11â14 October 2015, Montréal, Canada. Electronic poster abstracts hemispheric anteroposterior cerebellar diameter (APCD) in addition to the transverse ...
11–14 October 2015, Montr´eal, Canada
Electronic poster abstracts
hemispheric anteroposterior cerebellar diameter (APCD) in addition to the transverse cerebellar diameter (TCD) and discussed whether or not the cerebellar measurement was useful for the detection of T18. Methods: TCD and APCD of 175 cases of normally grown fetuses were measured by a fetal ultrasound scan. Then, the reference standards of the cerebellar diameter before the 22nd week of gestational age and from the 22nd week of gestational age and afterwards were created (median and 5%–95% tile values). The cases having a less than 5% tile value were diagnosed as cerebellar hypoplasia. The cerebellar diameters of 27 cases of T18 were measured and compared with the reference standard. Results: Less than 22 weeks of gestational age (GA): The reference standard of the TCD was shown as TCD = (1.03 × GA) − 0.82 (R2 = 0.96, P < 0.001). The standard deviation was 0.36 mm. The reference standard of the APCD was shown as APCD = (0.71 × GA) − 4.5 (R2 = 0.73, P < 0.001). The standard deviation was 0.80 mm. In the cases that fell below a 5% tile value of the reference standard among 9 cases of T18 fetuses, the TCD was 8/9 (89%) and the APCD was 9/9 (100%). In and after the 22 weeks of GA: The reference standard of the TCD was shown as TCD = (1.57 × GA) – 11.3 (R2 = 0.93, P < 0.001). The standard deviation was 1.40 mm. The reference standard of the APCD was shown as APCD = (0.87 × GA) − 7.76 (R2 = 0.87, P < 0.001). The standard deviation was 1.29 mm. In the cases that fell below a 5% tile value of the reference standard among 18 cases of T18, the TCD was 14/18 (78%) and the APCD was 18/18 (100%). Conclusions: When the cerebellar hypoplasia was diagnosed with the reference standard, the APCD, in particular, had less than a 5% tile value in all cases of T18, so that the clinical application of the cerebellar diameter reference standard was suggested to be very useful.
A 38 year-old pregnant woman was referred to our Fetal Medicine Unit after US detection of an abdominal vascular anomaly at 24 weeks of gestation. The prenatal US scan showed a female fetus, biometry according to gestational age. Both in axial and longitudinal views of the fetal abdomen, an aberrant vessel could be observed with an straight course from the left portal system to the left iliac vein without braching. Colour-Pulsed Doppler showed a venous flow waveform from the portal area to the systemic vein. A SUA was also noted. No other cardiac or extracardiac anomalies were detected. Fetal karyotype was performed with normal results. Consecutive US scans showed a normal fetal growth and hemodynamic patterns. At 39 weeks of gestation, vaginal delivery resulted in a female neonate weighted 3860 g without intrapartum distress. Neonatal image testing (US and MR) confirmed the prenatal findings. Percutaneous endovascular closure of the portosystemic shunt was tried at 7 months without success. The child has not developed any signs of cardiac insufficiency or portal hypertension. The only findings at 18 months are a temporary liver enzymes elevation and mild hypocoagulation (INR 1.4) secondary to deficit of liver coagulation factors. Prenatal diagnosis of an extrahepatic portosystemic shunt is a rare finding; however, its detection allows parents counselling and the design of a multidisciplinary strategy for the neonate. The prognosis is uncertain from asymptomatic cases to liver failure, tumors and transplant. Endovascular closure of the shunt seems to be the most efficient treatment.
EP09.15 3D ultrasound finding of fetal adrenal hemorrhage
EP09.17 Epignathus: case report and review of literature
S. Kim2 , J. Shin1
R. El-Said, M.A. Abdel-Naby
1
Faculty of Medicine, Obstetrics and Gynecology, Alexandria University, Alexandria, Egypt
Department of Catholic University of Korea, Seoul, Republic of Korea; 2 Department of Obstetrics and Gynecology, Holy Family Hospital of Catholic University, Kyungido, Republic of Korea A 37 year-old woman was referred to our hospital for further assessment of abdominal mass at 36 weeks’ gestation. Her medical history of parity 0-0-0-0 had been unremarkable. A anechoic cystic mass located superior to the right kidney measuring 50 x 48 mm was found by detailed by sonography (Samsung-medicine, Seoul). Three dimensional ultrasound clearly demonstrated that the mass was arising from the adrenal gland site. At 40 weeks’ gestation, she was delivered of a male neonate weighing 3,600 g. Neronate sonogram showed a solid mass with heterogenous echo in the right adrenal and showed progressive resolution of the mass after 1 month.
Supporting information can be found in the online version of this abstract
EP09.16 Prenatal diagnosis of extrahepatic portosystemic shunt 1 ´ ´ C. Bravo2 , F. Gamez , L. Ortiz1 , T. Alvarez3 , J. De Leon Luis1 1 Department of Obstetrics and Gynecology, Hospital General Universitario Gregorio Maran˜ on, ´ Madrid, Spain; 2 Department of Obstetrics and Gynecology, Hospital Central de la Defensa Gomez Ulla, Madrid, Spain; 3 Department of ´ Pediatric Cardiology, Hospital General Universitario Gregorio Maran˜ on, ´ Madrid, Spain
Ultrasound in Obstetrics & Gynecology 2015; 46 (Suppl. 1): 185–228.
Supporting information can be found in the online version of this abstract
Oropharyngeal teratomas (Epignathus) are rare congenital tumors with an estimated incidence of one in 35,000 to one in 200,000 live births. Epignathus is a rare, benign, congenital teratoma of the hard palate. Most of these teratomas are unidirectional and protrude through the mouth. Hence, the prognosis depends on the size of the tumor and the degree of face distortion and airway obstruction that it causes. However, some epignathi protrude bi-directionally, involving and destroying the brain tissue, resulting in a poor prognosis. We present a Case of an oropharyngeal teratoma was referred to our centre for Detailed fetal anomaly scan due to abnormal fetal facial mass; 32 year-old primigravida, with no relevant family history, medical history and negative consanguinity at 22 weeks of gestation by her menstrual date A detailed real-time ultrasound examination (ACCUVIX XQ Prestige @ MEDISON, using abdominal 3D 3-5EK curved 3 MHz-5 MHz probe) revealed a single live fetus with average gestational age was 22 weeks & 4 days & estimated fetal weight by ultrasound was 540 gm. Normal amount of liquor, Detailed anomaly scan using revealed a large mass heterogeneous complex mass (103x107x75mm), partially cystic, partially solid, protruded from the oral cavity. Colour Doppler ultrasound detects the main blood supply with its wave form. 3D ultrasound (Surface rendering, Multiplanar, 3D XI mode) revealed that mass originating from the hard palate and the oropharynx, filling the oral cavity and protruded in front of the fetal face through a distended jaw into the amniotic fluid, with no intracranial extension could be detected, no other congenital anomalies could be detected, all these features were consistent with oropharyngeal teratoma (Epignathus). Parents decided termination of pregnancy and confirmation of diagnosis was done postnatal.
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