Spontaneous rupture of an unscarred uterus with an intact amniotic sac extrusion and fetal leg entrapment at 28 gestational weeks: a case report

The spontaneous rupture of an unscarred uterus at 28 gestational weeks is an extremely rare event, particularly when associated with an intact amniotic sac extrusion and fetal leg entrapment, which has not been previously reported. A 27-year-old primigravid woman was referred to our department, due to perpetual abdominal pain, at 28 weeks and 5 days of gestation. The patient, G3p0, had previously undergone two induced abortions. At the time of admission, abdominal ultrasonography suggested a defect in the left uterine horn. An emergency laparotomy was subsequently performed and revealed an intact amniotic sac extrusion and fetal leg entrapment. Considering the risk of placental abruption, and the possibility of a secondary rupture if the gestation was not terminated, an emergency Cesarean section was recommended. Uterine rupture may be suspected whenever a patient complains of durative abdominal pain at 28 weeks and 5 days of gestation, even in the absence of an intra-abdominal hemorrhage or vaginal bleeding.

Estimating the performance of lithium beam measurements of current density and electron density in an H-mode pedestal

The lithium beam is an effective diagnostic tool for investigation of stability and particle transport in the pedestal. It was used successfully to measure edge current density on DIII-D, achieving qualitative agreement with neoclassical models. Electron density profiles were also measured. Proposed upgrades will continue these measurements with higher reliability as well as explore edge current measurements using spectroscopy. The optics will be redesigned to optimize throughput and aperture broadening and to replace the photomultiplier tubes with avalanche photodiodes. The new system will yield detailed measurements of the pedestal, complementing existing diagnostics for investigating pedestal stability, edge localized mode cycle, and particle transport through the pedestal.

[Application of three-dimensional ultrasound for diagnosis of congenital preauricular fistula]

Objective: To explore the application of real-time three-dimensional ultrasound in locating the course, the brand and the blind end of internal opening of congenital preauricular fistula. Methods: Congenital preauricular fistula patients from Changhai Hospital were studied. All the cases were evaluated using two-dimensional and three-dimensional ultrasound before surgeries. The surgery findings were utilized as the gold standard. The imaging features of 3D ultrasound were described to determine the accuracy of the blind end location, the course of the main fistula tract and the branch tracts. The diagnosis was compared with the surgery findings. Results: In 89 cases, among which there were 21 branch fistulae. There were 68 bend fistulae without branch. The diagnostic accuracy of both two-dimensional ultrasound and three-dimensional ultrasound was 100%. The accuracy in locating the blind end of internal opening, the course of the branch tracts with 3D ultrasound was 92.1%(82/89), 85.7%(18/21) , compared to 80.9%(72/89), 57.1%(12/21) with 2D ultrasound. It was obvious that 3D ultrasound had more advantages. These differences were statistically significant (χ(2)=4.8, P<0.05; χ(2)=4.2, P<0.05). Conclusions: Compared with 2D ultrasound, 3D ultrasound can accurately locate the blind end of internal opening, the course, and the branch of preauricular fistula, clearly display the morphology and the spatial structure of preauricular fistulaand its surroundings. It has high clinical application value in preoperative imaging examination.