P08.07: Ectopia cordis: association with amniotic band syndrome in seven cases

Abstract

Objectives: To identify the outflow tracts of the fetal heart using the STIC method (spatiotemporal image correlation) in the 11–13 week scan. Methods: We performed 30 ultrasound examinations of pregnant women between 11 and 13 weeks from november 2009 to february 2010 at the Center for Fetal Medicine of Campinas (CENTRUS), according to the screening protocol in the first trimester traced by the Fetal Medicine Foundation using the HD11 (Philips). After the morphological analysis it was assessed the fetal heart following the methodology described by Paladini in 2008. We identified the heart through the four-chamber view and after activation of the color Doppler the STIC method was performed. It was then carried out post-processing, making it possible to identify the cardiac atria and the position of the aorta and pulmonary arteries, and the relationships among these structures. Results: A total of 30 women between 11 and 13 weeks. Six women (20.0%) had a gestational age of 11 weeks, 13 (43.3%) 12 weeks and the remaining 11 (36.7%) women had 13 weeks of gestation. The crow rump length averaged 64.3 mm (47.3 to 82.3 mm), with standard deviation of 9.4 mm. The mean nuchal translucency thickness was 1.9 mm (1.2 to 5.0 mm) with a standard deviation of 0.7 mm. Examination showed no regurgitation of the tricuspid valve. The nasal bone was present in 25 (83.3%) samples. The visualization of the outflow tract and their relationship to the cardiac atria occurred in 19 (63.3%) women. Inappropriate positioning of the fetus (7 cases), Doppler acquisition of poor quality (2 cases) and the impossibility of assessing the aorta (2 cases) were the reasons for not identifying the correct exit routes. Conclusions: The application of ultrasound examination suggested by the methodology described by Paladini proved to be feasible within the screening period of the first trimester, antecipating the identification of the outflow tract of the fetal heart.