D. Kwak

P20.08: Correlation of fetal ultrasonographic findings in prenatally diagnosed de novo balanced translocations: Poster discussion hub abstracts

We collected cases with de novo balanced translocations confirmed in chorionic villus sampling, amniocentesis and cordocentesis between 1995 and 2016. Detailed US evaluations were performed in each cases for prediction of prognosis. Chromosomes from the parents of affected fetuses were also analyzed to determine whether the balanced translocations were de novo or inherited. Results Table 1. Summary of 14 cases with abnormal ultrasound findings in prenatally diagnosed de novo balanced translocations

P20.05: Prediction of large-for-gestational-age neonates in in vitro fertilisation pregnancies and Crown-rump length at 11-13+6 weeks' gestation

had severe developmental delay (Developmental quotient (DQ)〈60) and 15 cases (32.6%) who had mild developmental delay (DQ 60∼80). Six patients were complicated with ASD (13.1%). DQ(age at testing) was 112(7), 76(6), 72(8), 67(2), 65(7), 63(5) respectively. The median of gestational age at birth was 36.5 (32/2∼38/3) weeks, birth weight (BW) was 1779 (1002∼2476)g, standard deviation of BW was -2.25 (-3.05∼-1.53). One case whose DQ was 76 had brain sparing effect and umbilical artery absent/reversed end-diastolic velocity. The case who had higher DQ had brain sparing effect and complicated with attention deficit hyperactivity disorder, learning disorder, and developmental coordination disorder. Ductus venous reversed A wave was not detected in all cases. Conclusions: The prevalence of ASD was significantly higher compared with the previous report in the general population (1.5%). FGR might be one of the risk factors of ASD. Severe FGR parameters such as growth and abnormal Doppler findings, did not seem to be associated with ASD occurrence.

EP01.07: Fetal intracranial space occupying lesions: MRI versus ultrasound

brain parenchyme was found. Due to fetal movement, measurement of the optic nerves were not possible. As a result, isolated ASP was suspected with possibility of septo-optic dysplasia. A full-term 3,245 gram female was born after a normal delivery. Postnatal evaluation with brain ultrasound was performed 3 days after birth and isolated ASP was suspected. The newborn was discharged afterward and no definite sign of focal neurologic deficit was found by this time. A-37-year-old G1P0 woman was referred at 17 weeks and 6 days of gestation due to increased risk of Trisomy 21 and neural tube defect in Quad test. Fetal karyotype was normal. In the mid-trimester ultrasound, estimated fetal weight was 3 percentile and small cystic lesion in fetal head posterior fossa was noted. She was hospitalised at 27 weeks due to symptoms of pre-eclampsia. In follow up ultrasound at 32 weeks and 1 day of gestation, estimated fetal weight was below 1 percentile and cystic lesion in posterior fetal head was still seen. The day after Caesarean section was performed due to fetal distress. A preterm 1,220 gram male was born. Brain ultrasound and MRI was performed 48 days after birth and isolated ASP with well visualised both optic nerves were noticed.

OP31.06: Prediction of postnatal renal function from fetal renal volume measured by 3D ultrasonography in hydronephrosis fetus near term - a preliminary study

database. A retrospective case-record review was performed for (i) those who miscarried up to 6 weeks post procedure and (ii) pregnancies complicated by fetal karyotypic abnormality. Results: During the 15 years studied, 1386 amniocenteses were performed. The main indications were high-risk antenatal screening (65%) and maternal age (26%). In total, there were 17 procedure related miscarriages (rate 1.2%). Ten of these occurred within 2 weeks of the procedure, of which 8 had evidence of chorioamnionitis. In the first 5 years (1994–8), there were 382 procedures and 14 procedure related miscarriages (rate 3.7%). In the second 5 years (1999–2003), there were 518 procedures and 2 procedure related miscarriages (0.4%). In the third 5 years (2004–8), there were 486 procedures and 1 procedure related loss (0.2%) occurring 4 weeks post-procedure. During the 15 years, 53 pregnancies with karyotypic abnormalities were identified; 43 were terminated, (27 Down, 5 Edward’s, 3 Patau’s, 4 Turner’s and 4 others), and one miscarried post-procedure (Down). There were more terminations for abnormality between 2004–8 (n = 22) compared with either 1994–8, (n = 10) or 1999–2003 (n = 11). Conclusion: In the 15 years studied, there has been a marked improvement in the amniocentesis-related miscarriage rate and we now comply with national standards. Termination now accounts for more pregnancy losses than miscarriage. These data provide accurate local statistics for our patients.

P34.04: The relationship among the maternal serum markers, uterine artery Doppler velocimetry, perinatal outcome and 3D ultrasonographic measurement of the placental volume in the first trimester

Objective: To determine the relationship among the first trimester placental volume, maternal serum markers, uterine artery Doppler velocimetry (UTDV), and perinatal outcome. Methods: The preliminary study group consisted of 74 women who received continuous antenatal care and delivered at our institution. Pregnancies with multiple gestation, congenital anomaly, and abnormal placenta were excluded. All patients received 3D ultrasonographic volumetry of placenta during 10 + 0 to 13 + 6 weeks of gestation, underwent routine second trimester maternal serum marker screening, and underwent UTDV during second and third trimester. Placental quotient (PQ) was calculated by dividing placental volume by CRL. Perinatal outcome was defined as small for gestational age (SGA), preeclampsia and NICU admission. Statistical analysis were carried out by Mann-Whitney U test, Spearman correlation and logistic regression test (SPSS 14.0). Results: CRL showed a significant relationship with placental volume (P = 0.026). Among the second trimester serum markers, β-HCG had correlation with PQ (P = 0.019). Other serum markers showed no such correlation. Abnormal UTDV was not statistically related to PQ. Mean PQ ± SD in SGA and appropriate for gestational age (AGA) group were 0.54 ± 0.23 and 0.56 ± 0.15, respectively. In NICU admitted group, mean PQ±SD was 0.47 ± 0.23 (vs. 0.56 ± 0.15 of the control group). The mean value of PQ was smaller in the group with poor perinatal outcome compared to the PQ of the control group. However, there were no significant correlation among the poor perinatal outcomes and PQ. Conclusion: The first trimester placental volume may affect maternal serum screening markers. However, PQ was not associated with UTDV and perinatal outcome. Further study with large sample size is needed to evaluate the association of placental volume and parameters such as maternal serum markers, UTDV, and perinatal outcome.

P32.02: Is it possible to predict placenta accreta by uterine artery Doppler velocimetry in placenta previa

Objective: The aim of this study was to evaluate the efficacy of uterine artery Doppler velocimetry in predicting placenta previa-accreta. Methods: Clinical records of all deliveries between April 1991 and June 2007 were retrospectively analyzed. Cases with small for gestational age, pregnancy-induced hypertension, multiple pregnancies, fetal anomalies, chromosomal abnormalities, and maternal medical illnesses such as cardiovascular disease, renal disease or diabetes mellitus were excluded. Out of 10,977 total cases evaluated, 173 had placenta previa without accreta (PP) and 28 placenta previa with accreta (PPA), diagnosed by histological confirmation. All patients underwent uterine artery Doppler flow velocimetry to measure the mean resistance index (RI) at third trimester, and age, parity, previous abortion history, previous cesarean section history, gestational age at delivery, child sex and birth weight were reviewed. Multiple logistic regression was performed to adjust for potentially confounding variables. Results: Statistically significant differences were found in age, parity, previous abortion, previous cesarean section, gestational age at delivery, and birth weight (P < 0.001, respectively) between the normal group (n = 10,776) and the placenta previa group (n = 201, PP + PPA). Uterine artery Doppler mean RI and sex were similar in both groups (P > 0.05). In placenta previa group, no difference was observed in all variables except uterine artery Doppler mean RI between PP and PPA. In cases of uterine artery Doppler mean RI lesser than 0.40, women who had placenta previa were at increased risk of having placenta accreta (odds ratio [OR] 3.39; 95% confidence interval [CI] 1.41, 8.16). Conclusions: This study shows that uterine artery Doppler RI is reduced in PPA compared with PP. Low uterine artery Doppler RI is independent risk factor of placenta accreta in placenta previa patients.

P43.09: Parovarian cysts: comparison of serial sonographic features and pathologic findings

disorders is extremely diverse. That is why it is very difficult to determine the type of tumor and to differentiate it from nontumorous changes. Therefore, it is very actual to look for reliable ultrasound signs, typical for malignant neoplasms. Evidence criteria are based on improved technology of ultrasound visualization and on their correlation with clinical and morphological peculiarities of different tumors. The sample included 119 patients 17–74 years old (36.4 ± 2.8) with ovarian formations. Ultrasound examination was made with Voluson-730 expert using transvaginal (5–9-MHz) and transabdominal (3.5–5-MHz) sensors. In 2D and 3D regimens the structure of formation and intratumorous blood flow were evaluated. Diagnosis was confirmed by operation with following morphological analysis. 3D power Doppler imaging evenly improved evaluation of spatial location and disturbance of treelike ramification of vessels inside the tumor. Sensitivity and specificity of method in prognosis of malignant neoplasms is 98.6% and 88.7%, respectively. In 94% of cases in which we used combination of 2D and 3D ultrasound with color Doppler mode echographic conclusion coincided with morphologically confirmed diagnoses. Tumorous formations were revealed in 53% (63), benign tumors in 34% (41), malignant tumors – 9% (11), metastatic tumors – 3% (three), in one case – rectosigmoid carcinoma. Only in two patients (with abundant vascularization and endometrioma of highly heterogeneous structure and tuberous inner surface) was malignant nature misdiagnosed. Three-dimensional technologies significantly diminish the rate of diagnostic mistakes by pre-operational examination of patients with ovarian tumors. Diagnostic accuracy determines timely choice of appropriate extent of surgical operation and as the result, effectiveness of treatment.