An absent or hypoplastic nasal bone as a marker of trisomy 21 has been widely reported in both the first and second trimesters. A mid sagittal view of the fetal profile on two-dimensional (2D) ultrasound is the optimal view for assessment of the nasal bone. However, an off-axis view can result in the false impression of a nasal bone by imaging the adjacent maxilla. Use of three dimensional (3D) volume ultrasound rendered imaging can permit more accurate evaluation of the nasal bone, especially when a mid sagittal view is difficult to obtain. We present a case of absent nasal bone in the second trimester in a fetus with trisomy 21 in which 2D imaging mistakenly suggested the presence of a nasal bone, whereas 3D imaging with surface rendering resulted in the correct diagnosis of an absent nasal bone. A 31 year old Gravida 3, Para 1 woman was referred for a second trimester fetal survey at 18 weeks 3 days gestation with no prior screening. The scan was interpreted as normal with the exception of an echogenic intracardiac focus. The nasal bone was thought to be visualized by a sonographer and the interpreting physician. As part of our protocol a 3D volume of the face was also acquired and was subsequently evaluated by a second physician following completion of the exam. Surface rendered coronal views of the face suggested absence of the nasal bone. The patient elected to undergo a second trimester serum screen ('quad' screen) which resulted in a calculated risk of 1 : 653 for trisomy 21, which was similar to her age-related risk. The patient returned one week later for a follow up evaluation and at that time both 2D and 3D volume imaging confirmed the absence of a nasal bone. The patient underwent genetic amniocentesis based on this information, yielding trisomy 21. We conclude that 3D volume imaging with surface rendering in the coronal plane may be more accurate than 2D imaging alone for determining whether a nasal bone is absent. P09.15 Caudal regression syndrome: a case reportA. Soria, J. Iglesias, G. Villagomez Martinez, G. Castillo, J. Villarreal, R. Ambriz, G. Treviño Martinez Medicina Materno Fetal, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey N. L., MexicoCaudal regression syndrome (CRS) is a rare and sporadic disorder. This may result in various types of anorectal malformations, agenesis of spinal segments (sacral or lumbosacral). In the most severe cases, the lower limbs are fused (sirenomelia). Incidence is estimated 1 : 10000-60,000 live births; male:female ratio 2.7 : 1. Etiology and pathogenic mechanisms are poorly understood, but maternal diabetes, genetic predisposition and vascular hypoperfusion have been proposed. Case report: 25 years old woman, G3 P2 (history of macrosomic), first-degree relatives with diabetes mellitus type 2; attend to 1 th occasion antenatal control taking a course in 18 weeks; accomplishing ultrasound of routine where we observed absence of sacrum, fusion of lumbar vertebrae, bilateral talipes. Diagnosis of gestational diabetes was made. We conclude a caudal ...

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El objetivo de este estudio es investigar los resultados perinatales adversos en gestantes con tuberculosis y compararlos con gestantes sin tuberculosis. Material y métodos: Se realizó un estudio retrospectivo, observacional,comparativo, de prevalencia, en el Hospital Universitario “Dr. José Eleuterio González”, en Monterrey, Nuevo León, México, en el cual se revisaron los expedientes clínicos de pacientes gestantes con tuberculosis en un periodo de tiempo de 8 años de Diciembre 2004 a Octubre del 2012; Los resultados tanto maternos y perinatales obtenidos fueron comparados con mujeres gestantes sin tuberculosis que tenían la misma paridad y edad. Resultados: La prevalencia de gestantes con tuberculosis fue del 0.26%. Observamos una correlación estadísticamente significativa entre la presencia de tuberculosis y parto pretérmino(Rho= -0.395, p=0.034), disminución en el peso de los productos (Rho= -0.301, p=0.007) y una tendencia a presentar una disminución del APGAR al minuto, con pobre recuperación a los 5 minutos (Rho= -0.233, p=0.04); lo anterior con el método de Spearman (IC95%). La mortalidad materna en el grupo de pacientes con tuberculosis fue del 11.5% (Fisher=0.032). Conclusiones: La tuberculosis durante el embarazo se asocia con resultados perinatales adversos, en nuestro estudio se asoció con parto pretérmino, retraso en el crecimiento intrauterino, APGAR bajo e incremento en la mortalidad materna.

There can be a spontaneous lysis of the amniotic band without consequences; constriction remains superficial and do not compress vascular structures; fetal body constriction becomes deep and blocks nervous-vascular structures leading to cutaneous and subcutaneous necrosis; amputation of the fetal district in utero. Management of constriction band syndrome is focused on improving function and development while providing a more acceptable esthetic appearance. For the most severe forms, termination of pregnancy can be offered. A 35 years old woman G0P0 during the execution of an ordinary ultrasound examination showed a fetus with partial amputation of right hand and omolateral arm. No chromosomal anomalies were identified (amniocentesis). In this case the patient opted for pregnancy interruption. The fetal face and neck represents one of the key anatomic regions in ultrasound investigation from a pscyhological and clinical standpoint of view. Although the sonographic appearance of some masses is characteristic a substantial overlap exists in echotexture of the masses of the face and neck. In addition to analysing the echotexture of the mass, attempts should be made to determine: the site of origin, the presence or absence of other malformations, and polyhidramnios. Cervical teratomas are very rare and account for 5% of all teratomas. The majority of them are benign are, often large and produce airway obstruction. We present a rare case of a large cervical teratoma diagnosed at 30 weeks gestation. P15.14 P15.15 Short-rib polydactyly syndrome type IIA. Soria, J. Iglesias, G. Sepulveda Gonzalez, H. Triana, C. Flores Acosta, D. Saldivar, G. Treviño Martinez, M. Vidales Medicina Materno Fetal, Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey N. L., MexicoShort rib-polydactyly syndrome (SRPS) is part of a group of lethal skeletal dysplasias characterized by hypoplastic thorax, short ribs, short limbs, polydactyly, and visceral abnormalities. The four variants are SRPS I (Saldino-Noonan), SRPS II (Majewski), SRPS III (Verma-Naumoff) and SRPS IV (Beemer-Langer). All variants are thought to be inherited in autosomal recessive pattern. Prenatal diagnosis has been reported by conventional 2D sonography. We report a case about a 26 year old woman G3P2, with a 33 weeks pregnancy, referred with an achondroplasia diagnosis. Medical and familial history was unremarkable. Ultrasound examination showed severe micromelia (LF 41 mm = 23.2 weeks and LH 30 mm = 19.6 weeks), thoracoabdominal dissociation 0.6, lung to head ratio 1.23, ascites, micrognathia and polyhydramnios. Threedimensional (3D) detected cleft lip and a medial palate defect with bilateral postaxial polydactyl. SRPS was suspected. Induction of labor was performed at 38 weeks due to PROM. A 3250 g male stillbirth was delivered. A genetic physical examination detected hypertelorism, broad nasal bridge, cleft lip and midline palate defect, microretrognatia, low-set ears and bilateral postaxial polydactyly. An autopsy was performed and genetic evaluation confirme...