Objectives: To analyse the cases of fetuses with persistent left superior vena cava (PLSVC) at our centre, evaluating prenatal, perinatal and postnatal data. Methods: This is retrospective observational study carried at a tertiary hospital which included all cases of with PLSVC diagnosed or referred to our Prenatal Diagnosis Unit from 2015 to 2021. Results: A total of 46 fetuses diagnosed with PLSVC were found. However, due to loss of follow-up, we performed the analysis at 37 patients. The diagnosis of PLSVC was established in 11% of patients at < 18 weeks, 81% at 18-23 weeks and in 8% at > 23 weeks. Isolated persistent left superior vena cava was in 32% and in 68% of the patients presented PLSVC together with other ultrasound findings, being the most frequent pathologies coarctation of the aorta, pathologies of cardiac axis and heterotaxy syndrome or central nervous system abnormalities. In the 13% we found the absence of the right superior vena cava. Invasive testing was performed on 12 patients, all of which 50% were abnormal. We did not do invasive test in isolated PLSVC.19% of the patients decided to carry out termination of pregnancy. 1 antepartum fetal death occurred at week 25 in a patient with important ultrasound malformations who decided to continue with the pregnancy. All the newborn (NB) had an Apgar score > 7 at 5 minutes.80% of the children were asymptomatic and was being monitoring by a cardiologist. There were 2 late neonatal deaths, one due to complications after cardiac surgery in a newborn with complex heart disease and another in a case of Vacterl association in a patient whose pregnancy was not controlled. 4 NBs received surgery, 3 of cardiac pathology with adequate evolution who had a prenatal diagnosis of heart disease and 1 of anal atresia not diagnosed prenatally. Conclusions: PLSVC is the most common form of anomalous venous drainage. Is usually an isolated finding but its incidence in congenital heart disease is 10 times higher than in the general population. The diagnosis must be followed by a rigorous review of the cardiac anatomy.VP21.12 Clinical course and perinatal outcomes of prenatally diagnosed complete atrioventricular block
Objectives:The main objective of this study is to analyse the cases of isolated fetal ventriculomegaly (VM) detected prenatally, the neurodevelopment of the newborn and also estimate the prevalence in our centre. Methods: A retrospective descriptive observational study of a cohort of fetuses with prenatal diagnosis of VM. The study period was from January 2010 to August 2020. The inclusion criteria were: more than 18 weeks of gestation, without other malformations in the moment of diagnosis or during the follow up, with neurosonographic study and delivery at our centre. Results: We obtained 194 fetuses affected of VM for the study, 49,5% corresponded to isolated VM. The mean maternal age was 35,6 ±6,4 years old. The mean gestational age at diagnosis was 23,8±4 weeks of gestation. 90,6% were mild ventriculomegaly, 5,2% severe ventriculomegaly. 81,3% were unilateral. During the follow up in 85,7% of the cases the VM remains stable and in 5,7% increases the size. 71,9% of the cases were male. The prevalence of this entity in our centre is 3,73/1000 newborns. In 95,5 % of the cases we don't performed MRI study prenatally. In the follow up after birth 8,3 % presented neurological disease in 13% of the cases the follow up was done by neurologist and in 9,1% of the cases the child need to do rehabilitation. The pathologies detected postnatally were: situs inversus and mocociliar dyskinesia, congenital torticolis, macrocephaly, myoclonic distonia, postnatal genetic exome with loss of genetic material in the region 1p22p22.1 interstitial duplication of chromosome 1. There were no cases of perinatal mortality. Conclusions: The prevalence of isolated fetal VM is most higher in our centre as published in the literature (3,7 vs 0.3-1/ 1000 live birth). The percentage of cases with neurological conditions in our centre are similar as reported in the literature. The isolated VM is in the majority of cases a benign condition but is important to do a fetal advanced neurosonography and genetic test to rule out associated abnormalities and stablish the prognosis and management.VP27.
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