B. De Keersmaecker

Receptor‐mediated uptake of Legionella pneumophila by Acanthamoeba castellanii and Naegleria lovaniensis

Aims:  Investigation of the attachment and uptake of Legionella pneumophila by Acanthamoeba castellanii and Naegleria lovaniensis, as these are two critical steps in the subsequent bacterial survival in both amoeba hosts.

Sonographic detection of central nervous system defects in the first trimester of pregnancy

The fetal central nervous system can already be examined in the first trimester of pregnancy. Acrania, alobar holoprosencephaly, cephaloceles, and spina bifida can confidently be diagnosed at that stage and should actively be looked for in every fetus undergoing first‐trimester ultrasound. For some other conditions, such as vermian anomalies and agenesis of the corpus callosum, markers have been identified, but the diagnosis can only be confirmed in the second trimester of gestation. For these conditions, data on sensitivity and more importantly specificity and false positives are lacking, and one should therefore be aware not to falsely reassure or scare expecting parents based on first‐trimester findings. This review summarizes the current knowledge of first‐trimester neurosonography in the normal and abnormal fetus and gives an overview of which diseases can be diagnosed.

High‐intensity focused ultrasound in the treatment of postpartum hemorrhage: an animal model

To investigate the use of high‐intensity focused ultrasound (HIFUS) to reduce uterine artery blood flow in ewes in the postpartum period.

ISUOG Practice Guidelines: performance of fetal magnetic resonance imaging

The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice, and high-quality teaching and research related to diagnostic imaging in women’s healthcare. The ISUOG Clinical Standards Committee (CSC) has a remit to develop Practice Guidelines and Consensus Statements as educational recommendations that provide healthcare practitioners with a consensus-based approach, from experts, for diagnostic imaging. They are intended to reflect what is considered by ISUOG to be the best practice at the time at which they are issued. Although ISUOG has made every effort to ensure that Guidelines are accurate when issued, neither the Society nor any of its employees or members accepts any liability for the consequences of any inaccurate or misleading data, opinions or statements issued by the CSC. The ISUOG CSC documents are not intended to establish a legal standard of care because interpretation of the evidence that underpins the Guidelines may be influenced by individual circumstances, local protocol and available resources. Approved Guidelines can be distributed freely with the permission of ISUOG (info@isuog.org). These guidelines are based on consensus reached between participants following a survey of current practices, conducted by ISUOG in 2014 (Appendix S1).

F106Prenatal diagnosis of syndromic and nonsyndromic craniosynotosis by ultrasound

Background

P02.07: Termination of pregnancy for midline cerebral anomalies

Objectives: To compare the accuracy of neurosonography (NSG) and magnetic resonance imaging (MRI) in the assessment of the fetal cortex within a high risk cohort of fetuses diagnosed with central nervous system (CNS) abnormalities. Methods: Single centre prospective study involving an Italian Tertiary Unit. The included cases had antenatal diagnosis or suspicion of CNS abnormality and underwent twoand three-dimensional NSG, which was performed using a 3-5 MHz and a 4-6 MHz endocavitary probe equipped Samsung WS-80 scanner, and MRI. Antenatal findings were compared between the two techniques and differences in terms of CNS anatomy and cortical findings were recorded. Postnatal imaging was also investigated for the study purposes. Results: In all, 31 cases were submitted to NSG at a median gestation of 26+0 weeks (18+3 – 33+2) due to one of the following: abnormal or absent cavum septum pellucidum (5 cases), ventriculomegaly (9 cases), head circumference <3SD (4 cases), posterior fossa abnormalities (3 cases) or other reasons (8 cases), including previous intracranial anomaly or fetal CMV infection. At expert NSG, abnormal cortical findings were diagnosed in 8/31 cases, including lissencephaly (3 cases), microcephaly (1 case) and focal cortical dysplasia in the remaining. All fetuses underwent antenatal MRI, which was performed at a median gestation of 28+4 weeks (20+0 – 34+2). MRI yielded abnormal cortical findings consistent with those reported at NSG in all 8 cases. Additionally, mild asymmetry in the cortical sulci and gyri was noted at MRI in 2 of the remaining 23 cases with normal cortical appearance at NSG. Antenatal findings were confirmed at postnatal imaging or post-mortem examination in all cases. Conclusions: Our results from a cohort at high risk of CNS abnormalities have suggested that antenatal MRI is not superior to expert NSG in the detection of abnormalities of the cortical folding and development.

OC06.05: Termination of pregnancy for central nervous system (CNS) anomalies

B. Deloison1,2, P. Sonigo3, A. Millischer3, N. Bahi-Buisson4, G. E. Chalouhi1,2, N. E. Russell1, F. Brunelle3, N. Boddaert4, Y. Ville1,2, L. J. Salomon1,2 1Obstetrics and Gynecology, University Paris Descartes, Sorbonne Paris Cite, Assistance Publique-Hopitaux de Paris, Hopital Necker-Enfants Malades, Paris, France; 2SFAPE Societe Francaise pour l’Amelioration des Pratiques Echographiques, Paris, France; 3Pediatric Radiology, University Paris Descartes, Sorbonne Paris Cite, Assistance Publique-Hopitaux de Paris, Hopital Necker-Enfants Malades, Paris, France; 4Pediatric Neurology, University Paris Descartes, Sorbonne Paris Cite, Assistance Publique-Hopitaux de Paris, Hopital Necker-Enfants Malades, Paris, France

OP16.09: Termination of pregnancy for central nervous system (CNS) anomalies: Short Oral Presentation (OP) Abstracts

B. Deloison1,2, P. Sonigo3, A. Millischer3, N. Bahi-Buisson4, G. E. Chalouhi1,2, N. E. Russell1, F. Brunelle3, N. Boddaert4, Y. Ville1,2, L. J. Salomon1,2 1Obstetrics and Gynecology, University Paris Descartes, Sorbonne Paris Cite, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France; 2SFAPE Société Francaise pour l’Amélioration des Pratiques Echographiques, Paris, France; 3Pediatric Radiology, University Paris Descartes, Sorbonne Paris Cite, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France; 4Pediatric Neurology, University Paris Descartes, Sorbonne Paris Cite, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France

P313: PPROM before 24 weeks of gestation: correction of oligohydramnios with synthetic antidiuretic hormone

Thyrotoxicosis in pregnancy is almost caused by maternal Grave’s disease. During pregnancy, women with a history of Grave’s disease under treatment with propylthiouracil (PTU) have an increased risk for fetal goitre. Antenatal diagnosis of fetal goiter should be appropriately managed to avoid perinatal complications. In this report, we describe a case of fetal goiter detected by antenatal ultrasound at 26 weeks’ gestation in a mother treated with PTU for Grave’s disease. Ultrasound examination revealed 60 × 50×40 mm fetal goiter, each lobe measured 31 × 24 × 14 mm. Subsequently, fetal thyroid function was examined by cordocentesis. Cord blood showed elevated serum TSH: 40.2 mU/L and, normal concentrations of free-T4: 9.5 pmol/l and free-T3: 2.6 pmol/l. Amniotic fluid was normal and, there was no other ultrasonographic signs of fetal hypothyrodism. Then the mother’s PTU dosage was reduced to 150 mg daily and weekly ultrasonographic examinations were recommended. 6 weeks later ultrasound showed a significant decrease in size of fetal goiter. The fetal neck returned to a normal flexed position. After 34 weeks gestation, amnionic fluid volume decreased because of intrauterine growth restriction. Patient delivered a male newborn, weighing 2150 gr by C/S. The newborn’s thyroid gland was not palpable and thyroid ultrasound was normal. Cord blood serum TSH, free-T4 and free-T3 was also within normal limits (TSH: 8.4 mU/L, free-T4: 0.7 ng/dl, free-T3: 1.0 pg/ml). Follow up thyroid function test was also found to be normal a week later and the baby did well afterwards. In conclusion, after evaluation of fetal thyroid status, selected cases with fetal goiter could be managed initially without intrauterine treatment. As in this report, adjustment of maternal antithyroid medication can dramatically decrease the size of the fetal goitre in patients who are treated with antithyroid medication.

F107Ultrasonographic diagnosis of spina bifida at 12 weeks: heading towards new indirect signs

Background