Neonatal infective endocarditis is a rare condition and usually pertains to a specific class of immunologically depressed preterm infants, with a long history of invasive procedures in the Neonatal Intensive Care Unit. We report the case of an aggressive and fatal neonatal infective endocarditis in a full-term infant, who developed massive endocardial vegetations on the tricuspid valve, leading to persistent pulmonary hypertension of the newborn, unresponsive to nitric oxide ventilation. Post-mortem cardiac cultures were positive with Serratia marcescens, an unusual germ for an early-onset infection, which was absent in blood cultures.

Objectives:To describe the antenatal ultrasound findings and outcome of fetuses with congenital cystic adenomatoid malformation of the lung (CCAM). Methods: We used the classification of Adzick for describe the CCAM. The gravity of the pathology has been established according to the type, localization and size of the lesion, the CCAM volume ratio (CVR), and the presence of fetal complications (hydrops, mediastinal shift, polyhydramnios). For differential diagnosis between CCAM and pulmonary sequestretion was performed color Doppler. Cases with CVR > 1.6 and associated with fetal complications or associated with fetal malformations at the time of diagnosis were interpreted as cases with severe evolution. In these situations we discussed with patients about elective termination. In cases with favorable evolution we practiced serial scans. We have not practiced in-utero percutaneous pulmonary drainage in fetuses. Starting with 2012 we practiced prenatal maternal treatment with betamethasone in cases with microcystic CCAM. Newborns have conducted chest X-ray scan and surgical clinical examination. In cases with elective termination was practiced necropsy. Results: Between 03.01.2005-31.03.2013 we diagnosed 9 cases with CCAM at median gestational age of 23 (range, 18-30) weeks. Severe CCAM was identified in 6 cases, in which the elective termination of pregnancy was practiced. Necropsy was practiced in five cases and confirmed prenatal diagnosis. In three of the 9 cases the lesions was decrease, of which a case has been with maternal prenatal treatment with betamethasone. To all those 3 newborn prenatal diagnosis has been confirmed by chest X-ray scan. None of them required postnatally surgical treatment. Conclusions: In severe macrocystic CCAM without surgical treatment (in-utero percutaneous pulmonary drainage) the fetal prognosis remains reserved. In microcystic CCAM maternal prenatal treatment with betamethasone may improve the fetal and neonatal prognosis.Matthew-Wood syndrome (MWS) is known as the combination of pulmonary agenesis/hypoplasia, microphthalmia/anophthalmia, congenital cardiac, digestive, renal-urinary malformations and a diaphragmatic defects due to mutations within the STRA6 gene. MWS is most often lethal because of respiratory failure in presence of pulmonary defects.

Umbilical cord entanglement occurs during early pregnancy. Typically, fetal asphyxia and demise because of umbilical cord entanglement is a unique characteristic of mono-amniotic twin pregnancies. We describe a case of a woman in late pregnancy that presented to medical consult at 36 weeks of amenorrhea because of the absence of fetal movements. The ultrasound found no fetal heartbeat and because the patient had two previous cesarean sections, another one was performed. We discovered a complex entanglement of the umbilical cord around the leg of the fetus that proved to be the cause of the fetal demise. Cord entanglement must be considered in cases of unexplained intrauterine fetal death. For all cases of intrauterine demise, it is important to look for marks of this condition around different parts of the body.

Objective: Maternal anxiety negatively affects the fetus. Women awaiting fetal echocardiography (FEcho) report increased anxiety but it is not known if anxiety decreases post-FEcho. Methods: Women answered two questionnaires at the time of FEcho at MSCHONY. The Spielberger State-Trait Anxiety Inventory assessed how subjects feel ''now'' (state) vs how they ''usually feel'' (trait). Separate state and trait anxiety scores ranging from 20 to 80 were calculated; a score ≥ 35 is moderately anxious. A second form recorded pregnancy specific information. Anxiety scores of the preand post-FEcho groups were compared. Results: From 1/07-1/09, 40 pre-FEcho and 44 post-FEcho subjects were enrolled: 58 (69%) were ≥ 35 yrs old, 25 (30%) were primigravid, and 24 (29%) reported a prior miscarriage. There was no group difference in maternal age or parity but prior miscarriage was more common in the pre-FEcho group (42.5% vs 16%, p = 0.007). Among the self-reported indications for FEcho referral, 49 (58%) had an anomaly on a prior test. Neither state nor trait anxiety scores were associated with maternal age, parity, history of miscarriage or known fetal anomaly. The mean state anxiety score of the pre-FEcho group (42.1 ± 15.1) differed from that of the post-FEcho group (35.9 ± 13.0; p = 0.048); there was no difference in trait scores (34.7 ± 10.8 pre vs 35.8 ± 10.6 post; p = 0.63). In the post-FEcho group, FEcho result influenced both state and trait anxiety. Subjects with an abnormal FEcho (N = 12) had higher state (46.8 ± 15.5) and trait (40.9 ± 12.2) anxiety compared with those with a normal FEcho (state 30.8 ± 8.5, p = 0.005; trait 33.3 ± 9.2, p = 0.03, N = 30). There was no difference in mean state anxiety score among the pre-FEcho group and the post-FEcho group with an abnormal FEcho. Conclusions: Women who have had a FEcho report decreased anxiety compared with women awaiting FEcho. Anxiety levels of women awaiting FEcho are similar to those of women post-FEcho who are told there is fetal cardiac anomaly. P25.11 Prenatal diagnosis of isolated ductus arteriosus aneurysm Ob&Gyn, Chosun University, School of Medicine, Gwangju, South KoreaDuctus arteriosus aneurysm is often detected in the late third trimester of the pregnancy. It usually regresses spontaneously in neonatal period. Some postnatal complications such as spontaneous rupture of the aneurysm, compression of the surrounding tissues, infection and sudden death have been reported. We diagnosed ductus arteriosus aneurysm at 37 weeks of gestation. The aneurysmal dilatation of the ductus arteriosus was seen in the three vessels view. A healthy female baby delivered by repeat Cesarean section at 39 weeks of gestation. After delivery, ductus arteriosus aneurysm without shunt was delineated by MDCT and echocardiography.Supporting information can be found in the online version of this abstract. Objective: To examine the performance of early fetal echocardiography in a high-risk population. Methods: This is a retrospective study of all early fetal echocardiograms (fECHO) pe...

Purpose:We present our experience in prenatal diagnosis and obstetrical management of congenital lung malformations (CLM). Materials and methods:The diagnosis of CLM was performed during routine second and third trimester fetal morphology assess ment. The extent of the disease was established accor ding to the type, localization and size of the pulmonary lesion and the presence of fetal complications (mediastinal shift, fetal hydrops, hydramnios). Termination of pregnancy (TOP) was indicated in cases associated with extrapulmonary anomalies, untreatable cases and fetal hydrops. After delivery a pulmonary Xray and surgical examination was performed in all newborns. Results:We diagnosed 15 cases with congenital lung mal for ma tions. Of these, 9 had congenital cystic adenomatoid malfor mation (CCAM). TOP was performed in 6 cases with CCAM. Three cases had a favorable pre/postnatal evolution. Bronchopulmo nary sequestration (BPS) was diagnosed in 3 cases, all with favorable perinatal evolution. Right pulmonary agenesis was diagnosed in one case and the outcome was neonatal death. One case of congenital high airway obstruction syn drome was followed by TOP. One case of severe bilateral pul monary hy poplasia (secondary to a severe bilateral hydrothorax) resulted in neonatal death. Conclusion:Obstetrical management is established individually depending on the severity of the cases.