Ilaria Zucca

Reliability of the first-trimester cardiac scan by ultrasound-trained obstetricians with high-frequency transabdominal probes in fetuses with increased nuchal translucency.

To examine prospectively the reliability of ultrasound‐trained obstetricians performing a first‐trimester fetal cardiac scan with high‐frequency transabdominal probes, by confirming normal or abnormal heart anatomy, in pregnancies referred for increased nuchal translucency thickness (NT).

1233 Estimating the prevalence of occupational exposure in lung cancer. results from an hospital-based case-series in italy

Introduction Lung cancer (LC) is the leading oncologic cause of death among males. The role of occupational history with exposure to well-established carcinogens is very important, but usually deeply underestimated. To undervalue the occupational origin of cancer can affect the efficacy of preventive measures and preclude patients to receive insurance benefits. We performed a systematic occupational medicine evaluation of a cases-series of lung cancer cases to properly quantify the proportion of LC cases with previous occupational exposure to carcinogens. Methods We systematically evaluated all consecutive LC cases hospitalised in a large university hospital, in Milan. An active systematic search was carried out for 24 months, by trained occupational physicians, using a standardised questionnaire. Results We collected 123 consecutive LC cases (66% males). Former and current smoking habit was found in 61% and 22%, respectively. A clear exposure to occupational carcinogens (in details: asbestos, polycyclic aromatic hydrocarbons, paintings, diesel exhaust) was recognised in 10% of males cases. Discussion Previous occupational exposure to carcinogens was frequent among males cases in Northern Italy. The observed prevalence was even lower than the one reported in a previous systematic search in Lombardy (Porru S, et al. Int Arch Occ Env Health 89:981–9). If we applied our observed proportion of occupational cases to the entire incident LC cases in Lombardy population, we should observe about 460 male occupational LC cases per year (AIRTUM-AIOM report 2016), actually more than the entire number of cancer (all sites, both gender) annually notified to National Institute for Insurance (INAIL Rapporto regionale 2015).

OP05.08: Quantitative umbilical venous flow in twin–twin transfusion syndrome (TTTS): intertwin differences and modifications after therapeutic procedures

Objective: To compare the transfer of technetium-99m labelled red blood cells (99mTc RBCs) in monochorionic (MC) placentas, MC placentas after laser coagulation of the vascular anastomoses for TTTS and fused dichorionic (DC) placentas. Methods: Placental perfusion study with 99mTc O Rh – RBCs in 5 MC, 5 lasered MC and 5 fused DC placentas. The arteries of twin 1 were injected with 20–30.10 × 9 99mTc RBCs diluted in 100 mL NaCl, whereas the vessels of twin 2 were rinsed with 200 mL NaCl. The % of transferred 99mTc RBCs was calculated by dividing the radioactivity measured in the rinsing solution of twin 2 by the initial radioactivity injected in twin 1. Afterwards, each placenta was injected with dyed barium sulphate to document the angioarchitecture. Results: GA at birth was similar in the 3 groups. None of the lasered MC and fused DC placentas had visible anastomoses, whereas all 5 MC placentas had visible anastomoses-1 had only small arteriovenous (AV)-venoarterial anastomoses (VA) without an arterioarterial (AA) anastomosis, 4 had an AA with AV/VA. The % of transferred 99mTc RBCs in lasered MC placentas (0, range: 0–000012) was similar to fused DC placentas (0, range: 0–001760) (NS), but significantly lower than in MC placentas (8.5, range: 1–66) (p < 0.01). In MC placentas, the larger the AA, the higher the % of transferred 99mTc RBCs. Conclusion: In MC placentas successfully separated by laser coagulation of the vascular anastomoses, the transfer of 99mTc RBCs was not significant and similar to fused DC twin placentas. Therefore, laser seems to functionally separate the 2 fetal circulations.

P06.06: Vesicocentesis in the first and second trimesters of gestation for treatment of fetal megacystis

Objective: Fetal megacystis in the first and second trimesters of pregnancy is an indication for diagnostic vesicocentesis. Our goal is to assess the effectiveness of early vesicocentesis as a treatment option of megacystis. Materials and Methods: From 1995 to 2005, 18 pregnancies were identified with early fetal megacystis. Fetal biometry, morphology, amniotic fluid, bladder size and volume were evaluated. Karyotype was available in 6 cases (6/18 = 33%). Vesicocentesis was performed in 8 fetuses (8/18 = 44%). Fetal urine biochemical markers were determined after each vesicocentesis. Results: Megacystis was never isolated: 6 cases (6/18 = 33%) demonstrated oligohydramnios or anhydramnios, 5 fetuses (5/18 = 28%) presented renal dysplasia, 4 had renal hyperechogenicity (4/18 = 22%), 3 had mild pyelectasis (3/18 = 17%), 1 ureteral dilatation (1/18 = 5.5%) and 1 a polymalformative syndrome with sacrococcigeal mielomeningocele (1/18 = 5.5%). Any case had chromosomal abnormalities. In 3 fetuses (3/8 = 37.5%) biochemical markers indicated a good fetal kidney function, in the remaining 5 fetuses (5/8 = 62.5%) a poor renal prognosis was suggested. In 2 cases (2/8 = 25%) pregnancy proceeded with normal amniotic fluid volume and a normal-sized urinary bladder with normal dynamics. In 3 cases (3/8 = 37.5%) megacystis recurred and a second vesicocentesis was performed. In the remaining 3 cases (3/8 = 37.5%): 2 terminations of pregnancy were performed and 1 spontaneous abortion occurred. Conclusions: Fetal vesicocentesis in the first trimester of gestation is a useful treatment option in case of megacystis. Fetal vesicocentesis is a minimally invasive procedure that can be life-saving if performed in early pregnancy.

OC24.03: Changes in Doppler waveform of ductus venosus: a comparison between IUGR and congenital heart diseases

time to perform the entire scan in 3-D (adding the 3D acquisition time to the interpretation times) was 7.34, 6.60, and 7.10 minutes for the 3 physicians respectively. The individual fetal anatomic landmarks were identified more than 94% of the time using the 3D method compared to 2D, except for the fetal arms and cavum septum pellucidum. Grouping the anatomic views by region, the heart, head, extremities and abdominal views were completely seen in 88%, 90%, 90% and 95% of cases respectively. There was no statistical difference between the abilities of the 3 physicians to complete the fetal surveys using only 3-D imaging. One fetus had multiple anomalies and was correctly identified by all three physicians on 3D. Overall, 74% of the 3-D BPD measurements were within 1 mm of the 2-D measurements, and 64% of the 3-D femur measurements were within 1 mm of the 2-D measurements. Conclusion: This study shows that a fetal screening sonogram can be performed in less than 2 minutes on the exam table and interpreted off line in 6–7 minutes, as compared to a mean of 19 minutes for the standard 2-D exam. This results in a time-savings of more than 10 hours in scanning and interpreting 50 fetal sonograms.