Laura D'Emidio

The role of ultrasonography in the diagnosis of fetal isolated complete agenesis of the corpus callosum: a long-term prospective study.

Objective. To evaluate the role of a dedicated neurosonographer in prenatal diagnosis of isolated complete agenesis of the corpus callosum (iCACC) and to asses the postnatal outcome of these infants. Methods. Prospective study between January 2004 to December 2004 at Fetal Maternal Medical Centre ‘Artemisia’, Rome, Italy. A detailed ultrasound scan was performed in fetuses affected by iCACC by a dedicated fetal neurosonographer (CG). In all cases, magnetic resonance imaging (MRI) within 5 weeks and 13–15 months after birth was performed. A comparison was made between prenatal findings following the ultrasound scan and postnatal MRI. In these cases, a follow-up of 4-years was performed with a neurological evaluation. Results. Among 23 cases of ACC diagnosed at our centre in the study period, CACC was diagnosed in 17 fetuses. Two were then excluded due to associated malformations, one was lost at follow-up and one patient opted to terminate her pregnancy. Newborn MRI confirmed the ultrasonographic diagnosis of iCACC in all 13 cases. A regular development was present in 92.3% of prenatally diagnosed iCACC. Conclusion. A dedicated neurosonographer could diagnose the iCACC with the same accuracy as MRI and in up to 90% of cases the newborn will have a regular development.

Reference charts for fetal corpus callosum length: A prospective cross-sectional study of 2950 fetuses

The purpose of this study was to establish reference charts for fetal corpus callosum length in a convenience sample.

What Is the Rate of Incomplete Fetal Anatomic Surveys During a Second-Trimester Scan? Retrospective Observational Study of 4000 Nonobese Pregnant Women

The purpose of this study was to estimate the rate of incomplete fetal anatomic surveys during a second‐trimester scan due to an unfavorable fetal position in a nonobese population.

Supplementation with a dietary multicomponent (Lafergin(®)) based on Ferric Sodium EDTA (Ferrazone(®)): results of an observational study.

During pregnancy, iron deficiency anemia is recognized as a specific risk factor for both adverse maternal and perinatal outcome. We decided to test the hypothesis that the daily administration of Lafergin(®), a dietary multicomponent based on Ferrazone(®) (Ferric Sodium EDTA), Lactoferrin, Vitamin C and Vitamin B12, from first trimester of pregnancy until the end of gestation, may significantly reduce, in anemic women, the severity of anemia compared to controls who received ferrous sulfate or liposomal iron.

OP12.12: Accuracy of transabdominal fetal echocardiography prior to 16 weeks in fetuses at risk for congenital heart defects

diagnosed in about 20% of these cases. The sagittal view of the ductal arch is considered a standard sonographic view in fetal echocardiography, and can easily be visualized using fourdimensional (4D) ultrasonography. This study was designed to determine the value of this plane for the prenatal diagnosis of conotruncal anomalies. Methods: We reviewed four-dimensional volume datasets, acquired with the spatiotemporal image correlation technique (STIC), from fetuses with and without confirmed conotruncal anomalies. The visualization rate of the sagittal view of the ductal arch was compared among groups using standardized multi-planar views which allowed the simultaneous visualization of the four-chamber view, sagittal view of the ductal arch and the coronal view of the descending aorta. Results: This study included 183 volume datasets from fetuses in the following groups: (1) normal echocardiography (n = 130); (2) conotruncal anomalies (n = 18); and (3) other CHDs (n = 35). Volumes of poor image quality were excluded from analysis (8.2% (15/183)). The visualization rate of the sagittal view of the ductal arch was significantly lower in fetuses with conotruncal anomalies (5.6% (1/18)) than in normal fetuses (93.1% (108/116)) and fetuses with other CHDs (79.4% (27/34); P < 0.05). Absence of visualization of the sagittal view of the ductal arch was associated with an increased risk of conotruncal anomalies (LR 9.44; 95% CI, 5.8–15.5). Conclusions: Absence of visualization of the sagittal view of the ductal arch should raise the index of suspicion for a conotruncal anomaly.

OP01.09: Uterine Doppler findings and perinatal outcome in small for gestational age fetuses delivered near term

Objectives: To evaluate if uterine arteries Doppler may predict perinatal or maternal outcome in pregnant women with late onset pre-eclampsia. Methods: In our University Hospital all pregnant women admitted with pre-eclampsia at or beyond 34 completed weeks of gestation underwent Doppler interrogation of the uterine arteries. Flow velocity was considered abnormal if the mean resistance index (RI) was above the 95th centile for gestational age. Doppler results did not alter clinical management of the patients. The following outcome variables were considered for each case: gestational age at delivery, birth weight, occurrence of maternal (severe pre-eclampsia, eclampsia, HELLP syndrome) and neonatal complications (perinatal death, admission to neonatal intensive care unit). Results: Between January 2001 and December 2006, 92 women were diagnosed with late-onset pre-eclampsia, including 47 (51%) with abnormal uterine arteries Doppler at admission. In this latter group, compared to patients with normal uterine Doppler, median gestational age at delivery (36 (range, 34–40) weeks vs. 38 (range, 34–40) weeks; P < 0.005) and mean birth weight (2449 ± 604 g vs. 3028 ± 598 g, P < 0.00005) were significantly lower, whereas the chance of neonatal admission to the NICU was increased (15/47 vs. 5/45; OR: 3.7 (95% CI, 1.3–11.0)). No case of perinatal death and no significant difference in the occurrence of maternal complications (9/47 vs. 4/45; OR: 2.4 (95% CI, 0.7–8.0)) were registered in the two groups. Conclusions: Women with pre-eclampsia arising after 34 weeks show a higher risk of perinatal complications if uterine resistance is increased, although maternal outcome does not seem to be related to Doppler findings.

OP01.07: Prognostic role of uterine arteries Doppler in patients with late onset pre‐eclampsia

Objectives: To evaluate if uterine arteries Doppler may predict perinatal or maternal outcome in pregnant women with late onset pre-eclampsia. Methods: In our University Hospital all pregnant women admitted with pre-eclampsia at or beyond 34 completed weeks of gestation underwent Doppler interrogation of the uterine arteries. Flow velocity was considered abnormal if the mean resistance index (RI) was above the 95th centile for gestational age. Doppler results did not alter clinical management of the patients. The following outcome variables were considered for each case: gestational age at delivery, birth weight, occurrence of maternal (severe pre-eclampsia, eclampsia, HELLP syndrome) and neonatal complications (perinatal death, admission to neonatal intensive care unit). Results: Between January 2001 and December 2006, 92 women were diagnosed with late-onset pre-eclampsia, including 47 (51%) with abnormal uterine arteries Doppler at admission. In this latter group, compared to patients with normal uterine Doppler, median gestational age at delivery (36 (range, 34–40) weeks vs. 38 (range, 34–40) weeks; P < 0.005) and mean birth weight (2449 ± 604 g vs. 3028 ± 598 g, P < 0.00005) were significantly lower, whereas the chance of neonatal admission to the NICU was increased (15/47 vs. 5/45; OR: 3.7 (95% CI, 1.3–11.0)). No case of perinatal death and no significant difference in the occurrence of maternal complications (9/47 vs. 4/45; OR: 2.4 (95% CI, 0.7–8.0)) were registered in the two groups. Conclusions: Women with pre-eclampsia arising after 34 weeks show a higher risk of perinatal complications if uterine resistance is increased, although maternal outcome does not seem to be related to Doppler findings.

P41.12: Unilaterally increased uterine arteries resistance in the third trimester and pregnancy outcome

Doppler ultrasonographic mapping of the pseudoaneurysm, after the first embolization procedure, showed the partial revascularization of the lesion. Through the multiplanar 3D reconstruction and see-thru Doppler rendering mode we defined the exact lesion topography into the uterine corpus. We precisely observed a feeding vessel from the uterine corpus in connection with the uterine artery pseudoaneurysm previously selectively embolized. 3D sonographic reconstruction of the pseudoaneurysm vascular structure was then confirmed with a second X-ray angiography. A second selective embolization procedure was attempted. Embolization procedures were uncomplicated and only after a new uncontrollable heavy hemorrhage, surgical therapy was chosen. The hystopathological final examination revealed a full myometrial thickness pseudoaneurysm of the right uterine artery localized at the right limit of Cesarean uterine suture. B-mode and color Doppler ultrasound remain the primary diagnostic tools in patients presented with heavy vaginal bleeding in puerperium and also if X-ray standard angiography remains the gold standard, this report confirms the value of 3D power Doppler angiography in the diagnosis of uterine vascular anomalies.

P15.04: Role of maternal age in sonographic prediction of miscarriage in pregnant women with 1st‐trimester bleeding

bleeding recurred from the lower segment, the patient was taken to the theatre for hysterectomy which stopped the bleeding. The patient made a good recovery. She had 12 units of blood transfusion. Discussion: CSP is challenging to diagnose and little is known about the best management for them. Recently, new conservative methods using early local injection of methotrexate, potassium chloride were able to reduce the morbidity. In our case we found that continuation of CSP to term carries poor outcome. As the rate of CSP is rising, guidelines for management of this condition should develop.