BACKGROUND: Asthma is a chronic inflammatory disease of the airways that results from complex interactions between multiple environmental and genetic influences. In recent years, studies have observed an increase in caesarean section rates, and have suggested a strong association with the rapid increase in the incidence of childhood asthma that cannot be explained by genetic factors alone. In this case-control study, we investigate the association between the developments of childhood asthma with the mode of delivery. We also explored the relationship between mode of delivery and control of asthma. METHODS: Two groups (509 pediatric patients in total) were assessed between January 1, 2017, and January 1, 2018. Part of these patients, 257 (50.4%) were asthmatic children visiting specialised clinics, and 252 (49.6%) controlled cases selected from a primary health care clinic from the same institution (control group). RESULTS: The Chi-square test revealed a significant association between cesarean sections and bronchial asthma (OR, 1.483 [95% CI, 1.013–21.71]; P = 0.042). However, the adjusted OR from our binary logistic regression model revealed this association to be insignificant (adjusted OR, 1.417 [95% CI, 0.885–2.269]; P = 0.804). The value of the chi-square of the model shows that the overall model is statistically significant at 1%. The Nagelkerke R square indicates that 34.9% of the variation in having asthma is explained by the risk factors included in the model. CONCLUSION: We do not believe that the rise in cesarean sections explains the increase in childhood bronchial asthma – at least not in our population. We also found no association between the mode of delivery and asthma control. We encourage further research into this topic, namely to recruit a larger number of patients, and to adjust for the significant risk factors found in our study.

Severe combined immunodeficiency (SCID) is an extremely rare disease caused by a disruption in the forkhead box N1 (FOXN1) gene, with an incidence of <1 per 1 000 000 live births. We report a boy aged 4 months who presented with a history of fever for 3 weeks and enlarged lymph nodes. The fever was associated with dry cough and runny nose. On physical examination, we noted oral thrush, generalised lymphadenopathy, nail dystrophy and alopecia. Flow cytometry of lymph node biopsy showed high-grade B-cell lymphoma. In addition, Epstein-Barr virus (EBV) infection was documented by PCR. The diagnosis of SCID was made by genetic testing, which revealed a homozygous variant of the FOXN1 gene. The variant was confirmed with Sanger sequencing. Management of EBV infection and lymphoma was initiated; unfortunately, the patient passed away on day 45 of hospitalisation.

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Parapagus (laterally fused) diprosopus (two faces) dibrachius (two upper extremities) dipus (two lower extremities) conjoined twins are extremely rare and the coexistence of anencephaly with contiguous spinal defect (craniorachischisis totalis) makes it more extreme. In this report we present such a case diagnosed finally by the aid of 3D ultrasonography (US) at the 12 th week of the gestation of a gravida 2, para 1, 22 year old woman. 2D abdominal and vaginal US were inefficient for the diagnosis (Figure 1). The family decided to terminate the pregnancy. Postabortal anatomic fine dissection is still going on at the time of this writing. Macroscopic evaluation confirmed the US diagnosis. The heart, diaphram, liver and the perineum were observed as all united. Fine dissection of the heart showed 4 vessels arising from the ventricles and there was a membraneous type ventricular septal defect.Supporting information can be found in the online version of this abstract. P30.13A large amniocele with protruded umbilical cord diagnosed by 3D ultrasound S. Kim Obstetrics and Gynecology Department, Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Republic of KoreaAn amniocele is a herniation of the amniotic sac through the uterine defect. Uterine rupture during pregnancy may develop as a result of pre-existing injury, uterine anomaly, or unscarred uterus. A 30-year-old, parity 2-0-0-2, presented an aminiocele complicated by a left fundal perforation and was evaluated with threedimensional ultrasonography at 23 weeks. Because of worsening lower abdominal pain and vaginal bleeding, she underwent an exploratory laparotomy. Herein, we report a uterine rupture with amniocele.Supporting information can be found in the online version of this abstract.3D ultrasound. Through a focal defect in the uterus, the umbilical arteries and veins were colorized by Doppler sono.The umbilical cord appears as a long, extended, tubular structure. The anterior aspect of the fetal head was abutting the umbilical cord and the rupture site and umbilical cord closely. Fetal malignancies are rare complications during pregnancies. We present a case of prenatally diagnosed congenital fibrosarcoma that affected distal low right extremity. The complex and irregular mixed solid and cystic, vascularized mass that markedly distorted normally anatomy was diagnosed at 33 weeks by ultrasonography. Expectant management was performed with serial ultrasound management to detect rapid enlargement, metastasis or secondary fetal complications. At 38 weeks 4275 grams female fetus was delivered by cesarean section. The biopsy showed fibrosarcoma and pediatric oncologists started chemotherapy treatment. Here, we show 2D and 3D ultrasonographic appearance of this rare tumor and discuss the key points in its differential diagnosis and management. Case 1: A 16 years old primigravida, was referred to the fetal medicine unit at 30.2 weeks of gestation following a routine anomaly ultrasound scan which had detected a mass in the neck. A further ultrasound a...