plit-hand/foot malformations (SHFMs) span a wide spectrum of limb defects ranging from minor anomalies of the fingers to a lobster claw deformity. As a result, authors in the genetics and surgical literature use the term SHFM interchangeably with ectrodactyly, cleft hand, partial terminal aphalangia, oligodactyly, crab claw malformation, and lobster claw anomaly/ malformation. In this article, we use SHFM to describe the full spectrum of split-hand/foot anomalies as described by the Human Genome nomenclature in 1994, 1 including ectrodactyly and syndactyly with obvious median clefts of the hands and feet, due to aplasia or hypoplasia, or both, of the phalanges, metacarpals, and metatarsals. The purpose of this series was to identify cases that appeared on sonography to be splithand/foot malformations (SHFMs) in fetuses and correlate the sonographic findings, including 2-dimensional (2D) and 3-dimensional (3D) sonography, to outcomes. A retrospective review was conducted of sonographic studies from 2002 to 2012 at 2 fetal care centers. Data were collected with respect to the morphologic characteristics of splithand/foot abnormalities, the utility of 3D sonography, associated anatomic abnormalities, family histories, gestational ages at diagnosis, fetal outcomes, karyotype, and autopsy results. Ten cases were identified with gestational ages ranging from 15 to 29 weeks. Three-dimensional sonography was helpful in defining anatomy in 7 of 9 cases in which it was performed. Bilateral SHFMs were found in 7 cases (3 cases involving both hands and feet, 2 cases isolated to hands, and 2 cases isolated to feet), whereas 3 cases showed unilateral split-hand malformations. Associated anatomic anomalies were present in 6 cases, and 4 of these had recognized syndromes, including 2 with abnormal karyotypes, specifically, del(22q11) and del(7q31). Two cases occurred in the context of a positive family history of SHFM. Three cases were delivered at term, and 7 cases were electively terminated. In conclusion, SHFMs often occur with a broad range of chromosomal abnormalities, single-gene disorders, and other congenital anomalies. Some apparent SHFMs turn out to be other limb anomalies, such as complex syndactyly. Prenatal screening using 2D sonography can identify SHFMs, and 3D sonography often further clarifies them.

Objectives To explore whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect umbilical vein blood flow (UVBF) and fetal cardiac function. Methods Prospective case-control study of consecutive pregnancies complicated by SARS-CoV-2 infection during the second half of pregnancy matched with unaffected women. Measurements of UVBF normalized for fetal abdominal circumference (UVBF/AC), atrial area (AA) and ventricular sphericity indices (SI) were compared between the two study groups. Chi-square and Mann–Whitney U tests were sued to analyze the data. Results Fifty-four consecutive pregnancies complicated and 108 not complicated by SARS-CoV-2 infection were included. The median gestational age at infection was 30.2 (interquartile range [IQR] 26.2 34.1). General baseline and pregnancy characteristics were similar between pregnant women with compared to those without SARS-CoV-2 infection. There was no difference in UVBF/AC (study groups z value −0.11 vs. 0.14 control p 0.751) values between pregnancies complicated compared to those not complicated by SARS-CoV-2 infection. Likewise, there was no difference in the left and right AA (left 1.30 vs. 1.28 p=0.221 and right 1.33 vs. 1.31 p=0.324) and SI (left 1.75 vs. 1.77 p=0.208 and right 1.51 vs. 1.54 p=0.121) between the two groups. Conclusions SARS-CoV-2 infection does not affect UVBF and fetal cardiac function in uncomplicated pregnancies.

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Short oral presentation abstractsMethods: The study includes data from Norfolk and Norwich University Hospitals (NNUH) where a policy of routine POCUS was adopted from November 2020 following stage-wise implementation in 2016. We included two groups: a historical cohort of women who received routine care (2015) and those who had POCUS at the 36-week visit (November 2020-2021). Women with multiple pregnancies, preterm birth < 37 weeks, congenital abnormalities and those undergoing planned Caesarean section (CS) for breech presentation were excluded. Undiagnosed breech presentation was defined as: a) women who presented in labour or with ruptured membranes at term and were subsequently discovered to have a baby in a breech presentation, and b) women who attended for induction of labour at term and were found to have a breech presentation before commencing induction of labour. The primary outcome was undiagnosed breech presentation in labour. Secondary outcomes included mode of birth and neonatal adverse outcomes. Percentages were compared using chi squared test. Results: The analysis included 5013 pregnancies before and 4474 pregnancies after routine implementation of POCUS. After the implementation of routine POCUS, the rate of undiagnosed breech presentation reduced from 4.8/1000 births to 1.1/1000 births. The risk of undiagnosed breech in labour reduced by 77% with routine POCUS (Relative Risk: 0.23, 95% CI 0.09-0.61, p = 0.003). There was also a significant reduction in the incidence of emergency CS and breech delivery at term by 22.2% (p = 0.02) and 8.8% (p = 0.01), respectively. Approximately 271 POCUS would be required to prevent one undiagnosed breech presentation in labour. Conclusions: POCUS was associated with a reduction in undiagnosed breech in labour and emergency CS at term.

Electronic poster abstractsupon labour ward admission. The Wharton's jelly area (WJA) was calculated as the difference between the total umbilical cord area (UCA) and the vascular area. The WJA/birthweight and the UCA/birthweight ratio were compared between women who underwent an OI (i.e. Caesarean section, operative vaginal deliveries or intrapartum resuscitation) for suspected fetal compromise (group OI) and those where this was not necessary (group no OI). The correlation between the total deceleration area during labour and the WJA/birthweight and the UCA/ birthweight ratio was also assessed. Results: Overall, 185 women were included. Table 1 illustrates the maternal and labour characteristics between the two groups. The UCA/birthweight ratio did not differ between the two groups (0.6 ± 0.1 versus 0.5 ± 0.2 cm 2 /mg p = 0.07) as well as the WJA/ birthweight (0.4 ± 0.1 cm 2 /mg versus 0.3 ± 0.1; p = 0.06). Also, no correlation was found between the total deceleration area in labour and both the WJA/birthweight and the UCA/birthweight ratio. Conclusions: A lower thickness of the umbilical cord does not seem to represent a risk factor for suspected fetal compromise during active labour.