N. Benzina

Cause of fetal demise in first-trimester parvovirus infection: anemia, placentitis or myocarditis?

Increased nuchal translucency and/or the presence of fetal hydrops during first-trimester ultrasound examination has been reported as a sign of congenital infection with parvovirus. Recent reports on parvovirus infection in pregnancy have described altered fetal hemodynamics Figure 1 Ultrasound image of 13-week fetus showing increased nuchal translucency thickness and generalized subcutaneous edema.

P19.16: Not all large neural tube defects have a poor prognosis: a case report of prenatally diagnosed limited dorsal myeloschisis

Submission of an uncommon fetal condition, which is not usually diagnosed before birth, with good postnatal development. We report clinical data, most representative ultrasound images and a review of recent literature. 27 year old patient. Previous Cesarean delivery for non-progression of labor. In the current pregnancy 1/111 risk for trisomy 21, in the first trimester combined screening. The result of the amniocentesis was normal 46 XY karyotype. On 16 th week an urethral dilation and penile deformation was observed. On 20th week ultrasound we objective left curved penis with urethral dilation. Bladder wall thickening. Bilateral ureteral dilatation and mild pyelic ectasia. Ultrasound findings remain unchanged for the rest of gestation, mild pyelic ectasia and normal amniotic fluid. We observed corpus cavernosum development (scaphoid megalourethra). There was no hipospadias evidence. Testes in the scrotum. Good postnatal development with normal renal function. Currently awaiting surgical correction of penile deformity. Congenital megalourethra is a rare malformation characterized by dilation of the penile urethra. Its diagnosis is usually postnatal. It is characterized by hypoplasia of the corpus spongiosum and occasionally hypoplasia of the corpus cavernosum (megalourethra fusiform). It could be associated with upper urinary tract defects, VACTERL sequence, oligohydramnios with lung hypoplasia and abdominal wall defects. Prognosis is fairly good if normal renal function.

P13.01: Prenatal corpus callosum measurement: biometry 2nd and 3rd trimester

Objectives: We compared morphological parameters of urogenital hiatus in women after acute and elective Caesarean Section (CS). Methods: This is an open, prospective and non randomised study. All patients undergo 3D/4D ultrasound of the pelvic floor 6 weeks post partum, women are examined in supine position, after voiding. Patients are examined at rest, during pelvic muscle contraction and upon Valsava. Volumes are analyzed offline. Following parameters are measured: size of the urogenital hiatus (UGH, cm2) and parameter H (cm, measured as distance between the urethrovesical junction – UVJ and horizontal line going through the lower edge of the symphysis pubis). Results: We obtained data from 130 patients. 31 patients (23.8%) underwent elective CS, 99 patients (76.2%) delivered by acute CS. There was no statistically significant difference in measured parameters between patients after acute or elective surgery and there also wasn’t any difference when comparing acute CS in the first or second stage of labour. In patients after elective CS, mean UGH at rest was 11.92 (min. 7.67, ma. 17.68), H at rest was 3.2 (min. 2.4, max. 4.6), during contraction mean UGH was 10.56 (min. 6.92, max. 15.22), mean H was 3.56 (min. 2.72, max. 4.68) and upon Valsava mean UGH was 13.89 (min. 9.1, max. 18.74), mean H was 2.52 (min. 0.79, max. 3.51). In patients after acute CS mean UGH at rest was 12.3 (min. 7.79, max. 19.79), mean H was 3.26 (min. 2.1, max. 5), during contraction mean UGH was 10.5 (min. 6.98, max. 16.98), mean H was 3.58 (min. 2.28, max. 5.71) and upon Valsava mean UGH was 15.53 (min. 8.,22, max. 27.07) and mean H was 2.46 (min. 0, max. 4.18). Conclusions: There is no statistically significant difference in urogenital hiatus parameters measured by 4D ultrasound when comparing data from patients after elective and acute CS. We found no avulsion of the levator in women after CS.

OP17.03: Perinatal outcome of monochorionic twins with severe selective IUGR

Objectives: To determine whether a previous good response to IVIG treatment in pregnant women with neonatal alloimmune thrombocytopenia (NAIT) predicts a similar response in the next affected pregnancy. Methods: Thirty-six pregnancies in 24 women were managed by weekly administration of IVIG without monitoring platelet counts. Seven women had more than one pregnancy treated by IVIG resulting in 18 consecutive treated pregnancies. Results: The mean platelet count at the first affected pregnancy was 28,000/μL and the mean platelet count at birth following IVIG treatment was 126,000/μL. Four (11%) of the treated fetuses had a platelet count of < 30,000/ μL at birth. Four women with two pregnancies treated by IVG and one woman with three pregnancies treated by IVIG had a good response with platelet count at birth above 50,000/μL in all their pregnancies. One woman had an adequate response in her first two treated pregnancies but in her third pregnancy the platelet count at birth was 11,000/μL. Similarly, another patient delivered a thrombocytopenic infant with platelet count of 39,000/μL following 3 previous pregnancies in which a good response to IVIG has been achieved. None of pregnancies in our cohort has been complicated by intra-cerebral hemorrhage. Conclusions: A good response to IVIG in one pregnancy with NAIT does not guarantee effectiveness of treatment in the next affected pregnancy. The possibility of developing intolerance to IVIG treatment following recurrent pregnancies, which were successfully treated by IVIG, should be considered.