Maryam Tarsa

Congenital Cardiac Anomalies Prenatal Readings Versus Neonatal Outcomes

The purpose of this study was to determine the variation between prenatal and postnatal diagnosis of congenital cardiac lesions diagnosed by both fetal center primary physicians and fetal pediatric cardiologists at a single tertiary referral center in the United States and evaluate why cases were misdiagnosed.

Pregnancy in women with a history of Kawasaki disease: management and outcomes.

To characterise the obstetrical management and outcomes in a series of women with a history of Kawasaki disease (KD) in childhood.

Anomalous Pulmonary Venous Return Insights Into Prenatal Detection

To review all cases of total anomalous pulmonary venous return (TAPVR) or partial anomalous pulmonary venous return (PAPVR) identified prenatally or postnatally at a single institution and to identify factors that may lead to a correct or missed diagnosis in both high‐ and low‐risk fetuses on screening examinations.

Electrical velocimetry demonstrates the increase in cardiac output and decrease in systemic vascular resistance accompanying cesarean delivery and oxytocin administration

pain returned again in a few hours to NRS 5 to 6, and it took approximately 5 hours before the pain level was back to NRS 2 to 3. She used this combination for three months with persistent pain reduction. This treatment regimen reduced the pain more than 50% from baseline. Side effects such as a sensation of slight derealization due to the psychotropic effects of both drugs, were mild. Blood pressure was not affected. Furthermore, careful titration of ketamine cream volume and the cannabis cookies is possible so as to achieve an optimal balance between efficacy and psychotropic side effects. Cannabis is available in the Netherlands as a prescription drug. One of the main indications for its use is neuropathic pain [5], for which cannabis is generally seen as acceptable third-line treatment [4]. Cannabinoids are agonists for the central and peripheral cannabinoid receptors, CB1 and CB2, both playing an important role in pain modulation [6,7]. Ketamine acts on the N-Methyl-D-aspartate (NMDA) receptors, which, as with the cannabinoid receptors, are located centrally and peripherally [8]. Besides the NMDA receptors, ketamine acts also on many others, such as opioid, monoaminergic, and muscarinic receptors [9]. Ketamine and cannabis may act synergistically because cross-talk exists and the cannabinoid and the opioid receptor systems also have synergistic interactions [10,11].

P26.07: Success of prenatal diagnosis of TAPVR/PAPVR in high and low risk patients

Methods: This was a retrospective review over a 2 year period (1st June 2008 to 31st May 2010). Cases were identified from local registration, referrals to a tertiary centre, admission to the neonatal unit and the local paediatric cardiology outpatient. 4 chamber view and outflow tracts were evaluated at anomaly scan. Results: There were 17 cases of congenital heart disease out of 7690 deliveries (0.2%). Eleven of the cases were detected antenatally giving a detection rate of 65% (11/16). Six cases went undetected out of which two were transpositions of the great arteries, one pulmonary atresia, one pulmonary stenosis with an atrial-septal defect, one tetraology of fallot and two atrio-ventricular septal defects. One neonate died due to an inoperable defect and the others are all alive and well till date. Five out of the six undetected cases had more than one anomaly scan by sonographers due to ‘inadequate’ cardiac views Conclusions: The overall detection rate in our Hospital NHS Trust meets the required standard of 50% set by the National Screening Committee, UK. There is current inadequate capture of data on a regional level making underreporting likely. In those cases that were missed, repeated anomaly scans by sonographers should prompt specialist review. This is likely to improve the detection rate even further.

OP03.08: Congenital cardiac lesions: prenatal readings vs. outcomes

S. Jaudi1, N. Fries2, S. Tézenas du Montcel3, J. Nizard1, V. Halley Desfontaines4, M. Dommergues1 1Obstetrics and Gynecology, Groupe Hospitalier Pitié Salpêtrière, APHP and Université Paris 6 UPMC, Paris, France; 2Collège Français d’Echographie Fœtale, Paris, France; 3Department of Medical Statistics, ER4 Modeling in Clinical Research UPMC, APHP and Université Paris 6 UPMC, Paris, France; 4Paris 6 UPMC, Paris, France

P22.02: Recognition of fetal cardiac abnormalities by sonographers: still frames vs. fast cine vs. slow cine

Objectives: To identify the different sonographic findings on gray scale and color doppler in tuboavarian abscess (TOA) which conformed by surgery. Methods: Eighty women with surgically documented TOA were enroleed into this study. A retrospective review of their USG records was performed. Results: The mass was documented at the position of the ovary in 65 cases and at the cul-de sac in 15 cases. Th maximum diameter was 10 cm. The mass was a simple cyst in 10 cases, in 10 cases it was cyst with septation, in 15 cases it was a thickend tube-shaped structure with multiple internal echoes and in 39 cases it was a mixture of cystic and solid elements. Color doppler sonography demonstrated low impedance blood flow in the borders. Conclusions: The USG findings of TOA are not specific. However the presence of a mass at the ovary or cul-de-sac in combination with clinical findings is helpful for a correct diagnosis. Also the color doppler flow can further characterize the nature of pelvic mass by detecting a significant rich blood flow.