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Ultrasonography of the central nervous system is an integral part of a prenatal scan, and the development of imaging technologies has led to better diagnostic possibilities. Posterior fossa anomalies have traditionally been divided into Dandy Walke malformation, Dandy Walker variation and megacisterna magna, but this approach, due to diversity of the extensive number of possible disorders covered by this classification, unables accurate prognosis and therefore adequate counselling. An alternative approach to the classification of posterior fossa anomalies is to divide them into agenesis of the vermis, which could be partial or complete, cerebellar hypoplasia, pontocerebellar hypoplasia and cerebellar atrophy. Different ultrasonographic and magnetic resonance imagining of appearances of the posterior fossa anomalies in prenatal period are discussed in the article, as well as possible syndromes and prognosis of different entities. Diversity of anomalies of the central nervous system, and in particular, subtle differences in prenatal appearances of posterior fossa anomalies, which may have major impact on the prognosis, demand a multidisciplinary approach that encompasses two-dimensional and three-dimensional ultrasound scan, magnetic resonance imaging, infectious diseases and metabolic disorders work-ups as well as individual approach to every case involving of a team of experts in the field of perinatology, radiology, paediatrics, neurology and genetics. [ABSTRACT FROM AUTHOR]

The cervical length is an important factor in the risk evaluation of preterm delivery. The aim of this work was to determine the correlation between the cervical length and the demographic characteristics. A transversal type prospective study was done on a sample of 579 pregnant women at various gestational age of low risk mono-fetal pregnancy. The cervical length was measured by trans-vaginal ultrasound procedure within the regular pregnancy monitoring process. The following data were taken into consideration: the woman's age, her body mass at the beginning of the pregnancy and her height in order to calculate the body mass index as well as her smoking habit at the moment of conception. The mean cervical length was 34.3 mm and 35 mm in the group of women aged 30 and less and 31 and over, respectively. The cervix was insignificantly shorter in younger women (being 34.9 mm/35.9 mm in the 1st trimester, 34.5 mm/35.1 mm in the 2nd one and 33.9 mm/34.7 mm in the 3rd trimester}. The sample of 579 pregnant women consisted of 448 non-smokers and 131 smokers. The difference in the length of the cervix in smokers and nonsmokers was not significant (being 32.2 mm/35.9 mm; 35 mm/34 mm and 34.4 mm/33.5 mm in the 1st, 2nd and 3rd trimester, respectively). The correlation between the body mass index and the cervical length was analyzed by trimesters. In the first trimester the increase in the body mass index was followed by the shortening of the cervix; the cervical length was not affected by the BMI in the second trimester, whereas the higher the body mass index the longer the cervix in the third trimester. Our study has shown that the cervical length is affected neither by the age of the woman nor her smoking habit but it is affected by the body mass index at the moment of conception, that linear trend being negative in the 1st trimester but positive in the 3rd one. Since the cervical length may be affected not only by the socio-demographic characteristics but the gynecologic obstetric history of the woman as well, we strongly suggest further investigations in this field. [ABSTRACT FROM AUTHOR]

Introduction: Amniotic fluid volume reduction can have serious consequences: prior to 24 gestational weeks hypoplasia of fetal lungs and later in pregnancy cord compression and fetal hypoxia as well as contractions of extremities. Diagnosis of oligohydramnios is made either after a subjective estimation of amniotic fluid reduction or if the biggest amniotic fluid pocket is less than 1 cm. Amnioinfusion is a procedure during which a crystalloid solution, most often saline, is instilled into the amniotic cavity substituting amniotic fluid. To estimate the efficacy and safety of amnioinsfusion using our results and literature review., Material and Methods: Up to 800 ml of sterile saline solution was instilled intraamniotically (10-15 ml/min) in cases where the amniotic fluid index was less than 10 and intraamniotic infection was excluded. After that, 1 g of Longaceph was given intraamniotically. Infusion was stopped immediately when 800 ml was instilled, if a subjective estimation showed that there was enough fluid or if contractions occurred., Results: During a six-month period there were five amnioinfusions--four therapeutical and one diagnostic; in four cases the procedure was successful and in one preterm rupture of membranes occurred 20 hours after the procedure. The procedure was most often done in the first half of the third trimester and continuation of pregnancy in successful cases was between 4 and 5 weeks, with average fetal weight gain of about 1200 gr. No complications occurred in cases where pregnancy continued., Conclusion: In our preliminary study amnioinfusion led to prolongation of pregnancy in majority of cases providing better maturation of fetal lungs and higher birth weight, without any complications. Further studies are necessary to reach definite conclusions about the efficacy and safety of amnioinfusion.

Introduction: Induction of labor represents initiation of uterine contractions before their spontaneous onset. The aim of the study was to establish the role of Bishop score in prediction of labor induction in routine clinical work., Material and Methods: The study was a prospective, blind, observational one. All patients had a vaginal examination prior to induction, during which Bishop score was evaluated. The mode of induction was either intravenous infusion of oxytocin or endovaginal prostaglandins. The induction was considered successful if vaginal delivery took place within 24 hours from the onset of induction., Results: There were 100 patients, and induction was successful in 74% and unsuccessful in 26%. Mean Bishop score in group A was 5.65 (SD 1.40, 95% CI 5.27-6.03), and in group B 4.15 (SD 1.04, 95% CI 3.66-4.63) (p < 0.01). Statistical analysis of the area under the ROC curve showed that Bishop score is a good and reliable predictor of the outcome of labor induction (0.816, 95% CI od 0.710-0.896), with the best statistical performances at the cut-off value of 5 (sensitivity 65.5%, specificity 95%, PPV 97.3%, NPV 50%)., Conclusion: In our study Bishop score proved to be a reliable and good method for prediction of the outcome of pregnancy if a single, experienced operator evaluates it, with best statistical performances at the cut-off value more than 5 (sensitivity 65.5%, specificity 95%, PPV 97.3%, NPV 50%). The next step would be introduction of more operators, of different skills and experience and subsequent further testing of the method in different conditions.