Objective To compare the adrenal gland size of fetal growth restricted (FGR) and normal control fetuses. Study design In this prospective study the adrenal gland size of 63 FGR fetuses and 343 normal controls was measured between 20 and 41 weeks of gestation. The total width and the medulla width were measured in a new standardized transversal plane. The cortex width and a calculated ratio of the total and medulla width (adrenal gland ratio) were compared between both groups. Results The mean cortex width and the adrenal gland ratio in FGR fetuses were higher in comparison to the controls (P<0.001; P=0.036, respectively). The cortex width correlated positively with the gestational age (control group: P<0.001; FGR group: P=0.089) whilst the adrenal gland ratio showed no association with the gestational age (control group: P=0.153; FGR group: P=0.314). Conclusion The adrenal gland cortex width and the adrenal gland ratio were increased in FGR fetuses compared to normal fetuses.

Purpose Since pathogens can be transmitted to patients via transvaginal ultrasound probes, it is of particular importance that cleaning and disinfection are performed adequately. This study was designed to do a qualitative comparison of a low-level disinfection technique with disinfectant-impregnated wipes and an automated disinfection technique using ultraviolet C radiation in a clinical setting. Materials and Methods The transvaginal ultrasound probes used in two groups of 160 patients were compared in a prospective controlled study regarding the effectiveness of manual low-level disinfection (Mikrozid® sensitive wipes) and automated disinfection using ultraviolet C radiation (Antigermix® AS1). Microbiological samples were taken from the whole surface of the probe before and after the disinfection process. Results Before disinfection, 98.75 % (316/320) of the samples showed bacterial contamination. After automated and manual disinfection, the contamination rates were 34.2 % (54/158, automated) and 40.5 % (64/158, disinfectant wipes) (p > 0.05). Pathogens with the potential to cause healthcare-associated infections, such as Enterococcus faecalis and Klebsiella pneumoniae, were removed completely by both techniques. Manual disinfection showed a lower contamination rate after disinfection of bacteria that usually belong to the vaginal, pharyngeal and skin flora (disinfectant wipes 10.6 %, 11/104, automated 32.5 %, 38/117) (p < 0.001). Conclusion For the clinical routine, automated disinfection with ultraviolet C is a promising technique for transvaginal ultrasound probes because of the simple handling and time efficiency. In our study, this method was completely effective against nosocomial pathogens. However, the study didn’t show any significant difference in terms of effectiveness compared to low-level wipe disinfection.

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Results: Four-chamber view and three vessels and trachea view were successfully achieved in 78% (104/133,78%)and 77% (103/133,77%)cases, respectively. Ten cases of congenital heart disease (CHD) were suspected by early fetal echocardiography. One case was lost at follow-up and the rest 9 cases were confirmed by autopsy. Among the 9 cases, 7 were diagnosed correctly and 2 were misdiagnosed. Additional 2 cases of CHD were detected during follow-up. The accuracy of early fetal echocardiography in the diagnosis of complex congenital heart disease was 63.6%(7/11,63.6%). A severe form of TOF has pathological vessels arising from the aorta or its branches and caring the blood flow to the lungs, instead of the pulmonary arteries. Those arteries call Major Aortopulmonary Collateral Arteries (MAPCAs). This anomaly usually is diagnosed only postpartum and has poor prognosis. ConclusionsWe present here for the first time prenatal detection of MAPCAs. The diagnosis was done in four cases in two Medical Centres:First case: TOF with pulmonary atresia was diagnosed in one twin of monoamniotic pregnancy at 27 weeks. The pulmonary arteries could not be detected, and total diversion of blood from both ventricles into the aorta was demonstrated. Careful examination reviled MAPCAs arising from the descending aorta to the right lung. Selective termination of pregnancy using Radiofrequency Ablation was done at 31 week gestation and Caesarean delivery for the second twin.Second case: A 37 week fetus diagnosed with TOF and Pulmonic Atresia. The pulmonary arteries could not be detected. At the age of 3 days CT scan demonstrate two MAPCAs arising from the subclavian artery from each side. The child was operated (unifocalisation) and died at the age of 5 month from lung complication.Third case: The diagnosis of TOF with pulmonary atresia and MAPCAs was made at 28 week gestation. The MAPCAs arise from the descending aorta to both lungs. This pregnancy was terminated.Forth case: A 19 week fetus was diagnosed with TOF, absent pulmonary valve, small right PA, hypoplastic left PA, absent ductus arteriosus and MAPCAs arising from the descending aorta. The pregnancy was terminated. Conclusion: Prenatal diagnosis of MAPCAs is possible, and important due to the grave prognosis.Supporting information can be found in the online version of this abstract Introduction: Fetal critical aortic stenosis (CAS) is a challenging lesion with poor prognosis such as fetal hydrops and intrauterine fetal death. It has been known that the double reverse pattern in pulmonary veins relates to poor prognosis. We had a case with CAS with fetal hydrops, and spontaneously resolved the hydrops with the increased forward flow in aorta. We evaluated the hemodynamic changes with pulmonary venous Doppler pattern as well as the left atrium area/ cardiac area ratio (LA/CA). Case: A 30 year old woman, gravida 2, para 1, was referred at 28 weeks of gestation for polyhydramnios, fetal hydrops and cardiac abnormality. Markedly enlarged left atrium and severe mitral regurgitation wit...