22nd World Congress on Ultrasound in Obstetrics and GynecologyPoster abstracts and extracardiac sonographic survey was performed. During the study period the recommendation of fetal invasive testing relied on well-accepted indications and not solely on the presence of ARSA. Results: ARSA was detected in 64/15.352 fetuses examined (0.4%). The mean gestational age at diagnosis was 21.9 ± 2.9 weeks. 8/64 fetuses had an abnormal karyotype (7 T21, 1 22q11 microdeletion) and one had sonographic suspicion of trisomy 18 but the parents refused fetal karyotype analysis. In the same period, 72 fetuses were diagnosed of T21 and without ARSA. The prevalence of ARSA in fetuses with T21 was higher than in those without this aneuploidy (7/79=9% vs. 57/15273=0.4%). ARSA was an isolated finding in 43/57 (75.4%) fetuses without T21, and in 2/7 patients with T21 (28.6%). In one of these 2 cases the diagnosis of T21 was made postnatally while the other was diagnosed by amniocentesis indicated because advanced maternal age (40 years). In these two cases the results of the first trimester combined screening for aneuploidies was not available. The likelihood ratio for T21 when isolated ARSA is detected was 9 (95% CI: 1.8-41.9). Conclusions: The prevalence of ARSA is higher in T21 fetuses than in fetuses without this aneuploidy. ARSA may be an isolated finding in T21 fetuses; therefore, fetal karyotyping should be recommended whenever ARSA is diagnosed, especially if the results of first trimester combined screening are not available. P25.03Effect of IVF/ICSI on second trimester screening markers
Objectives: To measure quantitative UV and DV blood flow between and during uterine contractions and to assess if subsequent hemodynamic changes could be related to an adaptive mechanism to hypoxia in labour. Methods: Pregnant women in the first stage of labour were prospectively included in the study. Inclusion criteria were: term singleton uncomplicated pregnancy with normally grown cephalic fetus in active spontaneous labour, without intrapartum analgesia.For each fetus, ultrasound and Doppler examinations during and between uterine contractions were performed (Hitachi Aloka Prosound Alpha 10), to obtain Diameters (D UV , D DV ) and Time Averaged Maximum Velocity (TAMV UV , TAMV DV ). Blood flow rates (Q UV , Q DV ) and the percent of umbilical blood flow through the DV were thereafter calculated in each condition using the formulas: Q = [πD 2 x h x TAMV] ml/min and Q DV / Q UV %. Student's T-test was used to evaluate the differences between measurements during and between uterine contractions. Results: 11 Patients were examined. UV measurements were obtained in 9/11 fetuses. During contractions D UV didn't change (7,7 ± 1 mm vs 7,1 ± 0,8 mm P = NS), TAMV UV significantly decreased (18,2 ± 2,1 cm/s vs 15 ± 2,4 cm/s , P < 0,001), consequently Q UV decreased by 26% (mean value) (78,5 ± 17,2 ml/kg/min vs 54,5 ± 16,4 ml/kg/min, P < 0,01).DV measurements were obtained in 11/11 fetuses. During contractions D DV significantly increased (1 ± 0,3 mm vs 1,8 ± 0,6 mm P < 0,001), TAMV DV was constant or non-significantly decreased (60,8 ± 15,6 cm/s vs 52,1 ± 11,5 cm/s, P = NS) and Q DV increased by 194% (mean value) (13,5 ± 7,1 ml/kg/min vs 37,3 ± 16,2 ml/kg/min, P < 0,001). As a consequence the percent of umbilical blood flow through the DV significantly increased during contractions (18 ± 11% vs 67 ± 38%, P < 0.01). Coefficient of variability for DV measurements was 10% during and 22% between uterine contractions. Conclusions: During uterine contractions, in normal labour, Q UV decreases and Q DV increases due to DV dilatation, to maintain constant the well oxygenated blood flow to the noble organs. Objectives: The aim of this study was to explore the role of ultrasound in predicting neonatal outcome in prolonged singleton gestations. Methods: Prospective observational study of consecutive uncomplicated singleton pregnancies. Adverse neonatal outcome was defined as the presence of operative delivery or Caesarean section; post partum fever; post partum infection; abnormal CTG during labour; low birthweight; neonatal acidemia; neonatal ipoglicemia; need for mechanical ventilation, neonatal hyperbilirubinemia, need of phototherapy, neonatal infection; hypothermia (<36 OP08.11 Ultrasound predictors of neonatal morbidity in prolonged pregnancies• C); admission to NICU; hospital readmission within one month of life and respiratory morbidity, including: RDS, transient tachypnea of newborn, need of continous positive airways pressure (CPAP) for at least 24 h, mechanical ventilation need and duration of supplemention oxygen. Re...
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