P. Antsaklis

Screening for pre‐eclampsia and fetal growth restriction by uterine artery Doppler and PAPP‐A at 11–14 weeks' gestation

To assess the role of maternal demographic characteristics, uterine artery Doppler velocimetry, maternal serum pregnancy‐associated plasma protein‐A (PAPP‐A) and their combination in screening for pre‐eclampsia and small‐for‐gestational age (SGA) fetuses at 11–14 weeks.

Assessment of fetal anatomy at the 11–14‐week ultrasound examination

To assess the feasibility of examining cardiac and non‐cardiac fetal anatomy in a low‐risk population in the setting of the routine 11–14‐week ultrasound scan.

Screening for pre‐eclampsia and small for gestational age fetuses at the 11–14 weeks scan by uterine artery Dopplers

Objective. To assess the role of uterine artery Doppler studies at 11‐14 weeks in screening for pre‐eclampsia (PET), small for gestational age (SGA) fetuses, and placental abruption. Methods. Prospective study on 1,123 women presenting for routine ultrasound examination at 11–14 weeks for nuchal translucency measurement. Uterine artery blood flow was studied by transvaginal colour Doppler, the mean pulsatility index (PI) was calculated, and the presence of a diastolic notch was recorded. Results. The mean, median and 95th centile of uterine artery PI were 1.71, 1.64 and 2.54, respectively. Bilateral notches were observed in 63.4%, and a unilateral notch in 18.4% of cases. The sensitivity of mean uterine artery PI ≥95th centile for PET, early onset severe PET necessitating delivery before 34 weeks, SGA ≤5th centile, SGA necessitating delivery before 34 weeks, SGA ≤10th centile and placental abruption were 21.4, 33.3, 17.8, 100, 9.6 and 44.4%, respectively. One in 6 women with increased resistance in the uterine arteries at 11–14 weeks will develop a complication related to utero‐placental insufficiency. Conclusions. Abnormal uterine Dopplers at 11–14 weeks identified one‐third of women with severe early onset pre‐eclampsia, all fetuses with SGA ≤5th centile that were delivered at ≤34 weeks, and 40% of cases with placental abruption. Uterine artery Doppler examination at the 11–14 weeks scan can identify a high risk population in which preventive or therapeutic interventions might be effective.

Short-Rib-Polydactyly Syndrome Presenting with Increased Nuchal Translucency in a High-Risk Family

Short-rib-polydactyly syndrome represents a group of rare, autosomal recessive, lethal skeletal dysplasias characterized by hypoplastic thorax, short ribs, short limbs, polydactyly, and visceral abnormalities. We describe an affected fetus from a high-risk family presenting with increased nuchal translucency at 13 weeks of pregnancy. The diagnosis was established in the 2nd trimester.

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.

OC05.01: Reliability of first trimester structural sonographic extended evaluation

J. Degenhardt1, R. Schürg2, A. Kawecki3, M. Pawlik1, C. Enzensberger1, R. Stressig4, R. Axt-Fliedner1, T. Kohl3 1Division of Prenatal Medicine, University of Giessen and Marburg, Giessen, Germany; 2Department of Anesthesiology, University of Giessen and Marburg, Giessen, Germany; 3German Center for Fetal Surgery & Minimally Invasive Therapy, University of Giessen and Marburg, Giessen, Germany; 4University Hospital of Bonn, Bonn, Germany