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O/e-TotFLV using 3D-US appears to be the most accurate predictor of perinatal mortality because it can predict both PH and PAH.

Although o/e-ContFLVR can be precisely measured with 3DUS and can be used to predict neonatal death in CDH, it is less accurate than LHR and o/e-TotFLVR for that purpose.

Objective: To evaluate the precision of three-dimensional ultrasonography (3DUS) in estimating the ipsilateral lung volume and the potential of this measurement to predict neonatal death in congenital diaphragmatic hernia (CDH). Methods: Between January 2002 and December 2004, the ipsilateral lung volumes were assessed by 3DUS using the technique of rotation of the multiplan imaging in 39 fetuses with CDH. The observed/expected ipsilateral lung volume ratios (o/e-IpsiFLVR) were compared to the lung/head ratios (LHR) and to the observed/expected total fetal lung volume ratios (o/e-TotFLVR) as well as to postnatal death. Results: Ipsilateral lung volumes (median 0.12, range 0.01–0.66) were more reduced than the total lung volumes (median 0.52, range 0.11–0.95, p < 0.001) in CDH. The bias and precision of 3DUS in estimating ipsilateral lung volumes were –0.61 and 0.99 cm³, respectively, with absolute limits of agreement from –2.56 to +1.33 cm³. The o/e-IpsiFLVR was lower in neonatal death cases (median 0.09, range 0.01–0.46) than in survivals (median 0.18, range 0.01–0.66), but this difference was not statistically significance (p > 0.05). The sensitivity, specificity, (positive and negative) predictive values and accuracy of o/e-IpsiFLVR in predicting neonatal death was 52.6% (10/19), 83.3% (10/12), 83.3% (10/12), 52.6% (10/19) and 64.5% (20/31), respectively. Conclusion: Although the ipsilateral lung volume can be measured by 3DUS, it cannot be used to predict neonatal death when considering it alone. However, it is important to measure it to calculate the total fetal lung volumes as the o/e-TotFLVR has the best efficacy in predicting neonatal death in isolated CDH.

Three-dimensional ultrasonographic technologies may improve the pre-natal diagnosis of main stem BA.

Oral poster abstractsBackground: CCAM is an uncommon pathology that involves proliferation of terminal respiratory bronchioles. The diagnosis is often made in the prenatal period using ultrasound. The antenatal diagnosis has become more frequent with increasing sonographer training and higher resolution ultrasound imaging platforms. Methods: This was a retrospective analysis of all fetuses of CCAM diagnosed antenatally that were born in our department during last three years. The ultrasound diagnosis was confirmed by prenatal MRI scan in all cases. Results: In a 3-years period, 14 cases of fetal CCAM were reffered for further management. All the lesions were noted to be unilateral CCAMs. The gestational age at diagnosis was 16-22 weeks. Two cases were diagnosed as CCAM type I (14%), 5 CCAM type II (36%) and 7 CCAM type III (50%). In two cases diagnostic type of CCAM was different from US and MRI investigations. The lesions were usually complicated by varying degrees of mediastinal sfift (78%). Severe hydrops fetalis was present in two cases only (14%). All the fetuses had normal karyotype. Termination of pregnancy was performed in three cases. Spontaneous regression of the sonographic appearances during pregnancy was observed in 46% (5/11) cases. All cases had good perinatal outcome (91% after postnatally surgery). Conclusions:The postnatal outcome of fetal CCAM is better than previously assumed, probably because of the detection ob subtle lesions and the high rate of prenatal spontaneous resolution of such tumors.

Results: All of the ten fetuses who underwent postnatal renal function tests had grade 3 or 4 hydronephrosis in postnatal ultrasonography. Six of them needed surgical correction. Relative kidney volume does not correlate well with relative kidney function (Pearson correlation coefficient r 0.195). Conclusion:This preliminary study demonstrated that relative kidney parenchymal volume measured by antenatal 3D ultrasonography provide no relation with postnatal kidney relative function. OP31.07Specificity of hypocoiled umbilical cord in prediction of fetal trisomy 21 in the second trimester N. Phithakwatchara, V. Titapant, K. Nawapun, S. Anuwutnavin, N. Srisantiroj, C. Phatihattakorn Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandObjective: To assess sonographic morphology of umbilical cord coiling in chromosomally normal fetuses and estimate the specificity of hypocoiled appearance as a marker for fetal trisomy 21 in the second trimester. Methods: 536 singleton pregnancies undergoing amniocentesis for fetal karyotype were scanned at 17-22 weeks' gestation. The umbilical cord was evaluated in a longitudinal section using 2D with color Doppler sonography. The cross-sectional data of umbilical coiling index (UCI), defined as the reciprocal of the distance between umbilical coils, were analyzed to establish the normal range according to gestational age. UCI less than the 5 th percentile was the cut-off value for hypocolied umbilical cord. The specificity of hypocolied umbilical cord to predict fetal trisomy 21 was calculated. Results: As a result of amniocentesis, there were 527 chromosomally normal fetuses and 9 trisomy 21 fetuses. There was no significant difference in maternal characteristics between these two groups. In trisomy 21 fetuses, there was a higher proportion of fetal anomaly indicating for fetal karyotype (22.2% VS 0.6%, p = 0.003). The regression equation of UCI (cm-1, y) on gestational age (weeks, x) was y = 1.205-0.033x. The hypocoiled umbilical cord was characterized in 2/9 (22.2%) fetuses with trisomy 21 and in 22/527 (4.2%) chromosomally normal fetuses (p = 0.01), with specificity of 95.83%. Conclusions: Coiling pattern of umbilical cord visualized by sonography has a potential value in second-trimester screening for fetal trisomy 21. Nevertheless, further studies of this model in a larger cohort would provide more information in sensitivity and predictive values.