M. Cara

First trimester two‐ and four‐dimensional cardiac scan: intra‐ and interobserver agreement, comparison between methods and benefits of color Doppler technique

To evaluate intra‐ and interobserver agreement for first‐trimester fetal cardiac structural assessment, using two‐dimensional (2D) ultrasound (2D‐US) and 4D‐US (4D spatiotemporal image correlation (STIC) technology), to compare the methods and to assess the advantages of adding color Doppler to each technique.

Agenesis of ductus venosus in sequential first and second trimester screening

The goal of this study is to evaluate the potential of first trimester (FT) screening in the diagnosis of agenesis of the ductus venosus (ADV) and to study its prevalence in a low‐risk population, the associated conditions, and pregnancy outcome.

OP22.03: First trimester diagnostic accuracy of two-dimensional ultrasound technique in congenital heart diseases and great arteries anomalies: Short oral presentation abstracts

of the major CHDs. Using a standardized and low time-consuming technique will probably raise detection rates in this specific group of diseases. It will lower the operator-dependency and will eliminate the fetal position-dependency, two main reasons for the delayed diagnosis in certain CHDs cases. Despite the extremely low number of false positive cases, the overall accuracy of the method is too low for introducing it in national screening programs. This is mainly due to the spectrum bias of CHDs, with poor FT ultrasound markers in some cases and an evolving pattern in others. Objectives To assess the accuracy of a standard first-trimester (FT) conventional two-dimensional ultrasound (2DUS) examination protocol in detecting congenital heart diseases (CHDs) and great arteries anomalies, in an unselected population.

OC22.02: Clinical significance of congenital uterine corporeal anomalies: a prospective observational study in unselected population

Methods: A retrospective cohort study of women who underwent a laparoscopic myomectomy at University College London Hospital between December 2014 and November 2017 was carried out. Ultrasound images and operation notes were reviewed. The size and minimum distance of the fibroid from the endometrial cavity in a 2-dimensional longitudinal plane were determined from ultrasound images (negative distance was scored when the fibroid protruded into the cavity). Endometrial cavity breaches at the time of surgery were identified from the operation notes. Women who did not have a preoperative ultrasound and those who had more than two fibroids removed were excluded. Results: 74 women who had laparoscopic myomectomy and a preoperative ultrasound were identified. The median age was 36.0 (IQR 33 – 39.8) and the median fibroid diameter was 68.2mm (IQR 47.7 – 80.6). 10/74 (13.5%, 95% CI 5.7 – 21.3) had a breach of the endometrial cavity. Women who suffered a breach had a fibroid that was close to or within the endometrial cavity (distance from cavity -9.9 vs. 8.9mm, p=0.001, degree of protrusion 17% vs. 0.0% and intracavitary surface area 1463mm2 vs. 0.0). A logistic regression model with cavity breach as independent variable and ultrasonic variables as predictors selected minimum distance from cavity as the best predictor of cavity breach (OR 0.79, 95% CI 0.73 – 0.92). 10/19 (52.6%, 95% CI 30.2 – 15.1) of women with a submucosal component to their fibroid did not have a cavity breach. No women with a fibroid further than 5.2mm from the cavity had a breach identified at surgery. Conclusions: Identifying patients who are at increased risk of endometrial cavity breach based on ultrasound facilitates appropriate preoperative counselling regarding the risk of intrauterine adhesions and the need for Caesarean section.

OP19.03: The role of prenatal assessment of placental cord insertion in unselected singleton pregnancies: Short oral presentation abstracts

Methods We performed a single-center, prospective cohort study. We enrolled 2500 unselected singleton pregnancies who underwent late first trimester (FT) ultrasound scan, having a complete follow-up in our unit. We excluded pregnancies having early ultrasound markers for abnormal invasive placenta. These cases were rescanned between 20 and 23 weeks of amenorrhea and the location of the placental cord insertion was reassessed.

P26.08: Screening for congenital uterine anomalies by three-dimensional transvaginal ultrasound in premenopausal women: the online added information

female offspring of PCOS women already show higher androgen levels compared to the female offspring of non-PCOS women. Methods: Androgen levels were determined in maternal serum and umbilical cord blood from PCOS and non-PCOS women and the respective offspring at the Medical University of Graz, Austria, between 2012 and 2015. Results: A total of 79 PCOS and 354 non-PCOS women were recruited. The main results are shown in table 1. Conclusions: The comparison revealed that androgen levels in female offspring of PCOS and non-PCOS women do not differ although maternal hormone levels differ significantly.

OP12.05: First trimester: two- or four-dimensional fetal heart study?

14+6 weeks gestation in morphologically normal fetuses and fetuses with congenital heart abnormalities. Methods: Fetal echocardiogram was performed on 247 women between 11+0 and 14+6 weeks of gestation. Exclusion criteria included maternal age 30, and multifetal gestations. Combined transabdominal and transvaginal ultrasound was used for cardiac evaluation. The cardiac examination included assessment of the following eight planes: abdominal circumference (situs), four-chamber view, left ventricular outflow tract, right ventricular outflow tract, three-vessel-trachea view, aortic arch, ductal arch, and bicaval view. Successful visualization rate of each cardiac plane as well as full cardiac examination using 2D, 2D+ color Doppler and 2D+ HD color Doppler was evaluated. Results: CHD were diagnosed in 41 cases. Successful visualization of each diagnostic cardiac plane as well as a complete exam increased with gestational age. Use of HD color Doppler in addition to 2D ultrasound was associated with the highest visualization rate of the fetal cardiac anatomy at each gestational age in both normal fetuses and fetuses with CHD. Conclusions: High-definition color Doppler provides significant advantages in cardiac imaging between 11+0 and 14+6 weeks gestation and may help improve the detection of congenital heart anomalies in early gestation.