S60 Ultrasound in Medicine and Biology Volume 41, Number 4S, 2015

average abnormal ovarian volume was 22.2 cc (range 9.6-

No Sludge Sludge 40cc, median-17cc). Average abnormal to normal ratio was
Pregnancy Outcomes: (n513) (n533) P-value 11.3 (range: 2.8-50, median-3.7). The 17 postmenarchal cases
Gestational age at 37 5/7 37 2/7 0.643a ranged from 12-19 yrs. All the postmenarchal uteri were pear
delivery (wks)1 (23 1/7, 40 2/7) (22 3/7, 40 3/7) shaped (fundus wider than cervix). Uterine length mean was
Delivery at , 24 wks2 1/33 (3%) 1/33 (7.7%) 0.490b 7.6 cm (range: 5.3-9.7cm). Average normal postmenarchal
Delivery at , 25 wks2 1/13 (7.7%) 1/31 (3.2%) 0.508b ovarian volume was 6.5 cc (range: 3-17.6cc). Average abnormal
Delivery at , 28 wks2 2/13 (15.3%) 1/33 (3.2%) 0.204b ovarian volume was 44.4 cc (range: 17.8-88cc), median is 3.9.
Delivery at , 32 wks2 3/13 (23.1%) 5/33 (15.1%) 0.648b Average abnormal to normal ratio was 6.8 (range: 3.3-25.2, me-
Delivery at , 34 wks2 3/13 (23.1%) 8/33 (24.2%) 1.000b dian 6.4).
Deliver at , 37 wks2 5/13 (38.5%) 14/33 (42.4%) 0.749b Conclusions: Premenarchal uterine shapes were
Baby Weight (g)3 2813 (1003) 2802 (752) 0.977c tubular. Postmenarchal uterine shapes were pear shaped. The
median abnormal premenarchal ovarian volume was 17cc while
1
median(min,max); 2proportion (%) 3mean(sd); aWilcoxon-test;bFisher- the postmenarchal abnormal ovarian volume was 34cc. The me-
test;ct-test; dian abnormal ovarian volume to normal ratio was 3.7 for pre-
menarchal and 6.4 for postmenarchal cases. Uterine shape and
length can help determine prepubertal or postpubertal status
in the baseline number of previous preterm did not significantly and affect expected abnormal volumes helping aid torsion diag-
affect the results. nosis.
Conclusions: Despite associated differences in Cx
funneling and shorter Cx, the presence of IAS did not affect 2090707 The Effect of Bedside Ultrasound (US) Assistance
pregnancy outcome in terms of gestational age at birth. These on The Proportion Of Successful Infant Lumbar
results suggest that the presence of IAS does not contraindicate Punctures in a Pediatric Emergency Department:
the use of cerclage in asymptomatic pts who are candidates for A Randomized Controlled Trial
cerclage.
Jeffrey Thomas Neal,1 Aaron Chen1 1Pediatrics,
Children’s Hospital of Philadelphia, Philadelphia,
PA, United States
Pediatric Ultrasound Objectives: The reported rate of unsuccessful/trau-
matic lumbar puncture (LP) in children is as high as 50-60%.
Moderator: Annamaria Deganello, MD
Bedside US allows visualization of anatomic landmarks and
has been shown to reduce LP failure rates in adults. Increasing
2072981 Can Uterine Shape and Size Predict Expected
the proportion of successful LPs in the ED could significantly
Volumes In Ovarian Torsion: A Pilot Study
reduce the rate of unnecessary hospitalizations, procedures,
Anand Majmudar,1,2 Harris L. Cohen1,2 and antibiotic use. Data on the effect of bedside US on the suc-
1
Radiology, Lebonheur Children’s Hospital, cess rate of infant LP, however, is limited. Our OBJECTIVES: is
Memphis, TN, United States; 2Radiology, University to determine if bedside US-assisted site marking increases the
of Tennessee Health Science Center, Memphis, TN, proportion of successful infant LPs by clinicians in our pediatric
United States ED.
Methods: This was a prospective, randomized
Objectives: To observe, if there is a difference be- controlled study of infants aged 0 to 6 months presenting to
tween pediatric premenarchal and postmenarchal ovarian our ED and requiring an LP; subjects with a known spinal
measurements in torsion. To note, if uterine size analysis cord abnormality (such as tethered cord) were excluded. Sub-
can be used to help assess expected range of volumes of jects randomized to traditional LP (TLP) had LP as per routine
abnormal ovaries. standard of care; subjects randomized to ultrasound-assisted LP
Methods: We retrospectively evaluated the presurgi- (USLP) received a bedside US of the spine during which the
cal ultrasound exams of pathologically proven ovarian torsion conus was identified and the intervertebral space (L2/3, L3/4,
cases in a children’s hospital between Jan 2008 and July 2014. or L4/5) with the most cerebrospinal fluid (CSF) was marked,
The volumes of abnormal and normal ovaries were determined with the LP performed at the marked location. Subjects were
by the prolate ellipse formula of width x length x depth x 0.523. considered to have a successful LP if CSF fluid was obtained
Only the patients in whom two ovaries were seen in three di- and CSF red blood cells (RBC) were ,1000 per mm3. Fisher’s
mensions were included. Uterus shapes and lengths were evalu- exact test was used to analyze the proportions of success rates, at
ated to see whether they could help to determine premenarchal a significance level of 0.05.
or postmenarchal state and whether that information affected Results: 37 infants were included in this preliminary
the range of abnormal volumes or the ratio of abnormal ovarian analysis: 19 TLP, 18 USLP; mean age: 30.2 days TLP, 22.6 days
volume to normal ovarian volume. USLP; provider level of training on first attempt: TLP (78.9%
Results: 6 premenarchal and 17 postmenarchal cases trainee, 21.1% fellow/attending), USLP (94.4% trainee, 5.6%
of ovarian torsion were noted. The 6 premenarchal cases ranged fellow/attending). Results of success: first attempt (TLP
from 4-11yrs of age. All premenarchal uteri were tubular in 36.8%, USLP 55.6%, p-value 5 0.33), within three attempts
shape (fundal width equal to cervical width). The premenarchal (TLP 47.4%, USLP 72.2%, p-value 5 0.184).
mean uterine length was 4.0 cm (range: 2.9-5.6cm). Average Conclusions: Although not statistically significant, it
normal ovarian volume was 5.2 cc (range: 0.8-12.7cc). The appears there is a trend for improved success with USLP over