C. Bermejo

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.

Three-dimensional ultrasound and magnetic resonance imaging assessment of cervix and vagina in women with uterine malformations

To investigate the accuracy of three‐dimensional ultrasound (3D‐US) with respect to magnetic resonance imaging (MRI), and compared to clinical examination, in the assessment of cervix and vagina in women with uterine malformations.

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.

Interobserver Agreement in the Study of 2D and 3D Sonographic Criteria for Adenomyosis

Objective To study the degree of interobserver agreement for already known two-dimensional (2D) and three-dimensional (3D) sonography criteria of adenomyosis. Methods Fifty cases (25 adenomyosis cases, 25 non-adenomyosis cases) were studied by four expert observers and a less-experienced researcher. Each sonographic adenomyosis criterion was separately studied. Interobserver agreement was analysed by the kappa index with 95% confidence interval (CI). Results The degree of agreement about diagnosing adenomyosis was high or very high in all pair-wise comparisons (kappa values of 0.58–0–92). The agreement on identifying intra-myometrial cysts (kappa values of 0.46–0.79) and evaluating the junctional zone (JZ) by 3D-transvaginal ultrasound (3D-TVS) (kappa index of 0.46–0.88) was good. The agreements reached when evaluating the other criteria varied, but good agreement was generally reached. Conclusions Both the 2D-TVS and 3D-TVS criteria employed in diagnosing adenomyosis were reproducible parameters in adenomyosis diagnostics. The results were reproducible, even by a less experienced observer.

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.

Classification of Uterine Anomalies by 3-Dimensional Ultrasonography Using ESHRE/ESGE Criteria: Interobserver Variability

Objective: To evaluate the interobserver repeatability of the coronal view measurements and classification of the uterine malformations (UM) according to the ESHRE/ESGE consensus by transvaginal three-dimensional ultrasound (3D-US). Methods: 89 transvaginal 3D-US volumes acquired during the last two years at Delta Ecografía in Madrid, Spain, were selected from our archive by convenience sampling. Two expert operators blinded from each other, performed post-hoc analysis using render mode and multiplanar-Volume Contrast Imaging (VCI) navigation. Uterine wall thickness at the fundus, indentation of the cavity and indentation of the fundus were measured, classified and sub-classified following the recommendations of the ESHRE/ESGE consensus. The reproducibility of interobserver measurements and classification was examined by calculating intraclass correlation coefficients (ICC) and their 95% confidence intervals (CI) and kappa statistic (k). Results: Repeatability in the measurements: uterine wall thickness: ICC = 0.93 (95% CI, 0.90-0.96), P < 0.0001; indentation of the cavity: ICC = 0.93 (95% CI, 0.86-0.96), P < 0.0001; indentation of the fundus: ICC = 0.93 (95% CI, 0.90-0.96), P < 0.0001. Level of agreement in the classification: overall (U0, U1, U2, U3, U4, U5): k = 0.73 (95% CI, 0.61-0.84), P > 0.0001; U2 (U2a, U2b): k = 0.56 (95% CI, 0.31-0.80), P < 0.001 (0.78 observed agreement compared to 0.49 expected); U3 (U3a, U3b, U3c): k = 0.69 (95% CI, 0.16-1.00), P < 0.05 (0.85 observed agreement compared to 0.53 expected); U4 (U4a, U4b): k = 1.00 (95% CI, 1.00-1.00), P < 0.0001. Conclusions: Transvaginal 3D-US examination of the uterus allows assessment and classification of the UM by the ESHRE/ESGE criteria showing a good interobserver repeatability and reproducibility in most cases.

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.