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Abstract: Objective: Our purpose was to study prospectively the efficacy of digital rotation in reducing the prevalence of persistent occipito-posterior position (POP) and its consequences. Study design: Sixty-one women with a singleton pregnancy were enrolled prospectively between July 2003 and July 2004. They were in the second stage of labor with the fetal head engaged in the occipito-posterior position. During the first period of the study women were allowed to continue labor without intervention (group I); during the second period, digital rotation was performed (group II). Results: In group I 15% of the fetuses were delivered in the occipito-anterior position and 27% underwent spontaneous vaginal delivery, as opposed to 93% and 77%, respectively, when the procedure was performed—an increase in spontaneous vaginal delivery among the group undergoing rotation of more than 50% (p <0.0001). Cesarean section was performed in 23% and vacuum in 50% when the procedure was not performed (group I) in contrast to 0% and 23%, respectively, in the group undergoing rotation (0.0001). Conclusion: Digital rotation should be considered when managing the labor of a fetus in the occipito-posterior position. The maneuver successfully rotates the fetus reducing the need for cesarean section, instrumental delivery, and other complications associated with POP. [Copyright &y& Elsevier]

Abstract: Renal rhabdomyosarcoma is a rare malignant mesenchymal tumor with an aggressive clinical course. We describe the case of a 39-year-old woman with a large rhabdomyosarcoma of the left kidney serendipitously discovered ultrasonographically subsequent to cesarean section. To our knowledge, this is the first reported case of renal rhabdomyosarcoma during pregnancy. The importance of ultrasound examination in the differential diagnosis of gestational flank pain is discussed. [Copyright &y& Elsevier]

The optimal time to perform cryopreserved embryo transfer (CET) after a failed oocyte retrieval-embryo transfer (OR-ET) cycle is unknown. Similar clinical pregnancy rates were recently reported in immediate and delayed CET, performed after failed fresh OR-ET, in cycles with the gonadotrophin-releasing hormone (GnRH) antagonist protocol. This study compared outcomes of CET performed adjacently (<50 days, n = 67) and non-adjacently (≥50 to 120 days, n = 62) to the last OR-day of cycles with the GnRH agonist down-regulation protocol. Additional inclusion criteria were patients' age 20–38 years, the transfer of only 1–2 cryopreserved embryos, one treatment cycle per patient and artificial preparation for CET. Significantly higher implantation, clinical pregnancy and live birth rates were found in the non-adjacent group than in the adjacent group: 30.5% versus 11.3% ( P = 0.001), 41.9% versus 17.9% ( P = 0.003) and 32.3% versus 13.4% ( P = 0.01), respectively. These results support the postponement of CET after a failed OR-ET for at least one menstrual cycle, when a preceding long GnRH-agonist protocol is used. [ABSTRACT FROM AUTHOR]