P37.11: Antenatal ultrasonographic features of fetal hemimegalencephaly and giant lymphangioma

Abstract

Poster abstracts ultrasound early in gestation. Differential diagnosis is important because of avoiding unnecessary termination. We report here an epigastric heteropagus conjoined female twins case which was characterized by a completely formed fetus with an omphalocele and an adjacent second body consisting with a pelvis and two lower extremities. There was not a bowel or bony connections and there was a thin vascular pedicle between twins. The diagnosis was made with three dimensional ultrasonography at 18 weeks of gestation. P37.08Twin reversed arterial perfusion (TRAP) sequence: Case report of conservative management and good pregnancy outcome Twin reversed arterial perfusion (TRAP) sequence occurs only in the setting of a monochorionic pregnancy and complicates 1 percent of monochorionic twin gestations, with an incidence of 1 in 35,000 births. In the TRAP sequence, the acardiac/acephalic twin receives all of its blood supply from the normal, ''pump twin''. A case of TRAP sequence was diagnosed at 13 weeks of gestation using three-dimensional color Doppler ultrasound. Ultrasound imaging showed a monochorionic-monoamniotic twin pregnancy with normal morphology and growth of the first twin. Threedimensional ultrasound examination showed growth restriction of the second twin, abnormal cephalic pole with acrania, only lower extremities present, no presence of cardiac activity, and presence of perfusion in the umbilical artery of the abnormal twin. The acardiac/pump twin AC ratio was lower than 50% and we decided for conservative treatment with weekly ultrasound examination for signs of congestive heart failure and hydrops. The biometry and fetal Doppler measurements of the pump twin were normal throughout the pregnancy, with no signs of cardiac failure. At 24 weeks of gestation reversed umbilical flow was detected in the acardiac. The spontaneous cessation of blod flow in the umbilical artery of the acardiac twin was observed at 34 weeks of gestation. Intact neonate was delivered at 37 weeks of gestation by Cesarean section with no fetal complications. P37.09 Fetal reduction in twin pregnancy -does it improve pregnancy outcome?J. Har-toov, A. Sapira, G. Fait, R. Amster, I. Gull, I. Wolman, A. Jaffa US in Ob&Gyn unit, Lis maternity hospital, Tel-Aviv, IsraelObjective: The objective is to examine the pregnancy complications, delivery week, delivery weight and viability in the case of fetal reduction from twins to a singleton Methods: The study is retrospective based on 32 fetal reductions from twins to a singleton performed in Lis maternity hospital between 2000 and 2007. Demographic data, prior medical condition, reduction process, and pregnancy outcome were collected from medical files and interviewing the patients. The results were compared to two control groups: singleton pregnancies and twins pregnancies. Results: All groups resembled in demographic details (age, medical condition, parity etc.). Comparing complications: the remaining fetus (and its mother) did not benefit from the procedure: twenty (62.5%) s...