P24.03: Prenatal diagnosis of recto‐uterine fistula: a case report
Bibliographic record
Abstract
A 31 year-old woman, gravida 2, para 1, was referred at 30 4/7 weeks of a semingly uneventful pregnancy for large bowel dilation noted on ultrasound. She had no past medical history. In our center, ultrasound revealed macrosomia (above 99th percentile) bilateral hydronephrosis, multicystic ascites, microcephaly, duplication and distension of vagina and uterus. Fetal echocardiography demonstrated a complex cardiac malformation. Upon these findings, the patient elected for termination of pregnancy. On macroscopic evaluation, the fetus was a female weighing 1966 g. Cardiac examination showed significant right ventricular and pulmonary artery hypoplasia, stenosis of the pulmonary valve and atresia of the tricuspid valve with resulting dilation of the right atrium. The left ventricule and ascending aorta were remarkably dilated. Abdominal examination revealed multifocal intestinal adhesions suggesting peritonitis as well as complete anal agenesis and a resulting megarectum. A communicating fistula was noted between the rectum and a very dilated uterus. The fistulous tract ended at the level of a uterine septum which separated the uterus in 2 symmetrical cavities. Septal rupture was noted and the uterus contained traces of meconium. Fallopian tubes were dilated. Agenesis of the cervix and the proximal 2/3 of the vagina were noted. Bilateral hydronephrosis and slight ureteral dilation were found. To our knowledge, this is the first reported case of a terminal fistulous tract between the rectum and uterus. Supporting information can be found in the online version of this abstract. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.009 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".