Y. H. Lam

Prenatal ultrasonographic prediction of homozygous type 1 α-thalassemia at 12 to 13 weeks of gestation☆☆☆★

We determined the feasibility of prenatal prediction of type 1 homozygous alpha-thalassemia at 12 to 13 weeks of gestation by either abdominal or vaginal (or both) ultrasonographic examination to measure the fetal cardiothoracic ratio in 135 at-risk pregnancies. Forty-three fetuses were affected by homozygous type 1 alpha-thalassemia. The mean cardiothoracic ratio was significantly larger than that of the unaffected fetuses (0.54 vs 0.45, P <.0005), with no overlap between the 2 groups. A cardiothoracic ratio cutoff point of >/=0.5 was 100% sensitive and specific for disease.

Comparison of nuchal and detailed morphology ultrasound examinations in early pregnancy for fetal structural abnormality screening: a randomized controlled trial

To compare the effectiveness of a nuchal scan at 10 to 14 + 6 weeks and a detailed morphology scan at 12 to 14 + 6 weeks in screening for fetal structural abnormalities.

Ultrasonographic prediction of homozygous α0‐thalassemia using placental thickness, fetal cardiothoracic ratio and middle cerebral artery Doppler: alone or in combination?

To compare the predictive values of three ultrasonographic parameters: placental thickness (PT), fetal cardiothoracic ratio (CTR) and middle cerebral artery peak systolic velocity (MCA‐PSV), alone or in combination, in pregnancies affected by homozygous α0‐thalassemia at 12–20 weeks gestation.

A case of “familial atretic encephalocele”

This is the first pregnancy of a 22 years old healthy women from non-consanguineous marriage. A small 6 to 7mm occipital cystic mass was noted on anomaly scan at 17wk (figure 1). Amniocentesis was performed at 20 weeks gestation for conventional cytogenetics revealed normal karyotype 46,XX. Array comparative genomic hybridization (aCGH) showed arr[GRCh37] 5q35.2(173909361_175173029)x1 of maternal inheritance. This article is protected by copyright. All rights reserved.

OC280: Prenatal prediction of homozygous α‐thalassaemia using ultrasonographic placental thickness, fetal cardiothoracic ratio and middle cerebral artery Doppler

Objectives: The aim of this study was to provide a representative description of abnormal placental implantation images in 2D ultrasound and color Doppler, 3D multiplanar technique and magnetic resonance imaging, and to correlate this with intrasurgical images. Placenta accreta occurs 10% of women with placenta previa. The risk of placenta accreta is increased by previous Cesarean section. Methods: We present 15 cases (diagnosed between 2003 and March 2007) with placenta increta and percreta diagnosed prenatally by 2D ultrasound, color Doppler, 3D multiplanar technique (vascular mapping) and MRI. Imaging findings were correlated with intrasurgical findings. Results: Of the 15 cases with a diagnosis of placenta increta and percreta, only one had a posterior implantation; the other 14 cases had an anterior and uterine segment implantation. The diagnosis was prenatal in 14/15 cases and in one case the diagnosis was intrasurgical. The median gestational age at diagnosis was 28 weeks. The median gestational age at delivery was 35 weeks. All cases were confirmed at operation and needed Cesarean–hysterectomy. When we used the ultrasound signs (on 2D ultrasound, color Doppler, 3D multiplanar technique) placenta lacunae, bladder border, myometrial thickness and loss of the clear space, the diagnosis was better evaluated with 3D multiplanar technique. In eight cases the MRI was reported as normal. Conclusions: We conclude that the principal signs of placenta increta and percreta were loss of the clear space and the superficial vessels. These ultrasound markers and mapping of the vascular pattern were better evaluated in the 3D multiplanar technique; this technique allows an adequate and sufficient evaluation of all areas of placental implantation. It also provides better information for the surgical team than MRI. These findings should allow appropriate resources to be made available at delivery in order to minimize the complication rate.

OC21: Comparison of nuchal scan and detailed morphology scan in the first‐trimester screening for fetal structural abnormalities

E. Kirk1, P. Alnaes-Katjavivi2, G. Condous1, B. Van Calster3, S. Van Huffel3, O. Istre2, D. Timmerman4, T. Bourne1 1Early Pregnancy and Gynaecological Scanning Unit, St George’s Hospital, University of London, United Kingdom, 2Ulleval University Hospital, Norway, 3Department of Electrical Engineering (ESAT), Katholieke Universiteit Leuven, Belgium, 4Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium

Integrated first and second trimester screening for Down syndrome

Purposes:u2002 It is uncertain whether first trimester nuchal translucency is more effective than the well established second trimester serum screening for fetal Down syndrome or whether their combination works best. We report our data on a large multicenter non‐interventional trial in which all subjects underwent both first and second trimester screening to assess their relative efficacy.