25â28 September 2016, Rome, Italy. Electronic poster abstracts ... There were 2 neonatal and 4 childhood deaths, 3 infants survived. Conclusions: LI could be ...
25–28 September 2016, Rome, Italy
Electronic poster abstracts
EP07.12 Review of prenatally diagnosed major fetal cardiac anomalies – 5 years’ experience in a perinatology clinic S. Kurtulmus, E. Ekmekci, U. Turhan, E. Demirel, S. Kelekci Department of Perinatology, Izmir Katip Celebi University School of Medicine, Izmir, Turkey Objectives: Congenital cardiac anomalies represents by far the most common congenital malformation. Our aim was to review major fetal cardiac anomalies those are diagnosed during past 5 years in our clinic and to evaluate the association of genetic and structural anomalies with them. Methods: Among 3676 pregnant women referred to our perinatology clinic, 74 patient (2,01%) who diagnosed major fetal cardiac anomaly were reviewed. Results: The incidence of major fetal cardiac anomalies observed in our clinic was 2,01%. The median gestational age at the time of diagnosis was 18 (12–36) weeks and the mean maternal age was 29,63±5,24 years. Of the 74 patient, the distribution of major cardiac anomalies observed were as; atrioventricularseptal defects (n=31, 41,9%), conotruncal malformations (n=16, 21,6%), hypoplastic left heart (n=10, 13,5%), aort stenosis (n=4, 5,8%) and the others (n=5, 6,5%). 26 patient (35,1%) refused fetal caryotyping, 24 patient (32,4%) had normal caryotype and 24 patient (32,5%) had abnormal fetal caryotype (see table). No 22q11del was detetected among conotruncal cardiac anomalies. Cardiac anomaly was an isolated finding in 35 patient (47,3%), 39 patient (52,7%) had additional structural anomalies. Most common structural anomalies accompanied to cardiac anomalies were central nervous system anomalies (n=17, 22,9%), cystic hygroma (n=10, 13,5%) and skeletal anomalies (n=4, 5,4%) respectively. Conclusions: Prenatal diagnosis of the fetal cardiac anomalies is very important for the patients and clinicians. Patients should be offered fetal caryotyping and detailed fetal anatomic sonogram for counselling about the pre and postnatal management of cases. EP07.12: Table 1.
Fetal caryotype Refused fetal karyotyping Normal karyotype Trisomy 21 Trisoy 18 Turner syndrome Trisomy 13 Triploidy
Number of cases
Percent (%) of cases
26 24 11 6 4 2 1
35, 1 32, 4 14, 8 8, 1 5, 4 2, 7 1, 3
EP08: THE FETAL HEART AND OBSTETRIC COMPLICATIONS EP08.01 Prenatal manifestations of left atrial isomerism M. Medvedev Ultrasound and Prenatal Diagnosis Units, Federal Government Educational Institution of Additional Professional Education, Moscow, Russian Federation Objectives: To assess the prenatal spectrum of associated with left atrial isomerism (LI) cardiovascular and extracardiac malformations and postnatal outcomes.
Methods: 24 cases with fetal LI diagnosed prenatally were identified. Anatomic survey and fetal echocardiography were performed in a standardised fashion, also the shape of the atrial appendages was evaluated. Results: In all cases the prenatal diagnosis of LI was confirmed postpartum. Congenital heart disease (CHD) was demonstrated in 21 (87%) fetuses. Morphologically left atrial appendages (finger-like form) were identified in 24 (100%) cases, including one case at 13 weeks of gestation. Atrial septal defect (including atrioventricular septal defect) was seen in 19 (79%) fetuses; ventricular septal defect in 19 (79%); atrioventricular septal defect in 10 (41%); interruption of vena cava inferior (IVC) with azygos continuation in 18 (75%); left persistent vena cava superior (LPSVC) in 11 (45%). Visceral malformations frequently associated with LI were the central position of the liver in 17 (70%); abnormal position of the stomach in 15 (62%). Polysplenia was suspected in 3 fetuses. No suggestions about bilobed lungs with hyparterial bronchi were made. 13 pregnancies were terminated and 2 fetuses died in utero. There were 2 neonatal and 4 childhood deaths, 3 infants survived. Conclusions: LI could be diagnosed prenatally with high accuracy. The shape of atrial appendages is the most informative criterion for the determination of LI. Most fetuses with LI have CHD (87%), especially isolated atrial septal defect or as a part of atrioventricular septal defect (79%); venous system anomalies either interruption of IVC or LPSVC (100%). LI has a high overall mortality.
EP08.02 Ventricular systolic-to-diastolic time index in pregnancies with well-controlled type I and type II diabetes mellitus L.C. Bussamra3,4 , G. Tedesco5 , L. Nardozza1 , A.F. Moron3 , E. Araujo3 , A.B. Peixoto3 , L. Rocha Amorim3 , W.P. Martins2 , N.J. Bravo-Valenzuela3 , R. Mattar3 1 Sao ˜
˜ Paulo, Brazil; Paulo Federal University, Sao of Obstetrics and Gynecology, Medical School ˜ Paulo, Sao ˜ Paulo, Brazil; of Ribeirao Preto, University of Sao 3 Department of Obstetrics, Federal University of Sao ˜ Paulo ˜ Paulo, Brazil; 4 Fetal Medicine Unit, (EPM-UNIFESP), Sao ˜ Paulo, Brazil; Albert Einstein Jewish Hospital, Sao 5 Department of Obstetrics, Medical College Science of Santa ˜ Paulo (FCMSCSP), Sao ˜ Paulo, Brazil Casa of Sao 2 Department
Objectives: To assess the fetal cardiac function by right and left ventricular systolic-to-diastolic time index (SDI) in pregnant with well-controlled type I and type II diabetes mellitus pregnant women. Methods: We performed a prospective cohort study with 135 singleton pregnant women between 20w0d and 37w6d of gestation, which were divided in two groups: 89 normal pregnant women and 46 well-controlled type I and type II diabetic pregnant women. SDI was calculated as the following formula: (isovolumetric contraction time + ejection time + isovolumetric relaxation time)/filling time. Results were analysed by using unpaired t test and general linear model, adjusting by gestational age (GA), body mass index (BMI), and fetal heart rate (FHR). Results: There were no differences between GA, number of pregnancies, parity, weight, BMI, estimated fetal weight (EFW), maternal blood pressure (BP) and FHR between groups. Maternal age (years) was higher in DM group than controls (31.5 vs. 29.2, P = 0.04), while maternal height (m) in diabetes mellitus was lower than control (1.59 vs. 1.61, P = 0.02). Right SDI values of fetuses from diabetes mellitus pregnant women were not significantly different than controls (1.68 vs. 1.72, P = 0.5) even after adjust by GA, BMI and FHR (P = 0.5). Left SDI values of fetuses from DM mothers were lower than controls after adjust by GA, BMI and FHR (1.40 vs. 1.47, P
