S428

Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413S729

We describe a case of prenatal sacrococcygeal teratoma diagnosed

in a 37 years old Chinese lady. She is G3 P2, known to
have polycystic ovarian syndrome, with an obstetric history of
one previous normal vaginal delivery complicated by gestational
diabetes, followed by a caesarean section for twins. She conceived
on clomiphene citrate and booked at 8 weeks of gestation.
She opted for amniocentesis in view of her borderline risk for
Downs syndrome (1in 311) at rst trimester screening. Preamniocentesis ultrasound at 17 weeks revealed a sacrococcygeal
teratoma measuring 3.33.22.8 cm. Amniocentesis showed no
karyotypic abnormalities. She was followed up regularly in the
Fetal Medicine Clinic with fortnightly ultrasounds to monitor the
size of the tumour, fetal growth and signs of fetal hydrops. She
was counseled by the paediatric surgeon with regards to postnatal
surgery.
A baby girl with a birth weight of 4.47 kg was delivered via
an uncomplicated elective lower segment caesarean section at
37 weeks and 3 days, with an Apgar score of 9 at 1 and 5 minutes.
Baby underwent an uneventful resection of the sacrococcygeal
teratoma on Day 1 of life. Intra-operative ndings revealed a large
sacrococcygeal teratoma measuring 15125 cm, mainly cystic
with some solid component.
Histology came back as benign mature cystic teratoma. Postoperatively, baby recovered well, and was discharged on Day 13
of life.
P58
Breast brose-cystic disease (BFCD) as a factor of risk of
obstetric complications development in pregnancy
I. Zhabchenko, E. Bondarenko, A. Yaremko, O. Butkova, T. Shevel,
M. Pochitun, I. Shekera
At the present time there is increasing of quantity of young women
with innocent diseases of breast. Considering hormone dependent
etiology of these processes one can suppose complications of
pregnancy duration among these patients.
Materials and Methods: There are results of study of breast state
and peculiarities of pregnancy duration among 85 women with
BFCD, hormone provision, functioning of thyroid gland, micro
biocoenosis of genital ways and intestinal tract, state of foetus
and placenta.
Results: Among 80% of women BFCD initial revealing of disease was
during present pregnancy, nodulus and diffusive forms of disease
have been revealed in equal proportion, notably that majority
of obstetric complications were admitted with nodulus forms.
From the rst trimester the increasing of prolactin and estradiol
concentration in the blood was registered, and was supported by
the events of threatened miscarriage among 80% women. Among
55% of pregnant women with BFCD the pathology of thyroid gland
was revealed (data of USI) without damage of function. Placenta
dysfunction was revealed among 55% of pregnant with BFCD, and
among 1/3 of them was revealed cystic nodulus form of disease. In
80% of cases dysbiotic abnormalitiess of intestinal tract microora
which were provide with the similar changes in genital ways.
For abolition of revealing abnormalities in the process of gestation
pregnant women were suggested the complex treatment, consisting
of stabilization of hormone relations (Duphaston, Bromcryptin,
Dexamethason), treatment of placenta dysfunction (Actoveginum,
Glutarginum, Phlebodia 600, Chophitol), normalization of intestinal
tract microora (Biphyphorm Complex), and vaginal microora
(Hexiconum, Cyteal, Vagisan), abolition of satellites disorders
(Gynotardiferon, Ca Vitrum + D3, Folacinum).
Conclusions: Women with BFCD should be classied as the group of
risk according to development of complications during pregnancy.
Considering the high frequency of breast disease among young
women one should implement necessary US investigation of breast
while pregnancy follow-up.
Using of worked out complex allowed us to decrease obstetric and
perinatal risk among given group of pregnant women.

P59
In Iraq, illegal termination of pregnancy is still there
I. Alhamadani1 , T. Alhaidari2 . Iraqi Society of Obstetrics and
Gynecology, 1 Al Elwyiah Maternity Teaching Hospital, Baghdad, Iraq,
2
Alkindy College of Medicine, Baghdad University & Al Elwyiah
Maternity Teaching Hospital Baghdad, Iraq
Background: In Iraq according to UNFPA Report in 2003, it showed
that there is an increase in spontaneous and unsafe abortions but
there is no data on the exact number of unintended pregnancies
that end in illegal performed termination.
Methodology: The current work presents an observational
longitudinal study which performed in Al Elwyiah Maternity
Teaching Hospital, through out the year 2007. The prevalence rate
of illegal abortion among all abortions treated in our hospital before
24 weeks of gestation for any indication during the year 2007 was
322/3100 = 104/1000 abortions with a 95% condence interval for
prevalence (93115)/1000 abortions. All those women had a direct
interview with special questionnaire and clinical examination was
conducted thereafter.
Results: It has been found that most of our patients that is
(62.1%) were between 2030 y and (99.4%) of them were already
having children and the most common mode of termination were
combined medical and surgical methods; which have been done by
medical or paramedical staff (87.0%) of total terminated cases with a
condence interval (83.390.7). In (63.0%) of cases, the pregnancy
was conrmed by ultrasound and it was conrmed that being
illegal mainly by history from the patient/husband & or relative
companion in 91% with a condence interval (87.994.1). Failed
contraception use due to improper pills intake represents (53%) of
cases, while decision for termination was taken by the wife herself
in (64%) of cases due to nancial reasons mainly. The most common
presentation was septic abortion (86%) with a condence interval
(63.573.7). (70.8%) requiring 13 units of blood transfusion.
Conclusion and Recommendations: Illegal termination of
pregnancy is still an ethical, religious and medical problem all
over the world and our country is one of them and the main
determining factor for termination of pregnancy amongst these
women appeared to be the fact that it was unwanted and/or
unplanned, either because of inappropriate timing, the relationship
itself as well as the social and economic implications which are
important issues in our country. Improper contraceptive use was
an important contributing factor.
In addition, the misuse of misoprostol (not approved in our country)
which became available over the counter for the patients, and
paramedical staff which needs thorough attention. There is a
real need to update our national family planning and access to
contraception policy, and modifying this policy to meet emerging
social conditions.
P60
Ethical dimensions in prenatal diagnosis and fetal medicine:
An overview
C. Berceanu1 , S. Berceanu1 , A. Patrascu1 , O. Tica2 . 1 Department of
Obstetrics and Gynecology, University of Medicine and Pharmacy,
Craiova, Romania, 2 Department of Pharmacology, University of
Medicine and Pharmacy, Craiova, Romania
Objectives: The perinatal medicine on one hand, and the fetal
medicine on the other hand have been spectacularly developing
in the last decades, and as a consequence of this matter of fact,
besides the numerous benets, a lot of ethical controversies have
been also generated. Our paper is targeting to spotlight the main
ethical aspects in prenatal diagnosis and fetal medicine in the
complex circumstance of the evidence-based medicine.
Materials and Methods: Our study is carrying out up to date
aspects regarding ethical dimensions in prenatal screening and
diagnosis, fetus as a patient concept, multifetal gestation and
outcome, in vitro fertilization and selective multifetal pregnancy