P22.14: Early fetal morphological evaluation (12–14 weeks): abdominal ultrasonography approach

Abstract

Were analyzed the following data: reason for of MRI, GA at MRI, position of the stomach and jejunum in T2. Position of the jejunum was defined as normal if in the left flank below the stomach and abnormal otherwise, therefore classified into 3 groups : intra-thoracic (A), extra-fetal (B) and abnormal intrafetal (C). The position of the jejunum was studied by two independent operators. Antenatal data were correlated to postnatal imaging, surgical or autopsy findings. Results: 709 fetal MRI were performed during this period. The mean GA at MRI was 30 WG (22 min-37 max). In 64 cases (9%) jejunum was absent from the sub gastric area in the left flank on T2-weighted images. Forty-one fetuses (64 %) had a left diaphragmatic hernia with intrathoracic position of the proximal jejunum (group A). In 11 cases (17%), jejunum was extrafetal due to gastroschisis (group B). In 12 cases (19%) intra-abdominal proximal jejunum was in an abnormal position, i.e. in the middle or right flank, with a normally positioned stomach (group C). In only 2 cases of group C (16.6%), gastrointestinal abnormality was suspected on ultrasound. The two operators were concordant in 100 % of cases. All diagnoses of groups A and B (52 cases) were confirmed postnatally or at autopsy. In 10 cases (83%) of group C, malposition was also confirmed postnatally while it had not been suspected during prenatal ultrasounds. One case had a right jejunal deviation caused by a large duplication cyst but bowel position was normal at surgery. In the other one, jejunal position proved normal postnatally. Conclusions: due to T2-weighted sequences high contrast resolution, fetal MRI is a useful tool for prenatal diagnosis of digestive malposition, including in cases where fetal ultrasound did not suspect this diagnosis. P22.14 Early fetal morphological evaluation (12-14 weeks): abdominal ultrasonography approach