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Objectives: Evaluation of the advantages and limitations of routine screening in early pregnancy by transvaginal sonography (TVS) in an unselected population. Methods: A routine ultrasound examination was offered to every woman in the 12th week of her pregnancy using a transvaginal probe. The examination protocol was focused on searching for major structural anomalies. Routine transabdominal screening at 18 and 32 weeks was also performed. Anomalies were divided into three groups. Group 1: all cases were diagnosed; Group 2: only a certain percent of the cases were detected; Group 3: not detected. Diagnoses were confirmed by neonatological and pathological examinations. Results: In a twenty-year period 13 835 women were examined and 198 fetuses had malformations. Fetal anomalies were diagnosed in 78 cases at the 12th week (39.4%), 49 cases at 18 weeks (24.7%), 56 cases at 32 weeks (28.3%) and 15 cases later. All those malformations which cause severe defects and/or extensions of the body contour were detected (Group 1). Structural anomalies which can be diagnosed as a consequence of obstruction or stenosis and those causing small defects were recognised only in a certain percent of cases (Group 2). The explanation for the failure to detect the anomalies included in Groups 2 and 3 is discussed. Conclusions: Early transvaginal screening offers the possibility of early termination of pregnancies with severe structural anomalies in 39.4% of cases. However, standard mid-second-trimester transabdominal scanning is still recommended since a significant number of malformations cannot be detected so early in pregnancy. (a) There are malformations which do not manifest so early in pregnancy; (b) we do not have enough experience of the early pathological changes of these anomalies; (c) the resolution of the transvaginal probe is still not enough to recognise them. OP25.12Nuchal translucency reference range curve in Quito, Ecuador Objectives: To assess the behavior of nuchal translucency (NT) and crown-rump length (CRL) in the population of the Quito, Ecuador, at 2800 m above sea level, during weeks 11 to 14 of pregnancy and to compare with the normality range of the Fetal Medicine Foundation to establish a reference range for this population. Methods: A transversal study was performed in 602 fetuses that presented with a normal karyotype or phenotype. All the fetuses underwent measurement of NT during routine ultrasound examination. Student's t-test and percentilation with dispersion tables were used in the statistical analysis. The regression test was used to find a better mathematical model to describe the NT behavior. Results: 602 gestations with a CRL between 45 and 84 mm with a normal karyotype and perinatal follow-up were included in the study. Interval analysis of gestational age through regression models suggests that the power used should be between 0.5 and 1 (Table). Use of the 95 th percentile allowed us to include the patient with the highest NT. Results: In 10 twin pregnancies, one of the fetuses was found to h...

Background Our aim was to present a case of cardiac rhabdomyoma diagnosed at 24 weeks of pregnancy. A 20‐year‐old woman, G2P0, was referred for sonographic examination because of the history of cystic hygroma in her first pregnancy. Karyotyping revealed trisomy 21 and termination was performed. There were no cardiac and neurologic diseases in her family history. For the present pregnancy routine ultrasound scans at 12 and 18 weeks showed normal fetal anatomy. Fetal echocardiography at 24 weeks revealed a large cardiac tumour protruding from the intraventricular septum into the right ventricle (12 mm). Colour Doppler showed blood flow around the tumour and the flow pattern was not suggestive for obstruction of the right ventricular outflow tract. No other fetal anomalies were noted. The patient was informed about the diagnosis of rhabdomyoma and the possibility of associated tuberous sclerosis. Termination of pregnancy was performed upon patient's request. Pathologic examination confirmed the diagnosis but found no sign for tuberous sclerosis. Karyotyping was normal. Her next pregnancy was uneventful resulting a healthy newborn. Conclusion The natural history of intracardiac rhabdomyoma is not known and usually detected in the second half of gestation. The prognosis depends on its influence on cardiac functions and the associated anomalies.

Objectives: To evaluate the posterior fossa in fetuses with normal and chromosomal abnormalities at 11-13 + 6 weeks' gestation Methods: To measure the brain stem (BS) and brain stem to occipital (BSOB) in fetuses of 518 normal, and trisomy 13, 18, 21 and 45, XO in 8, 26, 38, 8 respective in singleton pregnancies at the first trimester between 11 and 13 + 6 weeks. All cases underwent fetal karyotyping using chorionic villus sampling or amniocentesis to confirm the fetus's normalcy. Results: In linear regression, BS and BSOB correlated significant linearly with CRL. (BS = 1.602 + 0.022CRL, R2 = 0.257, p value < 0.001), (BSOB = 2.588 + 0.033CRL, R2 = 0.247, p value < 0.001), (BS to BSOB ratio = 0.634-0.0002CRL, R2 = 0.001, p value = 0.577). The BS to BSOB ratio was below the 5 th percentile in 4(50%), 11(44%), 2(5.26%), and 4(50%) of trisomy 13, trisomy 18, trisomy 21 and 45, XO. In trisomy 13, trisomy 18 and 45, XO the BS and BS to BSOB ratio were significantly lower than in normal fetuses. But in the trisomy 21, BS, BSOB and the BS to BSOB ratio were no significant difference in normal fetuses. Conclusions: In the 11-13 + 6 weeks' scans, the many fetuses of the trisomy 13, 18, and 45, XO abnormalities posterior fossa, but trisomy 21 is no significant difference to euploid.

(20%) postnatally diagnosed and in 13 (7%) cases the timing of diagnosis was unavailable. In 13/128 cases reported antenatally the fetus/baby did not have unilateral CDH or had been misdiagnosed. The majority of affected pregnancies were singleton (98%). Of the antenatal suspected/diagnosed cases there were 70 babies delivered alive (39 died subsequently), 4 miscarried, 8 were stillbirths, 43 had termination of pregnancy (TOP) and in 1 case this information is missing. Most cases (68%) were diagnosed between 18-23 weeks. All TOP's were performed at less than 24 weeks gestation and 28/43 (65%) fetuses had other associated structural anomalies/chromosomal problems. Conclusions: The prevalence of CDH was 3.5 per 10 000 births in this region. 27% of pregnancies diagnosed with unilateral CDH antenatally resulted in a live born infant that survived the immediate postnatal period. Majority of the cases reported to the register were diagnosed antenatally. Increased surveillance for other anomalies is required when CDH is suspected/diagnosed antenatally. Population based data should be used in counselling parents. P04.29Is the finding of a central gall bladder an anatomic variant?C. Lara, I. Alcover, J. Bellver, F. F. Correa, J. Remohí, A. Pellicer, V. Serra Instituto Valenciano de Infertilidad (IVI)-Universidad de Valencia, SpainObjective: To describe our experience with a series of cases with a centrally located gall bladder. Methods: We retrospectively reviewed the data from 2752 pregnancies in whom a detailed fetal anomaly scan had been preformed and the characteristics of the gall bladder specifically recorded. High-and low-risk pregnancies were included. Results: A central fetal gall bladder was found in seven cases (incidence 0.25%). This finding was the clue for diagnosing a persistent intrahepatic right umbilical vein. Diagnoses were performed at 18-22 weeks, except for one case visualized at 30 weeks. Fetal growth was not impaired. The gall bladder was dilated in one case. Three cases had other associated findings: an heterotaxy syndrome, a marginally increased cisterna magna and a thin amniotic band. Conclusion:The finding of a central gall bladder with persistent right umbilical vein can be considered an anatomic variant if when it is isolated. A careful fetal anatomical survey, including fetal echocardiography, seems mandatory. For several recent years, we have diagnosed more than 100 cases of persistent right umbilical vein, 25 cases of umbilical vein varix, five cases of porto-hepatic venous shunt, and two cases of abnormal branch of intrahepatic umbilical vein, two cases of intracardiac total anomalous pulmonary venous return, and one case of obstruction of intrahepatic umbilical vein with multiple collateral circulations. All fetuses with persistent right umbilical vein showed good outcome. Ventricular septal defect was detected in two fetuses. Tetralogy of Fallot was diagnosed in two of them. One fetus with porthepatic shunt was Down syndrome and showed poor outcome with congestive heart failure. Operat...