Does the incidence of two-vessel cord correlate with an increased incidence of discordance in twin gestations?

Abstract

664 665 THE ACCURACY OF PRENATAL DIAGNOSIS OF FETAL HEART ANOMALIES IN THE OBESE GRAVIDA MAYRA TROYA-NUTT, ISRAEL HENDLER, SEAN BLACKWELL, MARJORIE TREADWELL, EMMANUEL BUJOLD, ROBERT SOKOL, YORAM SOROKIN, Wayne State University, Obstetrics/Gynecology, Detroit, MI Wayne State University, Obstetrics/ Gynecology/MFM, Detroit, MI OBJECTIVE: To compare the accuracy of prenatal ultrasound diagnosis for major fetal heart anomalies in obese and non-obese women. STUDY DESIGN: A computerized ultrasound and perinatal database was used to identify patients who had prenatally diagnosed major heart defects and delivered a live-born neonate at $24 weeks’ (10/1999-6/2003). Prenatal ultrasound reports were compared with neonatal examination including echocardiography. Demographic data, clinical characteristics, and outcome data were collected. Patients were divided into 2 groups based on body mass index (BMI). The agreement between prenatal and postnatal diagnosis was compared between obese (BMI$30 kg/m2) and non-obese patients (BMI < 30 kg/m2). RESULTS: Nineteen neonates met all study criteria. Prenatal diagnoses included left and right hypoplastic heart, atrial septal defect (ASD), ventricular septal defect (VSD), AV canal, tetralogy of Fallot, valvular or aortic anomalies. Of these, the diagnosis was confirmed postnatally in 12 (63%) cases. However, in obese patients 75% (6 of 8) newborns were found to have a normal cardiac evaluation postnatally, while only 1 of 11 newborns had a normal cardiac evaluation in non-obese gravidas (P = 0.004). Ventricular septal defect was the most frequently overdiagnosed anomaly (4 out of 7 cases, 57.1%); 1 case of ASD, 1 coarctation of the aorta, and 1 case of asymmetry between the right and the left heart. Volume 189, Number 6 Am J Obstet Gynecol SMFM Abstracts S239