N. Fratelli

Outcome of antenatally diagnosed abdominal wall defects.

To examine the natural history and detailed outcome of antenatally diagnosed abdominal wall defects.

Outcome of fetuses with antenatally diagnosed short femur

To examine the outcome of fetuses diagnosed with short femur length at the time of the routine anomaly scan.

Severe twin-twin transfusion syndrome: outcome after fetoscopic laser ablation of the placental vascular equator.

Objectiveu2002 To assess the safety and efficacy of a modified fetoscopic laser ablation technique for the management of severe twin–twin transfusion syndrome (TTTS) in a large series of pregnancies.

Prenatal ultrasound in the prediction of bowel obstruction in infants with gastroschisis

To assess the value of prenatal ultrasound in predicting bowel obstruction requiring surgery in fetuses with prenatal diagnosis of gastroschisis.

First-trimester uterine artery Doppler and spontaneous preterm delivery.

To assess the relationship between first‐trimester uterine artery Doppler measurements and spontaneous preterm delivery.

OP07.03: First‐trimester uterine artery Doppler and small‐for‐gestational‐age infants

Methods: Retrospective analysis of 11–14 weeks uterine artery Doppler findings in 73 singleton pregnancies with spontaneous preterm labor and 2417 pregnancies delivered at term. Cases with fetal chromosomal or structural abnormalities, pre-eclampsia, smallfor-gestational-age fetuses, concurrent maternal disease, cervical cerclage or history of cone biopsy were excluded. Results: The uterine artery mean resistance index (RI) was 0.69 (coefficient of variation 17%) and 0.68 (19%) in the preterm and term delivery group, respectively (p = 0.41). The mean pulsatility index (PI) was 1.42 (39%) and 1.42 (46%) in the term and preterm delivery group, respectively (p = 0.96). Bilateral diastolic notches were present in 34% of preterm deliveries and 33% of controls (p = 0.84). Restricting the analysis to the 19 pregnancies with preterm delivery before 34 weeks of gestation, no significant difference with controls was observed for RI (mean 0.71, coefficient of variation 11%, p = 0.41), PI (mean 1.56, coefficient of variation 29%, p = 0.27) or the number of bilateral notches (42%, p = 0.41). Conclusion: Despite pathological evidence suggesting that defective placentation is associated with spontaneous preterm delivery, first-trimester uterine artery resistance, as assessed by Doppler ultrasound investigation, is not different in pregnancies subsequently complicated by preterm labor compared to pregnancies delivered at term.

OC103: Outcome of antenatally diagnosed short femur

Objectives: To examine the outcome of fetuses with short femur length (FL) at the time of the routine anomaly scan. Methods: This was a retrospective review of antenatal, pediatric and genetics records of pregnancies where ultrasound measurement of FL at 18–24 weeks of gestation was found to be below the 5th centile. All pregnancies had an ultrasound at 11–13 + 6 weeks to confirm pregnancy dating and also had nuchal translucency (NT) risk assessment. Results: There were 129 fetuses over a 6-year period. In 46 (35.7%) cases short FL was associated with other structural abnormalities. In this group skeletal dysplasias (n = 16), chromosomal abnormalities (n = 10) and genetic syndromes (n = 4) were the most common associations. Short FL was classified as isolated in the remaining 83 (64.3%) cases. There were no cases of chromosomal abnormalities in this group. Eleven (13%) were false positives with FL at subsequent scans within the normal range; all of these had a normal outcome. In the remaining 72 (87%) FL measurements were consistently below the fifth centile. Early severe fetal growth restriction (FGR) with abnormal umbilical artery Doppler requiring delivery before 37 weeks of gestation occurred in 33/83 (40%); 90% of these had abnormal uterine artery Doppler at the time of presentation. This cohort was complicated by pre-eclampsia in 12/33 (36%) cases, intauterine fetal death in 11/33 (30%), while a further two suffered a neonatal death. In 39/83 cases umbilical artery Doppler remained normal; five of these patients delivered before 37 weeks owing to pre-eclampsia or placental abruption (n = 3) or spontaneous preterm labour (n = 2), while in 34 delivery occurred after 37 weeks of gestation. Conclusions: In a population previously screened by NT, isolated short FL at the time of the routine anomaly scan is not associated with chromosomal abnormalities. Severe FGR associated with high mortality occurs in 40%, making uterine artery Doppler evaluation more useful than amniocentesis in these pregnancies.

OP07.10: Short femur length as the presenting feature in pregnancies subsequently complicated by severe fetal growth restriction

subject. All subjects had a mid-trimester routine scan at 18–22 week, and BPD, FL, AC and HC were measured. The relationship between CRL and placental volume was examined by regression. Based on the regression model, the actual placental volume was transformed to the gestational-specific centile. Similarly, gestational specific centiles of all second-trimester biometic measurements were computed using locally derived normogram. Results: The placental volume increased linearly with the CRL. There was no correlation between first-trimester placental volume and any of the second-trimester biometric measurements: BPD (r = −0.055, p = 0.465), HC (r = −0.055, p = 0.464), AC (r = 0.059, p = 0.428), FL (0.007, p = 0.921). Conclusion: There was no relationship between first-trimester placental volume and second-trimester fetal growth.

OP10.09: Placental chorioangioma in pregnancies complicated by severe fetal growth restriction

one case was lost to follow-up. Of the remaining 16 pregnancies, 15 women delivered at term and all the infants were healthy. The remaining case delivered a stillborn fetus at 28 week due to an E. coli intrauterine infection. The cause of death was considered unrelated to the PSC. Discussion: According to this series, PSCs are associated with a good perinatal outcome. In contrast with umbilical cord cysts, it is unlikely that PSCs can jeopardize fetal wellbeing, despite continuous growth during pregnancy in some of them. Owing to the close proximity to the umbilical cord in most cases, PSCs should be clearly differentiated from umbilical cord cysts, which carry a poorer prognosis.

OP02.27: Outcomes of antenatally diagnosed anterior abdominal wall defects

distance atrium-aorta during 2 years, (more than 3000 fetuses). We recently had to study two others esophagus atresia without fistula. Results: The evaluation of the distance left atrium-aorta was possible in all cases, generally easily. In normal fetuses, the whole left atrium is separated from the aorta by the esophagus. We had also two esophagus’ atresia without any space between the left atrium’s upper portion and the esophagus, making the diagnosis of atresia without fistula. These findings have been confirmed by fetopathology in one case and celioscopy in the other, showing the left atrium recovering the inferior stub of the esophagus. All this was also entirely detected with the two pathways described. There was no false positive and no false negative. Conclusion: This study shows that the contact between aorta and the upper part of the left atrium is an easy and reliable sign of esophagus atresia without fistula (type I), and probably pathognomonic.