A. Olivella

Doppler assessment of the aortic isthmus and perinatal outcome in preterm fetuses with severe intrauterine growth restriction

To evaluate the characteristics and association with perinatal outcome of the aortic isthmus (AoI) circulation as assessed by Doppler imaging in preterm growth‐restricted fetuses with placental insufficiency.

Accuracy of four-dimensional spatiotemporal image correlation echocardiography in the prenatal diagnosis of congenital heart defects

To evaluate the accuracy of four‐dimensional (4D) spatiotemporal image correlation (STIC) echocardiography for the diagnosis of fetal congenital heart disease (CHD) in a selected high‐risk population.

Feasibility and accuracy of fetal echocardiography using four‐dimensional spatiotemporal image correlation technology before 16 weeks' gestation

To evaluate the potential value of early fetal echocardiography (EFE) by means of four‐dimensional (4D) spatiotemporal image correlation (STIC) technology for either reassurance of normality or prenatal diagnosis of major congenital heart defects (CHDs).

Intra- and interobserver repeatability of fetal cardiac examination using four-dimensional spatiotemporal image correlation in each trimester of pregnancy

To assess the intra‐ and interobserver repeatability of the evaluation of fetal cardiac structures and measurements using spatiotemporal image correlation (STIC) technology in each trimester of pregnancy.

Isolated ventricular septal defects in the era of advanced fetal echocardiography: risk of chromosomal anomalies and spontaneous closure rate from diagnosis to age of 1 year

To evaluate, in a cohort of 248 fetuses seen at a tertiary referral center, the frequency of isolated ventricular septal defects (VSD) among all congenital heart defects (CHD), the association with chromosomal and postnatal anomalies and the rate of spontaneous closure.

The ‘question mark’ sign as a new ultrasound marker of tetralogy of Fallot in the fetus

To describe a new ultrasonographic marker, the ‘question‐mark’ sign, to assist in the diagnosis of tetralogy of Fallot (TOF) in the fetus, and to evaluate its prevalence in TOF as compared with other cardiac defects.

P05.07: Two cases of ‘Mirror syndrome’ in TTTS with and without fetoscopic treatment

chorionicity. Only dichorionic twins entered to our study. They were compared with 160 singleton pregnancies. Results: There were 80 dichorionic twin pregnancy during our study period. Increased frequency of intrauterine growth retardation (OR = 6/3; CI = 3/96–15/97). Preterm delivery (OR = 8/6; CI = 4/93–16/23) low birth weight (OR = 10/81; CI = 7/46–21/12). Cesarean delivery (OR = 9/30; CI = 5/82–17/10) PPROM (OR = 5/34; CI = 3/23–9/81) was noted in the twin pregnancies in this study. The frequency of hypertension was 10/8% in mothers with twin compared with a frequency of 7/2% in those with singletons. Conclusion: Twin pregnancies are high risk for mothers & infants. With the appropriate management perinatal outcomes may improve.

OC22.06: Cardiovascular dysfunction in monochorionic pregnancies with twin‐to‐twin transfusion syndrome to predict fetal demise

If deliveries by planned Cesarean section and deliveries following induced labor are excluded, 872 twin pairs remain, where 28.6% were MMP, 44.6% were MFP and 26.8% were FFP. Mean GA at delivery was 246.8 days (SD 20.4) for MMP, 245.5 days (SD 21.8) for MFP and 246.2 days (SD 21.2) for FFP (p>0.05). The distribution of preterm and very preterm births was similar in the three groups. Conclusions: Mean GA at birth does not seem to be correlated to fetal gender in twin pregnancies.

OC02.05: Chromosomal anomalies in isolated fetal aberrant right subclavian artery

Methods: The study comprised IAA fetuses examined only by 2D echocardiography from 1994 to 2003, and those identified by 2D echocardiography and examined by 4D US with B-flow and STIC from January 2004 to July 2008 at 2 referral centers for congenital heart defects (CHD). Postnatal follow-up was available in all cases. Karyotyping and FISH for microdeletion 22q11.2 were performed in all cases. Results: 22 cases of isolated IAA (15 type B and 7 type A, 7 and 3 of which, respectively, underwent B-flow and STIC) were detected among 2520 cases of fetal CHD. In 7 of the 15 type B cases, a right subclavian artery arose anomalously (ARSA). 2D US failed to distinguish the type of IAA in only 2 cases and the ARSA in 5 of the 7 cases. B-flow and STIC successfully identified IAA types in all 10 cases examined and clearly visualized the ARSA, including cervical ones. FISH detected microdeletion in 10/15 type B cases and an unusual association with type A in 1 of the 7 cases. Fetal/neonatal outcome included: 8 terminations of pregnancy, 1 intrauterine death and 4 postoperative deaths in the neonatal period, and 9 neonates were alive after surgery at a mean follow-up time of 58 months. Conclusions: Our results confirm the feasibility of prenatal characterization of IAA and its different types based on 2D examination, albeit with some limitations in the thorough assessment. 4D US with B-flow and STIC can facilitate the detailed examination of the anatomical features of IAA types, including visualization of the neck vessels, thus supplying additional information with respect to 2D US. Our data indicate that types A and B are distinct, there being a close association of microdeletion only with IAA type B.

OP33.04: Assessment of the arterial trunks relationship in prenatally diagnosed transposition of great arteries using STIC technology

Results: In normal fetuses, it was possible to identify the respective position of the inferior vena cava and the descending aorta in all cases. In the 3 cases with left atrial isomerism, it was possible to identify the azygos continuation adjacent to the descending aorta and the abnormal stomach position. In no case could the multiple spleens be identified. In the 3 cases with right atrial isomerism, it was possible to identify the abnormal central position of the inferior vena cava and the displacement of the stomach to the left. The abnormal liver morphology consistent with left and right isomerism could be identified in 5/6 cases. Discussion: Identification of fetal situs has so far been carried out by assessing the position of the abdominal vessels on an axial view of the fetal abdomen. Using the coronal plane of the fetal trunk from three-dimensional volumes, it was possible to identify visceral anatomic patterns consistent with a diagnosis of situs solitus or ambiguous (left or right isomerim) independently from the type of congenital heart disease present. This may be of help in difficult cases to tag the type of cardiosplenic syndrome.