F. M. Andrade

New anatomical landmarks to study the relationship between fetal lung area and thoracic circumference by three-dimensional ultrasonography

Objective: To evaluate the relation between total lung area (TLA) and thoracic circumference (TC) ratio by three-dimensional (3D) ultrasonography applying new anatomical landmarks as the fetal aorta and inferior angle of the scapula. Methods: A longitudinal prospective study was conducted with 56 uncomplicated pregnancies between 24 and 32 weeks of gestation. Polynomial regressions were used to evaluate the correlation between TC and gestational age (GA) as well as TC and estimated fetal weight (EFW). A simple linear regression was used to evaluate the correlation between TLA and Total thoracic area (TTA) and GA. The intraclass correlation coefficient (ICC) was used to assess the intra and interobserver variability. Results: 127 examinations were performed. TC values ranged from 150 to 174 mm (mean 166 mm) at 24 weeks and 215–248 mm (mean 231 mm) at 32 weeks. The TLA/TC ratio ranged from a mean of 0.64 at 24 weeks (range 0.56–0.70) to 0.90 at 32 weeks gestation (range 0.79–1.01). The intraobserver variability using the ICC was of 0.919 for TC; 0.916 for TTA; 0.860 for right lung area (RLA) and 0.910 for left lung area (LLA). Interobserver reproducibility was with an ICC of 0.970 for TC; 0.984 for RLA and 0.910 for LLA. Conclusions: Measurement of fetal TC and the relationship between TLA and TC by 3D-ultrasonography applying new anatomical landmarks shows good reproducibility and allows a new assessment of thoracic and lung growth.

EP17.15: Obstetric ultrasound of patients in prison

Technology have transformed urine analysis in pregnancy. The responsibility for urine testing in antenatal care remains with health care provider. Monitoring have been self-testing for both blood and urine in diseases like diabetes. The changing child birth and NICE guideline advocated involvement of pts in antenatal care, which can improved by transferring of knowledge and skills. This survey is to evaluate opinions about pt self-testing and monitoring of urine during pregnancy in a UK district Hospital community. Methods: Questionnaire designed to evaluate pt and non–pt opinions of urine self-testing during pregnancy. Opinion evaluated were 67.6% pts & 32.4% others for: Accepted practice involving self-monitoring e.g. Urine HCG Knowledge of urine self–testing in pregnancy Acceptance, skill transfer and investment in self–testing of urine during pregnancy Results: Home urine HCG testing; 79.8% support and 96.2% found HCG kits acceptable >90 % of pts used HCG self -testing. %

P12.10: Relationship between fetal chest size and biometric parameters by three‐dimensional ultrasound using the multiplanar method

women were referred for fetal cardiac screening, the remainder for suspected abnormalities. Fetal Cardiac abnormalities were diagnosed in 16/375 (4.3%) of ‘high risk’ screened women. They included 3/61 (5%) screened women with maternal cardiac disease, 9/166 (5.4%) previous child/sibling? with CHD, 4/34 (11.8%) of screened women with diabetes mellitus. Fetal cardiac abnormalities were identified in 18/375 (4.8%) women who had multiple risk factors. There were no obvious fetal cardiac defects among screened groups with a history of paternal CHD, previous child with CHD, maternal antibodies, and history of drug intake. Conclusions: The rate of antenatally diagnosed cardiac defects is higher than expected among our screened population. However, subgroup analysis revealed that it may vary between groups. Future studies are required to evaluate the implication of implementation of routine fetal cardiac screening policy on the antenatal detection rate of CHD and its management.

P08.18: Relationship between lung area to chest size ratio in normal fetuses by three‐dimensional ultrasound using the multiplanar method

of 21 chest size. The Bland-Altman analysis was used to compare the measurement agreement and bias for a single observer. Results: One hundred and twenty seven examinations were perfomed. The chest size ranged from 15.0 to 17.3 cm with mean of 16.6 cm (±0.7 cm, SD) on the 24th week to 21.5 to 24.8 cm with mean of 23.1 cm (±0.8 cm) on the 32nd week. The intra-observer variability study utilizing the intraclass correlation coefficient was of 0.919. Conclusions: The fetal chest measurement by multiplanar method of 3-dimensional shows good reproducibility and can be utilized to quantify the thoracic circumference.

P08.17: Reference range of fetal chest size by three-dimensional ultrasound using the multiplanar method

Objectives: To determine the prevalence of the aberrant (right or left) subclavian artery in chromosomally normal and abnormal fetuses. Methods: The study was performed at two referral centers for CHD. Fetal echocardiography was performed prospectively in the first and second trimester to identify the subclavian artery and to determine whether this was normal or aberrant. Results: Over a period of a two years we were able to identify an aberrant subclavian artery in 0.9% of chromosomally normal fetuses and in 10% of chromosomally abnormal fetuses. Conclusions: The presence of the aberrant subclavian artery is more common in chromosomally abnormal than normal fetuses.

P28.09: Three dimensional ultrasonography of advanced ultrasound in first trimester using tomographic ultrasound imaging (TUI)

Objective: The objective of this study was to evaluate the time in the room used with the patient to perform a morphologic exam in the 1st trimester with TUI compared to the traditional technique 2D. Method: Twenty pregnancies between 11 and 14 week were evaluated. The measurements made were: DBP/CC/Femur/TN/Nasal bone and CA. Results: For 2D complete exam an average of 10 minutes were necessary with the patient in room, while with TUI the average time was 5 minutes. Conclusion: The TUI uses 50% less time to be executed in comparison to the 2D method.

P27.02: Three-dimensional ultrasonography of the cerebellum, cisterna magna, fourth ventricle and vermis cerebellar using slices ultrasound imaging (3DXi)

Background: Sternal clefts are rare congenital anomalies that may occur in isolation or in association with other structural malformations. The sternal malformation/vascular dysplasia association consists of sternal clefts with hemangiomas of the skin and internal organs. Abnormalities of the sternum have also been described in the PHACES syndrome which consists of posterior fossa malformations, hemangiomas, arterial anomalies, cardiac defects, and eye abnormalities. Case: We report a case and associated images of an infant prenatally diagnosed with an aortic aneurysm and chest wall deformity. Postnatally, echocardiogram and MRI revealed a large aneurysm of the proximal descending aorta measuring 1.1 × 1.8 cm. The aneurysm began just distal to the origin of the left carotid artery, and a moderate pre-aneurysmal coarctation was noted. The origin of the left subclavian artery was distal to the aneurysm. In addition, partial sternal cleft with agenesis of the manubrium was noted. The intracranial anatomy was normal, and U/S and MRI revealed no hemangiomas of the head and neck vessels. Dermatologic evaluation revealed no evidence of cutaneous hemangiomas. Bronchoscopy revealed no hemangiomas of the respiratory tract. Ophthalmologic exam revealed normal ocular anatomy. Conclusion: Hemangiomas are the hallmark of both the sternal malformation/vascular dysplasia association and PHACES syndrome. We have, however, identified a case of sternal cleft with aortic aneurysm in the absence of cutaneous or visceral hemangiomas. Although these malformations may be unrelated, this case may also represent a variant of the PHACES syndrome.

P25.17: Three dimensional ultrasonography of physiologic herniation using tomographic ultrasound imaging (TUI)

A. Daniilidis1, M. Mavromichali2, K. Kouzi3, G. Koliakos4, N. Tsagias5, J. Tzafettas1 1Obstetrics Gynecology, Hippokratio University Hopsital, Thessaloniki, Greece, 2Paediatrics, Hippokratio University Hopsital, Thessaloniki, Greece, 3Histology, Aristotle University, Thessaloniki, Greece, 4Biochemistry, Aristotle University, Thessaloniki, Greece, 5Biology, Aristotle University, Thessaloniki, Greece

OP02.12: Fetal structural abnormalities detected at the 11–14 week scan

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.