3397

Mirror image artifact of normal uterus mimicking double uterusKim T-S, Park O-R, Yi M-G, Mirae Woman’s Hospital, Korea;Daegu Fatima Hospital, Korea

Mirror image artifact during ultrasound is a double reflection at certaintissue plane like diaphragm or muscles. A 31-year old woman, gravida1 para 0, came to our hospital for routine antenatal care. Routinetransvaginal sonographic scanning at early pregnancy was unremark-able with normal shaped uterus with IUP and two ovaries. At term shedelivered a 3120 gm female and was discharged uneventfully. Threemonths later she returned to our hospital for routine check up. Attransvaginal sonography there was a didelphys like double uterus,which was different from previous sonographic finding. And we re-examined the uterus with high resolution sonography, and it wasnormal appearance. We think that the reflection plane was rectal airposterior to the uterus and the plane acted as mirror to ultrasound beam.If there is any doubt of this artifact, change the frequency or mode ofultrasound probe.

3398

Changes in the gestational and yolk sac volumes with normalpregnancy and missed abortion by three-dimensionalultrasonographyKim MJ, Kim EJ, Hur SY, Lee GS, Kim SJ, Holy Family Hospital ofCatholic University, Korea

Objectives: The volume of embryonic structures including gestationalsac volume (GSV), yolk sac volume (YSV) and yolk sac diameter(YSD) may have prognostic value during the first trimester. The aim ofthis study was to investigate whether first-trimester volume calculationsof these structures using transvaginal three-dimensional ultrasoundtechnique may have value as first trimester pregnancy.Methods: Between January 2004 and October 2005, 408 patients withsingleton pregnancies were included in the first trimester. A singleinvestigator performed all sonographic examinations and measure-ments. GSV and YSV were calculated by VOCAL (virtual organcomputer aided analysis) technology using a 7-MHz transvaginal trans-ducer (Accuvix XQ, Medison, Seoul, Korea).Results: There is comparison of threatened abortion and missed abor-tion’s YSV, GSV ratio, which shows meaningful gap from missedabortion. As a result, It shows YSV, YSV and GSV’s ratio meaningfulgap from missed abortion.Conclusions: These results suggest that three-dimensional ultrasonog-raphy can become an important modality in future embryological andearly fetal research and detection of embryonic and fetal developmentin the first trimester of pregnancy.

3399

A case of massive subchorionic thrombohematoma: Diagnosedby ultrasonography and magnetic resonance imaging inmidpregnancyKim SJ, Kim MJ, Hur SY, Lee HJ, Lim HW, Lee GS, Shin JC, HolyFamily Hospital of The Catholic University, Korea; Dept. ofPathology, Korea; Dept of Radiology, Korea; Vincent Hospital ofthe Catholic Hospital, Korea; St Mary’s Hospital of the CatholicUniversity, Korea

Placental abnormality is the important predisposing cause of intrauter-ine growth retardation. Massive subchorionic thrombohematoma isdefined as a large size of maternal blood clot that separates the chori-onic plate from the villous chorion and can result in serious obstetricalcomplications. Placental enlargement was detected in a 36-year old

primipara woman with fetal growth retardation and oligohydramnios isat 17 weeks gestation. 2D and 3D ultrasonography showed an abnormalsonolucency within the placenta, but could not give an unequivocaldifferentiation from placental abnormalities such as hematomas, cystsand other tumors. Therefore it might be difficult to make a discrimi-nation of massive subchorionic thrombohematoma by USG only, andmagnetic resonance imaging (MRI) may be useful for discrimination ofplacental abnormalities. We report a case of massive subchorionicthrombohematoma diagnosed prenatally, and propose an additionalequivocal finding confirmed by ultrasonography and magnetic reso-nance imaging (MRI).

3400

Broad spectrum of ultrasound findings of hydatidiform mole andmolar mimickerJung SI, Cho JY, Moon MH, Lee YH, Song MJ, Kim J-A, Min JY,Kim MY, Samsung Cheil Hospital, Sungkyunkwan University Schoolof Medicine, Korea

US play an important role in determining the presence of hydatidiformmole. The US finding of hydatidiform mole is solid collection of echoeswith numerous anechoic spaces, so called “snowstorm” appearance.These findings suggest edematous chorionic villi with trophoblasticproliferation. But incomplete abortion as hydropic abortus may haveedematous chorionic villi with trophoblastic proliferation though thevilli in nonmolar abortions have less pronounced edema. Subchorionichematoma is very common in early pregnancy may show various kindsof US findings from huge solid mass to multilocular cyst. Hematomaoccurred shortly after dilatation and curettage of uterus for abortionmay mimic pathologic condition as hydatidiform mole or invasivemole. We illustrate the various kinds of US findings of hydatidiformmole and molar mimicker as incomplete abortion, subchorionic hema-toma and hematoma after dilatation and curettage of the uterus.

3401

Fetal heart rate independent parameter of cardiac contractility:Fetal isovolumetric contraction time in a case with fetaltachyarrhythmiaFujita Y, Trudinger B, University of Sydney at Westmead Hospital,Australia

The isovolumetric contraction time (ICT), an index of cardiac contrac-tility, is the time interval between the onset of the ventricular contrac-tility and cardiac ejection. We have described a simple Doppler systemto measure this. In this case report, we measured the ICT sequentiallyin a fetus with a tachyarrhythmia diagnosed at 37 week gestation andwe sought to examine whether this parameter is independent of fetalheart rate. Despite of fetal tachycardia of over 200 bpm, the fetal ICTshowed a normal value. After cardioversion using maternal digoxin, thefetal heart rate returned to normal. Sequential measurements of the fetalICT showed a gradual lengthening of the ICT associated with fetalgrowth failure and operative delivery for fetal distress. After birth, thearrhythmia disappeared without any medication. This case highlightsthe fact that the fetal ICT is independent of fetal heart rate and its usein prediction of deteriorated fetal condition.

3402

Effects of maternal positions on the umbilical arterial DopplerwaveformsKim YH, Song T-B, Kim CH, Cho MK, Kim KM, Chonnam NationalUniversity Medical School, Dept. of Ob/Gyn, Korea

P258 Ultrasound in Medicine and Biology Volume 32, Number 5S, 2006

Objectives: The aim of this study was to compare the effects ofmaternal positions on umbilical artery (UA) S/D ratios in normal andhigh risk pregnancy women.Methods: UA S/D ratios were measured after 30 week gestation in 34normal pregnancy women and 19 high risk pregnancy women. Themeasurements were performed with the mother in the supine, leftlateral, sitting, and standing position serially.Results: UA S/D ratios in the supine, left lateral, sitting and standingpositions of normal pregnancy were 2.28 � 0.35, 2.24 � 0.27, 2.49 �0.40 and 2.31 � 0.34. Umbilical artery S/D ratios in the sitting positionwas significantly higher than other positions of normal pregnancy (p �0.05). UA S/D ratios in that position of high risk pregnancy were 3.18� 0.44 2.92 � 0.33, 3.67 � 0.39 and 3.32 � 0.57. UA S/D ratios inthe sitting position were significantly higher than other positions ofhigh risk pregnancy (p � 0.01). The rise in UA S/D ratios from otherpositions to sitting position of high risk pregnancy more significantthan that of normal pregnancy.Conclusions: The umbilical arterial flow of the mothers in sittingposition may be affected higher than any other positions. The differ-ence in UA S/D ratios from other positions to sitting position wassuggested a value as screening test for high risk pregnancy.

3403

Sonographically misdiagnosed degenerated myoma in pregnancy:A case reportCho HJ, Nam KH, Kim TH, Kim JS, Lee KH, SoonchunhyangUniversity Bucheon, Korea

The object is to improve the diagnostic ability of ultrasonography ofdegenerated myoma during pregnancy. We experienced one case ofdegenerated myoma in pregnancy of 12 weeks of gestational ages. Thepatient was diagnosed ovarian neoplasm by MRI and then transferredto our hospital. After evaluation with sonography, patient was diag-nosed ovarian mass and operated under spinal anesthesia at 12 weeksof gestational ages. Final diagnosis was cystic degenerated myomalocated in cervix. Accurate sonographic diagnosis made a patient avoidunnecessarily invasive treatment.

3404

Comparative study by diagnosis timing in cornual pregnancyRa LGS, Chul KK, Joo KD, Yang PI, Joong LH, Jin KS, Chul SJ,Pyung KS, St. Vincent’s Hospital, The Catholic University of Korea,Korea; The Catholic University of Korea, Korea

Objectives: To determine the efficacy of ultrasonogram in the detec-tion of cornual pregnancy and the factors that might be affected onearly diagnosis.Methods: We studied 20 cases which were diagnosed as a cornualpregnancy from January 1, 2000 to December 31, 2004 at St. Vincent’sHospital of the Catholic University of Korea. Two groups were com-pared. One group was diagnosed as a cornual pregnancy before oper-ation, the other was not diagnosed until operation.Results: Sixty-five percent were not diagnosed by ultrasonogram untilthe operation has been carried out; 35% were diagnosed by ultrasono-gram before operation; two cases of nine unruptured cases were diag-nosed as a tubal pregnancy before operation. There were not significantdifferences in age, amenorrhea duration between two groups. However,number of abortion, parity and past history of ectopic pregnancy weresignificantly increased in case of diagnosed group before operation.Conclusions: Awareness of sonographic findings of cornual pregnancyshould improve its detection and may alter management.

3405

Preoperative diagnosis of small-bowel intussusception inpregnancy with the use of sonographyChoi SA, Park SJ, Yi BH, Lee HK, Kim HC, SoonchunhyangUniversity Bucheon Hospital, Korea; Soonchunhyang UniversityCheonan Hospital, Korea

Intestinal obstruction during pregnancy is a rare condition and rangesfrom 0.067% to 0.0015%. When it happens, however, it causes con-siderable morbidity and mortality for both of the pregnant and the fetus.Intussusception is one cause of intestinal obstruction, occurring in up to6% in pregnant women. In addition, despite specific radiologic find-ings, preoperative diagnosis of small-bowel intussusception in latepregnancy is difficult and commonly delayed because of superiordisplacement of small-bowel loops by the enlarged uterus. If morepreoperative diagnosis were possible, fetomaternal morbidity and mor-tality would be reduced by appropriate management, including imme-diate surgery and aggressive fluid resuscitation. We report a preoper-atively diagnosed case of small-bowel intussusception in pregnancywith the use of sonography and describe the compression techniquewith a high-frequency transducer. Transabdominal sonography is anoninvasive diagnostic study that may provide important informationfor intestinal obstruction during pregnancy, particularly in cases ofintussusception.

3406

Successful conservative management of Cesarean section scarpregnancy (CSP)Lee H-C, Lee S-J, Lim J-H, Park Y-W, Kim Y-H, SeveranceHospital, Yonsei University College of Medicine, Korea

A Cesarean section scar pregnancy is a rare but possibly life-threaten-ing condition. The diagnosis is made mainly based on transvaginalultrasonography. We used the Doppler and serial bHCG in determiningthe severity and prognosis. Because of the rarity, universal treatmenthas not been established. In our cases, the severity of bleeding wasindependent of the level of bHCG and the duration of amenorrhea. Theshorter the interval from the previous Cesarean section, the more severethe symptom; in such case, we were able to preserve fertility by uterineartery embolization. CSP can be managed conservatively with metho-trexate injection. Based on our case review, we can conclude that it isvery important that we choose each therapeutic management based onpatient history and condition. In our review, we present four casesdiagnosed with CSP all managed conservatively to preserve futurefertility.

3407

Ultrasound in diagnosis of the fetal skeletal abnormalityYang TZ, He M, Luo H, West China 2nd Hospital of SiChuanUniversity, China

Objectives: To assess the value of the ultrasound in diagnosis of thefetal skeletal abnormality and study the characteristic of it in ultra-sonography.Methods: Analyze the ultrasonogram of 380 cases of the fetal abnor-mality among 2001 to 2005, retrospectively, and study the ultrasono-graphic characteristic of the fetal skeletal abnormality.Results: Twenty-seven cases of fetal skeletal abnormality were pre-sented in 380 cases of fetal abnormality and 7.2% of all.Conclusions: Ultrasound has definite accuracy in the evaluation of thefetal skeletal abnormality, therefore, it should be considered as theroutine method for prenatal detection of the fetal abnormality. For itsvarious performance, nevertheless, there are still some type of fetalskeletal abnormality cannot be detected prenatal.

Abstracts P259