M. Albig

Normal intracranial translucency and posterior fossa at 11–13 weeks' gestation in a fetus with closed spina bifida

At first-trimester screening (11–13 weeks) the midsagittal plane shows not only nuchal translucency (NT) and the nasal bone, but also the posterior brain region. Intracranial translucency (IT) and the posterior fossa have been shown to be abnormal in fetuses with open neural tube defects in the first trimester1–4 but, so far, no information about potential changes in fetuses with closed spina bifida is available. We report the case of a 37-year-old woman, para 2, with an uneventful history who underwent first-trimester screening at 13 + 1 weeks’ gestation. Crown–rump length was normal (77 mm) but NT was increased at 4.2 mm. Comprehensive transabdominal and transvaginal ultrasound examination revealed the absence of the left umbilical artery without signs of associated malformations. As part of a multicenter study in Berlin assessing the value of posterior brain measurements for early detection of neural tube defects the following structures were also evaluated: IT, brainstem (BS), distance of BS to occipital bone (BSOB), cisterna magna (CM), BS/BSOB ratio. All values were within the normal range4: IT, 1.7 mm; BS, 2.2 mm; BSOS, 5.8 mm; CM, 1.9 mm; BS/BSOB, 0.38 (Figure 1).

OP17.09: 125 single examiner cases of ARSA—additional malformations and chromosomal abnormalities

these cases. Four patients successfully underwent surgical correction and in one of them tracheoplasty was also performed. Conclusions: Isolated vascular rings can be accurately diagnosed prenatally by using the ‘‘three vessels and trachea view’’ and the ‘‘supraaortic branch view’’ that allow detection of vascular structure running around the trachea. Karyotyping and prenatal testing for 22q11 microdeletions should be offered to all parents. Affected children should undergo surgical correction as soon as the symptoms of tracheal compression appeared avoiding tracheomalacia.

P303: Prenatal diagnosis of foramen ovale obstruction—a report of two cases

outlet right ventricle, premature closure of the foramen ovale and a levoatrial cardinal vein draining into the innominate vein. In a prior study performed elsewhere the levoatrial cardinal vein had been interpreted as an aortic arch perfused retrogradely, and hypoplastic left heart syndrome had been diagnosed. Prenatal management, induction at 38 weeks and postnatal studies and treatment are presented. To the best of our knowledge, this is the first prenatal diagnosis of this embryological vessel, presenting a potential pitfall for prenatal echocardiography.

OP03.14: Different degrees of ventriculomegaly: frequency of chromosomal anomalies, associated malformations and congenital infections

Materials: The database was searched and all cases in which the sonographic diagnosis of a central nervous system malformation was made were included. Results: There were 280 patients in which a diagnosis of a CNS malformation was made. The most common diagnosis was related to dilation of ventricular system, followed by neural tube disease, agenesis of the corpus callosum and posterior fossa abnormalities.

OP03.15: Isolated mild cerebral ventriculomegaly: cytogenetic findings and pregnancy outcome

Materials: The database was searched and all cases in which the sonographic diagnosis of a central nervous system malformation was made were included. Results: There were 280 patients in which a diagnosis of a CNS malformation was made. The most common diagnosis was related to dilation of ventricular system, followed by neural tube disease, agenesis of the corpus callosum and posterior fossa abnormalities.

P10.07: Cardiac rhabdomyoma: prenatal diagnosis and postnatal outcome

chromosomal abnormality in the study population. The depth of the pericardial effusion was not related to the clinical course of isolated pericardial effusion. All studied babies were alive and healthy when this study was prepared. Conclusions: There were no adverse outcomes or chromosomal anomalies among fetuses diagnosed with isolated pericardial effusion. Most cases of fetal isolated pericardial effusion resolved spontaneously. If no other abnormality is detected upon meticulous inspection, our results will be reassuring to patients who have a fetus diagnosed with isolated pericardial effusion.

P01.20: Intrauterine spontaneous main bronchus obstruction in congenital diaphragmatic hernia mimicking CAM?

of innumerable capillary channels. It usually regresses after an initial rapid growth and involutes after 6 months. Although benign, it can be life-threatening due to high output cardiac failure with and without hydrops, hemolytic anemia, thrombocytopenia, and disseminated intravascular coagulopathy (DIC). We experienced a case with infantile hepatic hemangioendothelioma with Kasabach-Merritt sequence. A 41 year-old woman was referred to our hospital with rapid growing liver mass at 39.3 gestational weeks. Ultrasound examination at visit showed a large liver mass (8.4×6.1cm) with cystic and solid elements. Color Doppler showed increased flow in the wall of the tumor. There were no findings of hydrops and arteriovenous shunting. Because of breech presentation, Cesarean section was performed on the next day. The prenatally suspected hemangioendothelioma of the liver was confirmed by magnetic resonance imaging (MRI). On the day 3 after the birth, the neonate suffered DIC as KasabachMerritt sequence, he was treated with prednisolone and interferon. Following MRI showed decreased size of the liver mass (6.5 × 5.8cm) and DIC also resolved.

OC29.01: Association between first trimester PAPP‐A and adverse pregnancy outcome

first trimester cervical length between cases who delivered vaginally and those who had a C-section (p=0.04). Conclusion: Cervical length measurement is feasible at 11–14 weeks using a standardized technique. Our preliminary data indicate that a short cervix in the first trimester is associated with a higher risk of preterm delivery and the longer measurements are associated with an increased risk of Cesarean section.

P01.18: Congenital diaphragmatic hernia—factors influencing decision making

Results: We identified 84 cases. 24 had associated gastro-intestinal tract and respiratory anomalies; 22 had abnormal karyotypes (10 Trisomy 18s, 5 Trisomy 21s and 1 each of other aneuploidies or other karyotypical abnormalities); 6 had neuromuscular syndromes; 3 had major central nervous system anomalies; 7 had renal anomalies causing anhydramnios; 5 had other genetic syndromes; 2 had placental insufficiency leading to anhydramnios; 8 were found to have normal stomach appearances and had normal outcomes and 7 had a normal outcome despite persistently absent stomach on ultrasound examination. Of these 84: 26 underwent termination of pregnancy; 9 suffered in utero fetal demise; 8 died in the neonatal period; 3 died in infancy; 44 had a live birth and survived infancy and 5 outcomes were not obtained. Conclusions: A persistently absent stomach on ultrasound scanning is associated with a guarded prognosis – with an incidence of abnormal karyotype of 29% and a high incidence of associated structural abnormalities. In only 9.2% of persistently absent stomachs was the outcome normal. We have not been able to explain why these normal fetuses did not demonstrate stomach ‘bubbles’ on ultrasound.

P07.12: Uterine artery Doppler—the sampling point is critical

Placental chorioangiomas are the most common benign placental tumors, occur in 1% of all pregnancies. Small tumors have little impact on the fetus. Large tumors are rare, with a reported incidence of 1 in 3.500 to 1 in 9.000 births, and may cause serious complications such as fetal anemia, hydrops, congested heart failure and fetal death. We describe a pregnancy complicated by a placental chorioangioma at 26 weeks of gestation. Gray-scale ultrasound demonstrated solid mass protruding from the fetus surface of the placenta measuring 8, 5 × 6, 9 cm. Color flow imaging provides important demonstration of blood flow within the mass. The 3D power Doppler and Virtual Organ Computer-aided AnaLysis (VOCAL) calculation was performed, the angioarchitecture of the tumor was rendered, and confirmed that the vascular channels in the tumor were continuous with the fetal circulation. The relation between the large and vascularized chorioangioma and the adverse pregnancy outcome was well recognized. Color Doppler ultrasound plays a useful toll in the differentiation of solid placental masses and monitoring throughout gestation. The refinement of this technique is the use of 3D power Doppler ultrasound imaging and VOCAL software for monitoring and management.