P20.08: Hypoplastic left heart syndrome with prenatally diagnosed foramen ovale restriction: diagnosis, management and outcome

Abstract

The aim of this study is to describe the prenatal diagnosis and perinatal outcomes in fetuses with agenesis of the ductus venosus (ADV) and to perform a systematic review of literature. Methods: Retrospective descriptive study of all cases with prenatal diagnosis of ADV, occurring between 2011 and 2018 in three tertiary centres. We reviewed patient data of all ADV cases. We also conducted literature search of ADV in MEDLINE, PUBMED, and SCIELO, data bases. Series with 10 or more cases were included. Results: Ten articles were reviewed and our cases were included in the analysis. A total of 283 cases of ADV were included, 36 ours and 247 previously published. In our series mean maternal age was 34 years (16-43 y) and mean gestational age at diagnosis was 17 weeks (11-37 w). ADV was diagnosed at 11-14 screening in 17 patients (47%), 11 with increased nuchal translucency. 19 (53%) were diagnosed at the second-trimester ultrasound, 17 had a major abnormality associated. Shunt was intrahepatic in 22 patients, extrahepatic in 14. In the extra hepatic group, 11 communicated directly to inferior vena cava, 2 to right atrium, and 1 to the iliac vein. Chromosome analysis was performed in 19 of 36 cases; 12 of the fetuses were aneuploid (9 Turner syndrome and 3 Down's syndrome). As for perinatal results, of 36 patients 9 died; 30 had some anomaly (aneuploidy or major abnormality associated), and 6 were healthy. Conclusions: ADV is a rare condition and is associated with aneuploidies, especially Turner Syndrome. It is highly associated with major abnormalities; especially cardiac malformations and it is associated with poor perinatal outcomes (especially extrahepatic). Systematic review, including our series, shows similar perinatal outcomes. P20.07Review of ultrasound markers in diagnosis of total and partial anomalous venous connection in mid and late gestation