C. Votino

Acceptance, reliability and confidence of diagnosis of fetal and neonatal virtuopsy compared with conventional autopsy: A prospective study

To compare prospectively maternal acceptance of fetal and neonatal virtuopsy with that of conventional autopsy and to determine the confidence with which magnetic resonance (MR) virtuopsy can be used to diagnose normality/abnormality of various fetal anatomical structures.

Virtual autopsy by computed tomographic angiography of the fetal heart: a feasibility study

To determine the feasibility of postmortem computed tomographic (pm‐CT) angiography for fetal heart evaluation.

Magnetic resonance imaging in the normal fetal heart and in congenital heart disease

To evaluate prospectively the feasibility of magnetic resonance imaging (MRI) for assessment of the fetal heart for congenital heart disease (CHD).

Signaling molecules in the fetal rabbit model for congenital diaphragmatic hernia

Little is known about molecular changes in lungs of fetal rabbits with surgically induced diaphragmatic hernia (DH). Therefore, we examined in this model gene expressions of pivotal molecules for the developing lung.

Minimally invasive fetal autopsy using three-dimensional ultrasound: a feasibility study.

To evaluate postmortem ultrasound (PM‐US) for minimally invasive autopsy, and to demonstrate its feasibility, sensitivity and specificity, as compared with conventional autopsy, in detecting major congenital abnormalities.

Use of a high-frequency linear transducer and MTI filtered color flow mapping in the assessment of fetal heart anatomy at the routine 11 to 13 + 6-week scan: A randomized trial

To prospectively assess the contribution of a high‐frequency linear transducer and of moving target indicator (MTI) filtered color flow mapping in the visualization of cardiac fetal anatomy at the routine 11 to 13 + 6‐week scan.

Role of CGH array in the diagnosis of autosomal recessive disease: A case of Ellis-van Creveld syndrome

Whats already known about this topic?Array CGH permits high-resolution genome analysis and allows for the detection of submicroscopic chromosomal deletions and duplications.Today, this technology is frequently used in prenatal diagnosis. What does this study add?We describe for the second time in the literature a particular form of compound heterozygosity in Ellis-van Creveld syndrome.Array CGH can uncover monogenic autosomal recessive disorders.Array CGH can be helpful in unraveling complex prenatal cases.

Post-mortem high-field magnetic resonance imaging: Effect or various factors

Abstract Purpose: To evaluate image quality and diagnostic accuracy of high-field post-mortem (PM) magnetic resonance imaging (MRI) on fetuses below 20 weeks of gestation before and after the freeze-thaw process. Materials and methods: Nine fetuses were scanned with three different scanning procedures: “fresh”, just after termination of pregnancy (TOP), “non-fresh short scan” and “non-fresh long scan” after being kept at −20 °C, followed by a conventional autopsy. The brain, thorax except the heart, heart and abdomen were studied. The qualities of the images for the four different fetal regions and for the three different scanning procedures were reported. Regression analysis was used to investigate the effect on image quality of different factors. Additionally, the diagnostic accuracy was also evaluated. Results: Fetuses at 12.0–19.6 weeks were included. Regression analysis showed that better image quality was correlated to advanced gestation at TOP and scan on fresh fetuses. PM-MRI on fresh fetuses was always diagnostic for the brain and in more than half of cases on non-fresh fetuses and was nearly equally diagnostic for thoracic and abdominal structures. Conclusion: High-field PM-MRI seems to offer a quite reliable alternative to the parents declining conventional PM for fetuses before 20 weeks whether these fetuses are freshly scanned or after being frozen.

OP26.01: Post-mortem examination of fetal heart in the first half of the pregnancy: a comparison of high-field MRI at 9.4 T to lower-field MRI and to autopsy

Methods: We reviewed all deliveries at Duke University from 2002–2011 to identify parturients receiving treatment for malignancy. All pregnant women exposed to doxorubicin were selected for analysis. Maternal cardiac function of the cohort was compared to historic controls based on doxorubicin exposure level (5% incidence at 400 mg/m2). Cardiac dysfunction was defined as an abnormal left ventricular fractional shortening (FS%) or ejection fraction (EF). The Fischer’s exact test was used for analysis. Results: Twenty-four parturients underwent treatment for malignancy; fourteen of these utilized doxorubicin-based regimens. Malignancies were divided between solid tumors (62%) and hematologic (38%). Eight women had maternal echocardiograms performed in the peripartum period after exposure to doxorubicin. Cumulative dose exposure varied from 25 mg/m2 to 375 mg/m2. Four patients demonstrated evidence of mild (FS%) or pronounced (EF) cardiac dysfunction (OR 19, P = 0.001, 2-tailed Fisher Exact) when compared to historic controls. No maternal deaths occurred, however, one patient remains on a left ventricular assist device (LVAD) due to severe postpartum cardiomyopathy. Conclusions: Pregnancy should be considered a high risk factor for doxorubicin-induced cardiomyopathy. Maternal echocardiography should be considered for all parturients, exposed to doxorubicin, regardless of the exposure dosage.