M. Florea

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.

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.

P13.03: Correlations of the sonopartogram with classic clinical partogram and key points from a pilot study

Objectives: To determine if the degree of caput impacts the accuracy of assessing fetal position in labour when completed by third and fourth year obstetrics residents. Methods: Assessment of fetal position during labour was performed by third and fourth year residents when patients were 8 cm dilated or more, had ruptured membranes, and the gestation was 35 weeks or greater. The residents performed digital examinations for location and axis of fetal sutures and fontanelles in order to determine the orientation of the fetal brow and occiput. Ultrasound assessment was performed immediately following resident examination. Residents were blinded to ultrasound findings. Assessments were considered correct if within 15 degrees of ultrasound findings. Transabdominal and transperineal scanning with a 3.5mHz abdominal probe were utilised. Caput was measured at the time of transperineal ultrasound and grouped into no/mild (0-0.99 cm), moderate (1.0-1.99 cm), and marked (2cm+) caput. Chi-squared analysis was performed using SPSS. Results: Twelve residents assessed 143 labouring women. Mean maternal age was 26.4 years (SD 6.2), mean gestational age was 39.3 weeks (SD 1.2), and 42% had a history of a vaginal delivery. Maternal ethnicity was 60.1% black, 35.7% Caucasian, and 4.2% ‘‘other.’’ The overall accuracy of the resident exams was 47.9%. The amount of caput widely varied from 0 to 3.10 cm, with the largest number having 1.0-1.99 cm of caput. Caput did not change the accuracy of assessment of fetal position (table 1). Conclusions: Degree of caput did not play an important role in the ability to assess fetal position of sutures and fontanelles by palpation.

P06.04: First trimester screening for major congenital heart diseases: the septal-truncus angle

Objectives: The angle between the aortic outflow and the inter-ventricular septum can be measured during sonographic fetal survey while viewing the left ventricular outflow tract (LVOT angle). Our aim was to compare the LVOT angle between fetuses with and without congenital heart malformations involving the LVOT. Methods: In this prospective cross-sectional study we measured the LVOT angle in fetuses with and without conotruncal anomalies. At the level of ‘‘4 chamber view’’ the transducer was tilted so that the LVOT was demonstrated, creating a ‘‘5 chamber view’’. The LVOT angle was measured during early systole at complete opening of the aortic valve, from the interventricular septum to the base of the aortic valve. Results: LVOT angle measurements were acquired from 299 fetuses at 15-38 weeks. LVOT angle were between 127-163 degrees, mean 148.2, independent of gestational age. The LVOT angle was significantly higher in fetuses with TGA or AS, compared with fetuses without heart malformations involving the LVOT (165.0 vs. 148.2, p<0.001). The LVOT angle was significantly lower in fetuses with AVC, compared with fetuses without heart malformations involving the LVOT (125.5 vs. 148.2, p<0.001). Conclusions: The LVOT angle does not change during pregnancy. The LVOT angle significantly differs between fetuses with and without heart malformations involving the LVOT.