OP07.06: Ectopia cordis in prenatal life

Abstract

Objectives:The ductus arteriosus (DA) emerged from the pulmonary trunk and connects with the descending aorta. The normal Doppler evaluation depends on gestational age and the pulsatility index (PI) must be greater than 1.9. Anatomical and functional problems can occur as aneurysm of DA and DA with restrictive flow. DA anatomical changes can be caused by changes in blood flow and / or morphology of DA especially in the last trimester. Methods: Description of cases: 10 cases of anatomical changes of DA in fetuses with gestational age (GA) ranging from 28 to 37 weeks: 2 aneurysms DA (diameters of 5 and 8 mm) and 8 with morphological alteration with elongated, tortuous duct but with normal diameter with no points of constriction. Doppler flow changes was present with systolic velocity > 155 cm/s IP ranging from 1.7 to 2.5. Predominance of right heart chambers and tricuspid regurgitation was presented in 3 fetuses. ControI examinations were performed weekly or every two weeks. Results: Four women were found on routine obstetric ultrasound and three with suspected restrictive DA in previous fetal echo. One patient presented an excessive intake of grape juice, no use of drugs NSAIDs. All newborns born at term without significant symptoms and evolved with spontaneous closure of the DA. Conclusions: Changes of morphology in DA can be identified in the third trimester mainly because in this period the arteries and cardiac output pressures are greater and the proliferation of the intima occurs in DA preparing for postnatal closure. Evaluation with Doppler mainly using the PI help in the differential diagnosis of restrictive ductus arteriosus. Pediátrica, Clinica CardioFetal, São Paulo, Brazil; 2 Medicina Fetal, CPDT, Rio de Janeiro, Brazil; 3 Medicina Fetal, HNSL, São Paulo, Brazil; 4 Medicina Fetal, HLMB, São Paulo, Brazil Objectives: To assess fetuses with ectopia cordis (ec), association with cardiac and extra-cardiac malformation, chromosomal anomalies, pre and postnatal outcome. Methods: In a series of 13.664 fetal echocardiograms performed between May/1993 March/2011 using a Philips HD11EX ultrasound machine, 10 cases had ec. 4D echocardiography was performed in 2 pats. Gestational age ranged between 11-40 weeks. Diagnosis confirmed with postnatal echo and autopsy. The reason for fetal echo was the presence of heart exstrophy in all cases (10). OP07.06 Ectopia cordis in prenatal lifeResults: Ectopia cordis was diagnosed in 10 (3.3%) cases out of 623 cardiac malformations. Of these, 6 (60%) had the heart completely outside of the chest and 4 (40%) partially. Cardiac anomalies were detected in 9 fetuses: 2 (22.2%) dorv, 2 (22.2) vsd, 2 (22.2%) tetralogy of Fallot, 1 (11.1%) truncus arteriosus, 1 (11.1% ) avsd, 1 (11.1%), pulmonary atresia. Cardiac anatomy was not visualized in 11 week fetus with further termination of pregnancy. Exomphalos was detected in 7 (70%), gastrochisis in 2 (20%), 2 cystic hygroma (20%) and 1 single umbilical artery (10%). Autopsy in 5 pats showing midline thoracic-abdominal wall defect...