EP07.07: Congenital portosystemic fistulas: a case series
Bibliographic record
Abstract
Congenital portosystemic fistulas (CPF) are rare congenital malformations characterised by abnormal vascular communications between the portal system and the caval system. They can be isolated or may be associated with other congenital anomalies, including intrauterine growth retardation (IUGR). 4 patients were referred to our unit after prenatal diagnosis of CPF, identified by ultrasound during the early third trimester. Among these cases, 3 were associated with IUGR, and one presented with bilateral clubfoot where parents refused the amniocentesis. After the diagnosis, fetuses underwent a closed follow-up and fetal cardiac ultrasound. Fetal hemodynamics were normal, except for one case with moderate biventricular hypertrophy. Induction of labour was performed in two cases at 37 weeks due to pre-eclampsia, and in one case due to severe IUGR. The fourth case underwent a repeat Caesarean section at 37+6 weeks due to preterm premature rupture of membranes. After birth, abdominal and cardiac ultrasound was provided for each newborn. All newborns demonstrated good adaptation to extrauterine life, remained asymptomatic, and were clinically and hemodynamically stable. Spontaneous closure of the fistulas occurred without surgical intervention. Early detection of CPF through prenatal screening can improve postnatal outcomes and prognosis. Most CPF cases have a favourable outcome and remain asymptomatic in childhood. Spontaneous closure typically occurs within the first two years of life without sequelae in the majority of cases. 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 | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
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".