P309: Fetal echocardiography results in twins at the referral center

Abstract

Objective: Retrospective analysis of the spectrum of fetal aortic valve stenosis with completed neonatal follow-up. Methods: Fetal echocardiograms of 12 fetuses with aortic stenosis (AS) were analyzed. Mean gestational age at the time of diagnosis was 29.6 weeks. Results: In all 12 cases critical AS has been detected. The left ventricle was estimated as a small in three cases, in 7 cases as enlarged and hypokinetic LV (SF < 28%) and in the next two cases the LV was well formed. In 6 AS cases endocardial fibroelastosis has been detected. Six fetuses presented mitral valve insufficiency, in three cases with small LV mitral valve stenosis was diagnosed. Cardiomegaly occured in 7 cases, including 5 cases with HA/CA > 0.5. Hypoplastic aorta has been detected in 2 cases and in one coartaction of the aorta. Retrograde flow in aortic arch and poor left ventricular function was diagnozed in ten cases. In 2 fetuses extracardiac malformations were present: hydrocephalus and pylorostenosis. In 83% of the cases CS had been performed and 17% were delivered vaginally (2 demises in utero). Four neonates had been qualified to percutaneous balloon valvuloplasty, in three cardiac surgery had been performed. Three neonates with AS (25%) survived -two after valvuloplasty (one of them required also cardiac surgery) and one after Norwood procedure. Conclusions: 1. Poor prognostic factors for neonates with critical fetal SA were as follow: small LV, retrograde flow in aortic arch, hypoplastic asceding aorta, coartaction of the aorta and poor left ventricular function and presence of extracardiac anomalies. 2. Neonates who survived fetal SA had large left ventricle (also with endocardial fibroelastosis) or almost normal growth of LV. P309Fetal echocardiography results in twins at the referral center M. Respondek-Liberska, M. Grzesiak and K. Janiak Research Institute Polish Mother's Memorial Hosp., PolandAim: The aim of the study was a retrospective analysis of fetal echo in twins. Material: 81 pregnancies with 162 fetuses and completed followup. Mean age of pregnant women was 29.1 years, mean fetal age at the time of targeted fetal echocardiography was 25 wks, mean neonatal birth weight was 1754, Apgar 6. There were 43 deaths (43/162 = 26.5%), including 17 in utero and in 26 after delivery. Results: In 162 twin fetuses, the abnormal fetal echocardiography findings were present in 51 fetuses (31.5%). There were: 22 fetuses with TTTS (43.1%), 6 conjoined twins (11.8%), 4 pregnancies with acardiac twin (8 ''twins'') (15.6%), 6 fetuses with CHD (11.8%) and 9 fetuses (17.7%) with arrhythmias. In 22 fetuses with TTTS the most common anomaly was fetal cardiomegaly (11/22) and tricuspid valve regurgitation -TR (11/22). All conjoined twins had common hearts with different anatomy. The most common anomaly in ''normal'' twin with acardiac cotwin was cardiomegaly and TR. There were 6 fetuses (6/51-17.7%) with CHD: 3 × VSD, 1 × HLHS, 1 × AV Canal and 1 × Truncus arteriosus. There were 9 fetuses (9/51-17.7%) with arrhythmias, including 8 fetuses with...