal cardiovas- cular function, suggesting that manifestations of fetal programming result from maturational changes later in life. OC12.07: Table Fetal/Birth FGR (n = 40) ARED (n = 20) AGAAGA (n = 52) Gestational age (w) 35 (26–40) 31 (27–35)*† 37 (27–41) Birth weight (g) 1930 (710–2567)* 815 (640–1680)*† 2848 (940–4500) Cerebroplacental ratio 1.39 + 0.56 0.59 + 0.21*† 1.58 + 0.51 Ductus venosus PIV 0.59 (0.36–1.18) 1.34 (0.51–6.31)*† 0.52 (0.21–0.88) 6 months LV mass/BSA 40.3 + 11.8 45.6 + 12.8 42.7 + 9.8 LV ejection fraction (%) 72.7 + 7.7 70.6 + 6.3 70.4 + 5.8 LV end-diastole (z-score) −0.7 + 1.4 −0.2 + 1.9 −0.6 + 1.5 Mitral E/A Vmax 1.3 + 0.2 1.2 + 0.2 1.4 + 0.2 Central pulsed wave velocity (cm/s) 487 + 195 428 + 214, V 492 + 186 Peripheral pulsed wave velocity (cm/s) 72.7 +7.7 70.6 + 6.3 70.4 + 5.8 Systolic/diastolic BP (mmHg) 93 + 6 / 55 + 12 84 + 7 / 46 + 11*† 93 + 12/58 + 11 Heart rate (bpm) 129 + 13 148 + 17*† 127 + 17 P < 0.05 vs. AGA, †P < 0.05 vs. FGR. OC13: PELVIC PAIN OC13.01 Sonographic findings in adenomyosis after insertion of levonorgestrel intrauterine device M. Onofriescu , D. Nemescu, M. Tirnoveanu Obstetrics Gynecology, University Medicine, Iasi, Romania Objectives: The aim of this study (2006–2011) was to assess whether the sonographically detectable morphological alterations of the myometrium induced by adenomyosis changed after insertion of the LNG-IUD. Methods: 120 premenopausal symptomatic patients (menorrhagia, severe dysmenorrhea) with minimum five sonographic findings (glob- ular shaped uterus, myometrial cysts (2–6 mm), inhomogeneous myometrium, indistinct borders to a myometrial mass, indistinct endometrial stripe, subendometrial linear striations, hyperechoic myometrial nodules, asymmetric thickening of the anterior or pos- terior uterine wall, minimal mass effect on the endometrium or serosa) of adenomyosis were enrolled into the study. Before and at 3, 6 and 12 months after insertion of the LNG-IUD all the patients underwent transvaginal sonography which evaluated uterine diame- ters and volume, endometrial thickness, presence and dimension of myometrial cystic areas, thickness of uterine wall and asymmetric myometrium, presence of myometrial hyperechoic striation. Color Doppler can be utilized in all cases to help distinguish between leiomyomas and adenomyosis. Results: 23 patients become amenorrheic at 6 months and at 12 months – 43 patients become amenorrheic. 50 patients had a significant reduction in menstrual bleeding at 12 months. 4 patients need to extract the LNG-IUD because of important bleeding. Dysmenorrhea was significantly alleviated in all 78 patients. We observed a significant decrease in uterine volume (170.3 ± 10.4 mL vs. 104.5 ± 8.2 mL) and reduction in asymmetric wall thickness (29.3 ± 1.9 mm vs. 17.2 ± 2.8 mm). However sonographic signs of adenomyosis such as myometrial cystic areas and hyperechoic striation did not disappear. The accuracy of transvaginal ultrasound in the detection of adenomyosis is highly operator dependent. Conclusions: After insertion of a LNG-IUD in patients with adenomyosis, uterine volume decreased, the myometrial wall shrank and symptoms were significantly alleviated. However sonographic signs of adenomyosis did not seem to disappear completely. OC13.02 Office sonovaginography: redefining the concept of a normal pelvis on transvaginal ultrasound in women with suspected endometriosis S. Reid 1 , C. Lu 2 , I. Casikar 1 , M. Mongelli 1 , G. Condous 1 1 Early Pregnancy, Acute Gynaecology and Advanced Endosurgery Unit, Nepean Hospital, Penrith, NSW, Australia; 2 Computer Science, Aberystwyth University, Aberystwyth, United Kingdom Objectives: To use sonovaginography (SVG) to predict endometrio- sis location and severity in women planned for laparoscopic endometriosis surgery. Methods: Ongoing, multi-centre prospective observational study (June 2009–November 2011). All women included were of reproductive age, had a history of chronic pelvic pain, and had a plan for laparoscopy. A history was obtained and an ultrasonographic evaluation with office SVG was performed on all women prior to laparoscopy. During SVG, 20 mL of ultrasound gel was inserted into the posterior fornix of the vagina, followed by the insertion of a transvaginal (TV) ultrasound probe. The gel created an acoustic window between the TV probe and surrounding structures of the vagina, allowing for visualization of the posterior compartment. SVG was used to predict posterior compartment deep infiltrating endometriosis (DIE) prior to laparoscopy. The correlation between SVG findings and laparoscopic findings was analyzed to assess the ability of SVG to predict posterior compartment DIE. Results: 100 consecutive women with pre-operative SVG and laparoscopic outcomes were included in the final analysis. At laparoscopy, 84/100 (84%) women had endometriosis (73% peritoneal endometriosis, 35% ovarian endometrioma/s, 34% deep infiltrating endometriosis). 30/100 (30%) had POD obliteration and 20/30 (66.7%) of these women also had evidence of bowel endometriosis. Sensitivity, specificity, PPV and NPV for SVG in the prediction of midline posterior compartment DIE (rectovaginal, retrocervical, rectosigmoid nodules) was 78.3%, 90.9%, 72.0% and 93.3%, respectively. Sensitivity, specificity, PPV and NPV for SVG in the prediction of lateral DIE (uterosacral ligament nodules) was 40.0%, 95.6%, 50.0% and 93.5%, respectively. Conclusions: SVG demonstrated a high specificity/NPV, i.e. corre- lates highly with a ‘‘normal pelvis’’. Office SVG provides additional 26 Ultrasound in Obstetrics & Gynecology 2012; 40 (Suppl. 1): 1–54