A. Kim

Epidemiology of respiratory syncytial virus infection in infants born at less than thirty-five weeks of gestational age.

Background: The aims of this study were to observe the respiratory syncytial virus (RSV) hospitalization rate and to identify the risk factors for hospitalization for RSV infection among infants in Korea born at <35 weeks of gestational age and who had not previously received palivizumab. Methods: We conducted a study over a 2.5-year period (between April 2007 and September 2009) that included premature infants (<35 weeks of gestational age) who underwent follow-up during 1 year after discharge from the neonatal intensive care unit. Demographic information was collected for each subject at baseline, and the reasons for hospitalization were obtained during the 1-year follow-up period. Results: The study population included 1022 subjects who completed follow-up interviews. Eight hundred seventeen infants were included in analysis for RSV hospitalization. Excluded from the study were 167 subjects with chronic lung disease who had received palivizumab prophylaxis and 38 subjects who were not tested for RSV. The overall incidence of RSV hospitalization in the group that did not receive palivizumab was 4.5% (37 of 817 patients). Independent risk factors associated with RSV hospitalization were multiple gestation (P = 0.022) and longer duration of mechanical ventilation in the neonatal intensive care unit (P = 0.039). Conclusion: This study showed the epidemiology and risk factors of RSV hospitalization in preterm infants in Korea. RSV infection was one of the main causes of hospitalization after discharge from the neonatal intensive care unit in patients born at <35 weeks of gestational age.

OC11.05: Comparison of clinical manifestation in fetuses with Ebstein's anomaly and pulmonary atresia with intact ventricular septum

cases. With no previously affected child, about half use echo and fetal heart rate monitoring and about one quarter use echo alone. Most respondents (∼ 2/3) would start monitoring at 16-20weeks. Frequency of monitoring varied, being every 2 weeks in ∼40%, and weekly in about one quarter of responses. From replies, there was no consensus on how long to monitor the pregnancy for. If 1st degree atrioventricular (AV) block or myocardial abnormalities were found, most (50-60%) would increase frequency of scans and ∼40% would start steroids. Most use left ventricular inflow-outflow Doppler to measure the AV interval, but there is no consensus on how to define 1st degree AV block. With a previously affected child, most would monitor the pregnancy differently but ∼20% would not. Conclusions: Although there were some trends, there was no clear consensus on how to monitor these pregnancies. Evidence-based guidelines are likely to optimise fetal surveillance.

P18.07: Prenatal diagnosis of aortopulmonary window and its perinatal outcomes: a single-centre experience: Poster discussion hub abstracts

Objectives: The aim of this study is to constructing fetal CHD database system, to improve training effectiveness of prenatal diagnosis of CHD. Methods: From Jan 2011 to Dec 2017, we established the ultrasonic database of fetal CHD by continuous transverse scanning or STIC technology which included the transverse section of the abdominal cavity, four chamber, left ventricular outflow tract, right ventricular outflow tract and three vessels trachea section. For the fetuses with conus arteriosus or great vascular malformations, the STIC flow imaging is stored. The anatomical database was established when the fetus was terminated pregnancy. Every anatomical database contains 500 to 800 cross-section images. The above ultrasonic and anatomy database constructed the CHD database system. Results: Total 90 cases database system were established which involve more than 95% different types CHD. The anatomical databases could be displayed continuously and rotated arbitrarily which can be used to displaying the sectional and spatial anatomical structures of different types CHDs. Combining ultrasonic databases and STIC blood flow imaging (figure), students can easily understand and grasp the ultrasonic characteristics of different types of CHDs. Conclusions: The fetal CHD database system includes anatomy and ultrasonic databases of different types of fetal CHD. We can improve the quality and efficiency of training by contrastive learning.

P10.04: Clinical outcome of prenatally diagnosed isolated pericardial effusion

Objectives: The aim of this study was to analyze the antenatal characteristics of HLHS, its association with increased nuchal translucency, extracardiac anomalies and other obstetric outcomes. Methods: The medical records of antenatally diagnosed HLHS cases managed at Seoul National University Hospital between January 2007 and April 2012 were reviewed. The main policy of fetuses with HLHS in our institution is to maintain pregnancy and intention to treat with staged surgical palliation. Results: Twenty two fetuses (n = 22) were diagnosed antenatally during this period. Two cases had increased NT (9.09%). Only minor extracardiac anomalies were found in 2 cases (megacisterna magna, unilateral multicystic dysplastic kidney). Most fetuses (90.9%) had an isolated HLHS. Eleven cases performed karyotyping antenatally and all fetuses had normal karyotype. The 4 cases resulted in termination of pregnancy at other hospitals as parents wanted. In 18 cases who maintained pregnancy, there was no intrauterine fetal death and 2 cases (11.1%) developed cardiomegaly at near term. Seventeen cases attempted vaginal delivery, in 3 cases (17.6%), emergent cesarean section occurred due to intrapartum fetal distress. In 14 (82%) cases, labor progressed without any fetal distress. All cases had normal cord ABGA (Cord pH >7.1). Postnatally three cases had diagnosed as Cornelia de lange syndrome, 2q duplication, unilateral MCDK. Conclusions: Most fetuses with HLHS in our institution in Korea were isolated HLHS. And the incidence of increased NT, extracardiac anomalies and abnormal karyotype in HLHS were much less than previous reports in western country. There could be racial difference in characteristics of HLHS fetuses in Asian people.

OP27.04: Impact of a successful pleuro‐amniotic shunt on cardiac function in fetuses with pleural effusion

Objectives: To evaluate the potential use of the lung-head ratio (LHR) for the prediction of neonatal outcome in severe left congenital diaphragmatic hernia (CDH) after fetal tracheal occlusion (FETO). Methods: Between January 2006 and December 2009, 20 fetuses with severe, isolated left CDH (LHR < 1.0 and liver-up) were submitted to FETO between 26–30 weeks of gestation. The LHR was evaluated before (26–28 ws) and after (32 ws) FETO procedure and then correlated with neonatal outcome (deaths). Results: Neonatal deaths occurred in 9/20 (45.0%) cases. Significantly lower values of LHR were observed in those cases that died before (0.6 ± 0.3) and after (0.9 ± 0.4) FETO procedures in comparison to those that survived (0.8 ± 0.3 and 1.6 ± 0.4; respectively, P < 0.05). Conclusions: The LHR may be useful to predict neonatal outcome in fetuses with severe left CDH submitted to FETO procedures.

OP33.06: Ultrasonography as a prenatal screening method of fetal choledochal cyst

Amniocentesis was performed, and we confirmed the presence of meconium in 3 of them. The fetus with the amniotic fluid clear amniocentesis showed intestinal obstruction with reflux of stomach contents due to the narrow opening of the abdominal wall defect. There was no rupture of the bowel. There were no cases of bowel perforation in the other 24 fetuses. Conclusions: The presence of debris in the amniotic fluid and in the gastric contents, associated with the classic signs of bowel distress, may be an important tool to detect the presence of bowel perforation.

Preliminary experience with invasive procedure in utero using ‘live‐3D’ ultrasonography

Objective:  Technological advances in ultrasound have revolutionized the prenatal diagnosis and treatment. We recently began to evaluate the clinical applications of three‐dimensional (3D) ultrasonography (USG) to invasive procedures in utero. The purpose of this report is to describe the effectiveness of live‐3D USG on the operative in utero procedures.