P04.32: Early sonographic diagnosis of fetal abdominal wall anomalies

Abstract

(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...