D. Kamil

Absence of ductus venosus-importance of umbilical venous drainage site.

To evaluate the conditions associated with absent ductus venosus (ADV) diagnosed by prenatal ultrasonography.

The Syndrome of Left Isomerism Sonographic Findings and Outcome in Prenatally Diagnosed Cases

The purpose of this study was to evaluate the accuracy of the prenatal diagnosis of left isomerism and to assess possible diagnostic and prognostic markers.

Spectrum and outcome of prenatally diagnosed fetal tumors

To describe the spectrum of prenatally diagnosed fetal tumors, and the course and fetal outcome in affected pregnancies.

Fetal pericardial teratoma causing cardiac insufficiency: prenatal diagnosis and therapy

A 35-year-old Caucasian primigravida was referred at 25 + 0 weeks’ gestation with the diagnosis of a fetal heart tumor. B-mode sonography demonstrated a large, partly solid and partly cystic tumor arising from the surface of the right atrium next to the heart base and a massive pericardial effusion (distance from the heart to the pericardium, 10 mm; Figure 1). The tumor itself measured 28 × 21 × 29 mm. Based on the typical appearance and location a tentative diagnosis of pericardial teratoma was made. The cardiothoracic circumference ratio was 0.56 (heart biometry included neither the teratoma nor the effusion) and sequential analysis of the cardiac anatomy revealed no further anomalies. There were no signs of congestive heart failure at the time of the first presentation. Thus there was no atrioventricular (AV) valve insufficiency and ascites; the flow profiles in the ductus venosus were normal (pulsatility index for veins (PVIV) – defined as (systole – a-wave)/diastole – was 0.596); and there was a normal amount of amniotic fluid (amniotic fluid index (AFI) was 20.6 cm). Follow-up sonograms at weekly intervals showed an increase in the pulsatility indices of the ductus venosus (PVIV, 0.721) as well as an increase in the amount of amniotic fluid (AFI, 24.2 cm) at 26 + 2 weeks’ gestation. At 28 + 2 weeks’ gestation growth of the tumor (now measuring 24 × 38 × 33 mm) was noticed as well as the presence of ascites and an increase of pulsatility in the ductus venosus blood flow pattern (PVIV, 1.00). A pericardiocentesis was performed under sonographic

Prenatal diagnosis and therapy of upper extremity vascular malformation causing high cardiac output and Kasabach–Merritt sequence: a report of two cases

We present two cases of upper extremity vascular malformation causing a high output state in the prenatal period. One fetus responded well to transplacental digitalis treatment. Both newborns had a Kasabach–Meritt sequence including anemia and thrombocytopenia. Postpartum treatment included successful interventional occlusion of the main feeding arteries and subsequent surgical removal of the tumor. Copyright

P31.02: Diagnosis of trisomy 21 in a referral center: does first trimester screening improve the detection at an earlier gestational age?

Introduction: First trimester screening for aneuploidy has been proposed as a major improvement because of higher detection rates and an earlier gestational age at diagnosis. Objectives: To evaluate the possible influence of first trimester examination on the time of diagnosis in cases with trisomy 21 in a referral center. Methods: Retrospective database analysis of all cases with trisomy 21 over a 4-year period (2003–2006). The studied population consisted of patients referred for targeted ultrasound examinations at different weeks, including patients with suspected or externally diagnosed aneuploidies. Results: A total of 160 fetuses with trisomy 21 were identified. Of those, 40 (25%), 37 (23.1%), 37 (23.1%) and 46 (28.8%) were diagnosed < 13 + 6 weeks, at 15 to 18 weeks, 19 to 22 weeks and > 22 weeks, respectively. Maternal age in the first three groups was significantly higher than in the group with late referral (37.1 vs. 34.9 years). In the first trimester, 38% of cases were diagnosed after screening in our center and 62% were referred for suspicious findings or confirmed trisomy 21. Second trimester diagnosis was 21.6% and 13.6% after screening, compared to 78.4% and 86.4% referred for suspected or diagnosed trisomy 21 at 15 to 18 weeks and 19 to 22 weeks, respectively. All cases with late referral had ultrasound abnormalities. Conclusion: Despite an increasing proportion of first trimester examinations performed at centers and by local obstetricians, the vast majority of cases with trisomy 21 are still diagnosed in the second trimester. Cases in the high risk population are detected earlier, as these patients receive targeted ultrasound examination in the first and early second trimester.

OP02.11: The spectrum and outcome of prenatally diagnosed fetal tumors

to the base of the contraction. The time was recorded automatically on the screen. Results: The mean pace of change in the thickness of the SFMC was 1.2 ± 0.8 mm/min. There was no statistically significant difference between the contraction’s and the relaxation’s phase pace. The maximum thickness measured was 45.7 mm, whereas 79% of the measurements where less than 35 mm. Conclusions: A total relaxation can be expected in the majority of the cases after 30 minutes if the SFMC is encountered during the relaxation phase. The SFMC can be distinguished from leiomyoma, to which it is similar in appearance, by measuring twice the thickness five minutes apart.