Begoña Adiego

First-trimester diagnosis of cleft lip and palate using three-dimensional ultrasound.

To determine whether systematic examination of primary and secondary palates using three‐dimensional (3D) ultrasound aids in the identification of orofacial clefts in the first trimester.

Intracranial translucency at 11–13 weeks of gestation: prospective evaluation and reproducibility of measurements

This paper aimed to determine the feasibility of identification and measurement reproducibility of intracranial translucency (IT) in our population.

Feasibility of 3-dimensional sonographic examination of the fetal secondary palate during the second-trimester anatomy scan.

To determine the feasibility of obtaining adequate 3‐dimensional (3D) data sets to examine the fetal secondary palate during the second‐trimester anatomy scan.

Antenatally Diagnosed Renal Duplex Anomalies Sonographic Features and Long-term Postnatal Outcome

The purpose of this study was to assess the diagnostic accuracy and infant outcomes of antenatally detected renal duplex anomalies.

First-Trimester Assessment of the Nasal Bones Using the Retronasal Triangle View A 3-Dimensional Sonographic Study

Objective. The purpose of this study was to evaluate a new sonographic technique for identifying the nasal bones using the retronasal triangle view, ie, the coronal plane at which the palate and frontal processes of the maxilla are simultaneously visualized. Methods. Three‐dimensional (3D) volumes were acquired from women undergoing first‐trimester sonographic screening for aneuploidy by 2 accredited operators. Those data sets in which the fetal face was clearly identified were selected for offline analysis by 2 other observers who were unaware of the sonographic or clinical findings. The nasal bones were classified as both present, only 1 present (right or left), or absent according to the presence or absence of 2 small paired echogenic linear structures at the upper tip of the retronasal triangle as determined by 3D navigation in the coronal plane and compared to those findings obtained by 3D navigation in the sagittal plane. Additional 3D data sets involving a subset of 4 first‐trimester fetuses with trisomy 21 and absent nasal bones were also analyzed retrospectively and included randomly in the study group. Results. A total of 110 3D data sets were analyzed, of which 86% were obtained transabdominally and 14% transvaginally. The quality of nasal bone identification was classified subjectively by the observers as good in 67% of cases, fair in 29%, and poor in 4%. The nasal bones were classified as at least 1 present in 106 of the cases (96%) and absent in 4 (4%), with complete agreement between observers in both the sagittal and coronal planes (κ = 1). Discrimination between the right and left nasal bones was possible in 89% and 93% for observer A and in 96% and 96% for observer B by assessing the sagittal and coronal views, respectively (right nasal bone: κ = 0.90 [95% confidence interval (CI), 0.79–1]; left nasal bone: κ = 0.85 [95% CI, 0.60–0.99]). The nasal bones were not identified at the level of the retronasal triangle view in any of the fetuses with trisomy 21 and absent nasal bones. Conclusions. This study shows that the nasal bones can be confidently identified as paired echogenic structures located at the upper tip of the retronasal triangle. This coronal view of the fetal face offers the possibility of screening for the presence or absence of the nasal bones in the first trimester, especially when the standard midsagittal views of the fetal face are suboptimal because of fetal or maternal factors. Because both nasal bones can be evaluated simultaneously in the coronal plane, the retronasal triangle view may be advantageous over the conventional midsagittal view assessment, in which only 1 of the 2 nasal bones is evaluated.

Non-visualization of choroid plexus of fourth ventricle as first-trimester predictor of posterior fossa anomalies and chromosomal defects

To assess non‐visualization of the choroid plexus of the fourth ventricle (CP‐4V) as a simple, qualitative and reproducible first‐trimester ultrasound feature of the posterior fossa for the prediction of central nervous system (CNS) anomalies and chromosomal defects.

First‐trimester assessment of nasal bone using retronasal triangle view: a prospective study

To examine the feasibility and accuracy of fetal nasal bone (NB) assessment in the retronasal triangle (RNT) view for aneuploidy screening in the first trimester of pregnancy.

Fetal intracranial hemorrhage. Prenatal diagnosis and postnatal outcomes

Abstract Objective: To present our experience with 14 cases of fetal intracranial hemorrhage (ICH). Methods: Cases of fetal ICH detected in our institution between 2005 and 2016 by ultrasonography. Maternal characteristics, ultrasound and MRI findings, and postnatal outcome were noted. Results: Twelve cases (86.7%) were identified during a third trimester routine scan at a median gestational age of 30.6 weeks. The ICH was classified as Grade 2 in two cases, Grade 3 in three cases, and Grade 4 in nine cases. Nine cases were bilateral and five were unilateral (four left/one right). The 11 MRI available confirmed grade and location and, in six cases (54.5%), added new findings. There were six terminations of pregnancy, one intrauterine fetal death and seven babies born alive. These were followed up for 28 months (range 3–96). Some grade of neurologic impairment was observed in five children (71.4%, one Grade 3/four Grade 4), mainly mild to moderate motor sequelae. Conclusion: Diagnosis of fetal ICH is amenable to antenatal US. Most of the cases identified are of high grade and usually detected during the third trimester. MRI is a valuable complementary tool in evaluating ICH. Conversely to that previously reported, postnatal survival is high but it entails the risk of adverse neurologic outcome in most neonates.

Brainstem–vermis and brainstem–tentorium angles: 3D ultrasound study of the intra- and inter-observer agreement

Abstract Objective: The brainstem–vermis angle (BVA) and the brainstem–tentorium angle (BTA) have been proposed to quantify vermian and tentorial alterations associated to fetal posterior fossa malformations. Our objective is to evaluate the intra- and inter-observer agreement for the measurement of these angles during the prenatal ultrasound scan. Methods: Fifteen 3 D sets from fetuses with posterior fossa pathology were processed by multiplanar navigation. Four experts in prenatal ultrasound measured the BVA and the BTA on a mid-sagittal view of the fetal brain, following the criteria described by Volpe. Observer 1 did also repeated measurements following both the criteria by Volpe and Ghi. The intraclass correlation coefficient (ICC) was used to test consistency and absolute agreement for intra- and inter-observer measurements. The concordance is poor when ICC <0.40 and excellent when ICC >0.75. Results: Consistency ICC for measurements between the 4 observers was 0.74 (95% CI: 0.54–0.89) for the BVA and 0.55 (95% CI: 0.29–0.78) for the BTA. Absolute agreement ICC was 0.67 (BVA) and 0.45 (BTA). The intra-observer study showed a significantly greater angle with the criteria by Ghi (mean 52.1°, 95% CI: 49.5–54.8) than with the criteria by Volpe (mean 37.4°, 95% CI: 33.1–41.6). Conclusions: A more precise methodology for the measurement of these angles should be described.

P13.03: Transabdominal assessment of the mid‐sagittal plane of the fetal brain: comparison between two‐ and three‐dimensional ultrasound

were excluded. Measurements were performed transabdominally or transvaginally when technically required in a mid-sagittal plane passing through the CC, the third and the 4th ventricles. The length of the CC was measured from the most anterior aspect of the genu to the most posterior aspect of the splenium by using a straight rostrocaudal line. The relationship between CC length and gestational age as well as biparietal diameter (BPD), fronto-occipital diameter (FOD) and head circumference (HC) were investigated using various statistical models. Results: We reviewed 5635 exams. The length of the CC was best described by a third degree polynomial equation. Based on this approach, the mean, 1st, 3rd, 5th and 10th centile were 23.7, 20, 20.7, 21.1 and 21.7 and 40.3, 34.5, 35.6, 36.2 and 37.1 at 22 and 32 weeks’ respectively. The difference obtained based on regression model, LMS approach and raw data were detailed. Conclusions: The present study offers new reference ranges for CC measurements based on a large dataset. The various statistical approaches are detailed and discussed, allowing for a precise definition of lowest centiles which are the most relevant for prenatal management and counselling of CC development abnormalities.