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Objective: To describe the time sequence of changes in cardiac function in intrauterine growth restriction. Study design: This was a prospective longitudinal study on 22 singleton pregnancies with growth-restricted fetuses. Pulsatility indices of fetal arterial and venous Doppler waveforms, systolic peak velocity in the aorta and pulmonary artery, right and left ventricular shortening fraction and atrioventricular flow E/A ratio were assessed at each monitoring session. Logistic regression was used for modeling the probability of abnormality of a variable in relation to the time interval before delivery. Trends over time were analyzed by Mann–Withney U-test. Results: Umbilical artery pulsatility index was the first variable to become abnormal, followed by the middle cerebral artery, right diastolic indices (right E/A, ductus venosus), right systolic indices and, finally, both diastolic and systolic left cardiac indices. Conclusion: We have found an earlier and more pronounced right than left and diastolic than systolic fetal cardiac function deterioration in growth restricted fetuses monitored longitudinally.

Background: Endometrial ossification is a rare condition. The common feature in most reported cases is a previous history of abortion and retention of fetal bones. Few cases of endometrial ossification can be explained by osseous metaplasia. Clinical presentation may include abnormal vaginal bleeding or discharge, dysmenorrhoea, pelvic pain, and secondary infertility. Hysterectomy or dilation and curettage have been the usual therapeutic methods used. Recently, some cases have been treated by means of hysteroscopic resection. Case: We report a case of endometrial ossification in a woman who presented with dysmenorrhoea, dyspareunia and pelvic pain. The patient had a pregnancy voluntarily terminated at 16 weeks. Five subsequent routine annual gynaecological exams, including ultrasonographies, were normal. A new gestation was also voluntarily terminated at 6 weeks. One month later the patient started with clinical manifestations. Ultrasonograms performed 4 months after the second abortion revealed a strong uterine echogenic band. Bone tissue was successfully removed by hysteroscopic resection. Conclusion: This case adds further evidence favouring new bone formation in the uterus as a pathogenic mechanism for endometrial ossification and illustrates the feasibility of hysteroscopic treatment for this condition.

This report describes an adolescent female with a functioning unattached rudimentary blind uterine horn who presented with dysmenorrhea, severe lower abdominal pain and a pelvic mass. She had been unsuccessfully treated with prostaglandin inhibitors, and in her past history several episodes of urinary tract infections were reported. Removal of the uterine horn afforded complete relief of symptoms.