To define the feasibility of assessing the right subcalavian artery (RSA) in 1 st and 2 nd trimester ultrasonographic assessment of routine population and the association of ARSA with chromosomal, cardiac and extracardiac anomalies. Methods: RSA was prospectively evaluated since July 2009 in all routine patients booked in our fetal medicine Unit. We included 11-14 weeks assessment, pre-invasive US evaluation in patients that declined 1 st trimester screening at booking and opted directly for fetal karyotyping due to maternal age ≥ 35 y and routine anomaly scan. All patients referred for increased NT, amniocentesis, cardiac or extracardiac abnormalities were excluded. Results: We have assessed 4068 routine patients, 3036 in the 1 st and 3152 in the 2 nd trimester; 2281 patients were assessed in both 1 st and 2 nd trimesters. RSA assessment was feasible in 2529 1 st trimester exams (83%). Feasibility in the first trimester was related to the CRL/BMI ratio. In the 2 nd trimester the feasibility was higher reaching 98%. The overall feasibility in our series was 91.1% (3709 feasible cases, considering both 1 st and 2 nd trimester evaluation). An ARSA was found in 49 fetuses (overall incidence 1.32% of the feasible cases) where 28 were detected in the 1 st and 19 in the 2 nd trimester. Nine of the 2 nd trimester ARSA have been misdiagnosed in the 1 st trimester assessment. Fetal echocardiography always confirmed the initial diagnosis, when an ARSA was detected in the screening scan (no false positive cases). Of the 49 ARSA, 39 were euploid with no other findings; the remaining 10 cases included 5 aneuploidies, 1 genetic syndrome, 1 22q11 microdeletion, 1 cardiac and 2 extracardiac abnormalities. Conclusions: The feasibility of RSA assessment in a routine population depends on gestational age and maternal BMI, with more than 80% feasible cases in the first trimester. A high rate of ARSA are associated with genetic or structural, abnormalities.
Objectives:To define the feasibility of assessing the right subcalavian artery (RSA) in 1 st and 2 nd trimester ultrasonographic assessment of routine population and the association of ARSA with chromosomal, cardiac and extracardiac anomalies. Methods: RSA was prospectively evaluated since July 2009 in all routine patients booked in our fetal medicine Unit. We included 11-14 weeks assessment, pre-invasive US evaluation in patients that declined 1 st trimester screening at booking and opted directly for fetal karyotyping due to maternal age ≥ 35 y and routine anomaly scan. All patients referred for increased NT, amniocentesis, cardiac or extracardiac abnormalities were excluded. Results: We have assessed 4068 routine patients, 3036 in the 1 st and 3152 in the 2 nd trimester; 2281 patients were assessed in both 1 st and 2 nd trimesters. RSA assessment was feasible in 2529 1 st trimester exams (83%). Feasibility in the first trimester was related to the CRL/BMI ratio. In the 2 nd trimester the feasibility was higher reaching 98%. The overall feasibility in our series was 91.1% (3709 feasible cases, considering both 1 st and 2 nd trimester evaluation). An ARSA was found in 49 fetuses (overall incidence 1.32% of the feasible cases) where 28 were detected in the 1 st and 19 in the 2 nd trimester. Nine of the 2 nd trimester ARSA have been misdiagnosed in the 1 st trimester assessment. Fetal echocardiography always confirmed the initial diagnosis, when an ARSA was detected in the screening scan (no false positive cases). Of the 49 ARSA, 39 were euploid with no other findings; the remaining 10 cases included 5 aneuploidies, 1 genetic syndrome, 1 22q11 microdeletion, 1 cardiac and 2 extracardiac abnormalities. Conclusions:The feasibility of RSA assessment in a routine population depends on gestational age and maternal BMI, with more than 80% feasible cases in the first trimester. A high rate of ARSA are associated with genetic or structural, abnormalities. OP07.02Abstract withdrawn. OP07.03Fetal left brachiocephalic vein: visualization, biometry and blood flow pattern between 11 and 40 weeks of gestation E. Sinkovskaya, S. Horton, K. Talley, A. Sclater, A. Abuhamad Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USAObjectives: The aim of the study was to establish normal values of fetal left brachiocephalic vein (LBCV) dimensions and blood flow patterns during the pregnancy. Methods: After receiving written informed consent 87 patients with normal singleton pregnancies at gestational ages between 11+0 and 39+6 weeks were enrolled into the study. Transabdominal ultrasound was performed in all cases. In addition, transvaginal ultrasound was used in the first trimester. Visualization rate of the transverse view of the upper fetal chest at the level of drainage of LBCV into superior vena cava by 2D and 2D+color Doppler was evaluated. Reference ranges of LBCV diameter and characteristics of blood flow including velocities during ventricular systole, diastole and atrial contraction as well...
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