A. Hagen

Epignathus: always a simple teratoma? Report of an exceptional case with two additional fetiforme bodies

We report on a case of a fetal epignathus combined with two fetus‐like structures resembling acardius acranius. The anomaly was detected at 23 weeks of gestation and led to termination of pregnancy at 24 weeks. This is the first description of epignathus with parasitic fetuses detected prenatally. It shows that the boundary between fetal teratoma and multiple pregnancy in special cases may be difficult to define. Copyright

OP17.09: 125 single examiner cases of ARSA—additional malformations and chromosomal abnormalities

these cases. Four patients successfully underwent surgical correction and in one of them tracheoplasty was also performed. Conclusions: Isolated vascular rings can be accurately diagnosed prenatally by using the ‘‘three vessels and trachea view’’ and the ‘‘supraaortic branch view’’ that allow detection of vascular structure running around the trachea. Karyotyping and prenatal testing for 22q11 microdeletions should be offered to all parents. Affected children should undergo surgical correction as soon as the symptoms of tracheal compression appeared avoiding tracheomalacia.

OP03.14: Different degrees of ventriculomegaly: frequency of chromosomal anomalies, associated malformations and congenital infections

Materials: The database was searched and all cases in which the sonographic diagnosis of a central nervous system malformation was made were included. Results: There were 280 patients in which a diagnosis of a CNS malformation was made. The most common diagnosis was related to dilation of ventricular system, followed by neural tube disease, agenesis of the corpus callosum and posterior fossa abnormalities.

OP03.15: Isolated mild cerebral ventriculomegaly: cytogenetic findings and pregnancy outcome

Materials: The database was searched and all cases in which the sonographic diagnosis of a central nervous system malformation was made were included. Results: There were 280 patients in which a diagnosis of a CNS malformation was made. The most common diagnosis was related to dilation of ventricular system, followed by neural tube disease, agenesis of the corpus callosum and posterior fossa abnormalities.

P09.04: Prognostic reliability of the prenatal FISH‐test

results from a prospective study of high-risk singleton pregnancies undergoing such a screening between 2002 and 2009 in Bulgaria. Methods: Bilateral UA Doppler analysis was performed between 18 and 24 w.g. Mean RI and PI indices were calculated. Presence of notching was also recorded. Logistic regression analysis was performed. 169 pregnant women were enrolled in the study. 37 patients developed PE and 11 of those delivered 90th centile was associated with a significant increase of the RR for development of PE and early PE – 3.8 and 8.5 times, respectively (95% CI 1.34–10.9). The best predictor for development of PE and PE 90th centile and the presence of bilateral notching – 65 times increased RR for development of early PE, with 81% sensitivity and 1.2% FPR (95% CI 6–699). Conclusions: UA Doppler analysis is a non-invasive screening modality for assessment of patients at risk for development of PE, in particular those requiring delivery <34 w.g. RI and PI evaluation, combined with presence of notching, is the best predictor in identifying high-risk pregnancies.

P10.07: Cardiac rhabdomyoma: prenatal diagnosis and postnatal outcome

chromosomal abnormality in the study population. The depth of the pericardial effusion was not related to the clinical course of isolated pericardial effusion. All studied babies were alive and healthy when this study was prepared. Conclusions: There were no adverse outcomes or chromosomal anomalies among fetuses diagnosed with isolated pericardial effusion. Most cases of fetal isolated pericardial effusion resolved spontaneously. If no other abnormality is detected upon meticulous inspection, our results will be reassuring to patients who have a fetus diagnosed with isolated pericardial effusion.

P01.20: Intrauterine spontaneous main bronchus obstruction in congenital diaphragmatic hernia mimicking CAM?

of innumerable capillary channels. It usually regresses after an initial rapid growth and involutes after 6 months. Although benign, it can be life-threatening due to high output cardiac failure with and without hydrops, hemolytic anemia, thrombocytopenia, and disseminated intravascular coagulopathy (DIC). We experienced a case with infantile hepatic hemangioendothelioma with Kasabach-Merritt sequence. A 41 year-old woman was referred to our hospital with rapid growing liver mass at 39.3 gestational weeks. Ultrasound examination at visit showed a large liver mass (8.4×6.1cm) with cystic and solid elements. Color Doppler showed increased flow in the wall of the tumor. There were no findings of hydrops and arteriovenous shunting. Because of breech presentation, Cesarean section was performed on the next day. The prenatally suspected hemangioendothelioma of the liver was confirmed by magnetic resonance imaging (MRI). On the day 3 after the birth, the neonate suffered DIC as KasabachMerritt sequence, he was treated with prednisolone and interferon. Following MRI showed decreased size of the liver mass (6.5 × 5.8cm) and DIC also resolved.

OC29.01: Association between first trimester PAPP‐A and adverse pregnancy outcome

first trimester cervical length between cases who delivered vaginally and those who had a C-section (p=0.04). Conclusion: Cervical length measurement is feasible at 11–14 weeks using a standardized technique. Our preliminary data indicate that a short cervix in the first trimester is associated with a higher risk of preterm delivery and the longer measurements are associated with an increased risk of Cesarean section.

P01.18: Congenital diaphragmatic hernia—factors influencing decision making

Results: We identified 84 cases. 24 had associated gastro-intestinal tract and respiratory anomalies; 22 had abnormal karyotypes (10 Trisomy 18s, 5 Trisomy 21s and 1 each of other aneuploidies or other karyotypical abnormalities); 6 had neuromuscular syndromes; 3 had major central nervous system anomalies; 7 had renal anomalies causing anhydramnios; 5 had other genetic syndromes; 2 had placental insufficiency leading to anhydramnios; 8 were found to have normal stomach appearances and had normal outcomes and 7 had a normal outcome despite persistently absent stomach on ultrasound examination. Of these 84: 26 underwent termination of pregnancy; 9 suffered in utero fetal demise; 8 died in the neonatal period; 3 died in infancy; 44 had a live birth and survived infancy and 5 outcomes were not obtained. Conclusions: A persistently absent stomach on ultrasound scanning is associated with a guarded prognosis – with an incidence of abnormal karyotype of 29% and a high incidence of associated structural abnormalities. In only 9.2% of persistently absent stomachs was the outcome normal. We have not been able to explain why these normal fetuses did not demonstrate stomach ‘bubbles’ on ultrasound.

OP02.10: The impact of first trimester screening and early fetal anomaly scan on invasive testing rates in women of advanced maternal age

Results: The number of the referred cases was 28 in NT of 95th –99th centile (group 1;G1), 27 with NT of 3.5–4.4 mm (group 2;G2), 21 with NT of 4.5–5.4 mm (group 3;G3), and 66 for NT > = 5.5 mm (group 4;G4). Chromosomal anomalies were detected in 2 cases (Down syndrome) of G1, 2 cases (Down syndrome) of G2, 3 cases (2 Down syndromes, 1 trisomy 18) of G3, and in 21 cases (5 of Down syndrome, 10 of trisomy 18, 6 of Turner syndrome) of G4. In the normal karyotype fetuses the major cardiac defects were diagnosed prenatally and confirmed after birth in 2 cases of G3 and 5 cases of G4. Only 1 case of G4 developed bilateral hydronephrosis and thereafter hydrops in the third trimester. No structural abnormalities were detected in G1 and G2 fetuses with normal karyotype. Conclusions: The prevalence of chromosomal and cardiac anomalies increased with the thickness of NT. A detailed ultrasound examination, especially fetal echocardiography, should be offered even if the karyotyping proved normal. The long-term prognosis appeared normal if the fetus with thick NT had normal karyotype and no structural abnormalities.