P27.09: Diagnostic accuracy of basic fetal heart examination at 11–13 weeks' gestation of pregnancy

Abstract

Conclusions:The attempt of an early sonographic imaging of the fetal cardiac anatomy is very important for a timely prenatal diagnosis of major congenital heart diseases. The examination conditions are often difficult and require well-experienced examiners. It is feasible to perform basic fetal heart examination during routine first trimester screening. P27.08First trimester cardiac screening for major CV anomalies performance using transabdominal simplified fetal echocardiography protocol M. Calomfirescu MMF, Cabinet Dr Calomfirescu Marius Vicea, Bucuresti, RomaniaObjectives: To assess the performance of first trimester screening for cardiac anomalies using transabdominal examination with power Doppler of atrioventricular flow and aorto-pulmonary flow without extending the time of exam. Methods: The study was conducted in a retrospective manner in single centre, single operator, GE Voluson E8 ultrasound machine, period 01.01.2015 -31.12.2016, 665 patients (615 single, 50 multiple) examined with first trimester screening for chromosomal and fetal structural abnormalities and were without chromosomal anomaly. Results: Good visibility with confident assigning of normal or suspect imaging was obtained in 530 patients (25 multiple). Normal images were obtained in 525. Three were confirmed on later echocardiography and 1 with Fallot pathology was missed.Aspects associated with poor visibility were adiposity, uterine pathology, previous pelvic surgery (including Caesarean), multiple pregnancy and advancing age. 3 major CV anomalies were in this group.For twin pregnancies extension of examination time was necessary in order to acquire interpreting images. In triplets (3) we were unable to have interpreting images for all fetuses using just the transabdominal exam. Conclusions: First trimester cardiac screening for major CV anomalies is feasible.In this rather short series major CV anomalies were more frequent in unsatisfactory images using transabdominal examination. This observation would argue in favour of transvaginal examination in the cases with suboptimal images on transabdominal exam. P27.09Diagnostic accuracy of basic fetal heart examination at 11-13 weeks' gestation of pregnancy Objectives: Investigate the diagnostic performance of a simplified fetal heart examination in a routine setting of first trimester ultrasound screening for aneuploidies. Methods: This was a prospective observational study, in which a basic cardiac examination applying the cross-sections of the 4-chamber and/or 3-vessels views using colour Doppler was performed at the 11 to 13 weeks ' gestation scan in a routine setting in single pregnancies.Results: A total of 1850 single fetuses performed first and second trimester ultrasound scans between January 1st 2016 and January 13th 2017. Overall, 1799 cases with second trimester scan, echocardiography or autopsy findings were included. In 1177 cases (65.4%) basic heart examination was not performed during first trimester because of difficult fetal position, maternal obesity with inadequate v...