OP36.01: Feedback as an educational tool in gynecological ultrasound

Abstract

first trim scan, including DV Doppler assessment, has been performed by certified specialists. All cases of ADV underwent serial echocardiography looking for signs of cardiac insufficiency until birth and middle-term postnatal follow-up. Results: A total of 58 cases of ADV were detected (54 singleton and 4 twin pregnancies), 38 (48%) of them were diagnosed in first trim scan. 38 (66%) of these cases had intrahepatic (IH) umbilical venous drainage, 10% of them developed severe hydrops. Another one with associated anomalies underwent TOP, the rest were born uneventfully and are alive and well (1 Aortic Coartation operated at six months and 1 renal policystosis). The remaining 20 (34%) cases had extrahepatic (EH) drainage, either directly into right atrium (4), Inferior Vena Cava (4) or the Iliac Vein (2). 20% of them developed severe hydrops (4 died postnataly, 3 asked for TOP and 1 is alive). In the EH drainage group 11 (55%) of fetuses had associated malformations (5 cardiac and 6 extracardiac). Increased NT was present in both types of ADV, but was more related to poor prognosis in the EH group. The IH drainage group, when compared to EH group, had less incidence of hydrops (16% versus 60% (P < 0.05)) and less anomalies (16% vs. 50% (P < 0.05)) with a significantly better postnatal outcome (normality of 79% vs. 50% (P < 0.05)). Conclusions: Fetuses with IH umbilical venous drainage have better prognosis, especially in the absence of associated malformations or increased NT.