S124 Ultrasound in Medicine and Biology Volume 37, Number 8S, 2011

prediction is not a confirmative method, so more cases are needed to

confirm our data in the future.

P 188 se

Chorangioma and Fetal Anemia: A Case Report

F. Springolo,1 V. Spitilli,1 A. Fruscalzo,2 A. P. Londero,3 S. Bertozzi,4

L. Driul,1 D. Marchesoni1

1Clinic of Obstetrics and Gynecology, University of Udine, Udine/IT,2Gynecology and Obstetrics, Mathias-Spital, Rheine/DE, 3Gynecology

and Obstetrics, University of Udine, Udine/IT, 4Department of Surgery,

University of Udine, Udine/IT

Purpose: The aim of this report is to bring attention to the chorangioma

which, despite its rarity, should be taken into consideration when

a placental mass or suspected fetal anemia is present.

Material &Methods: The patient was a 37-year-old Caucasian woman

in her 27th gestational week.

Results: She was admitted to our department after the ultrasonographic

detection of a placental mass, suspected to be a chorangioma, for fetal

RDS prophylaxis. The ultrasound scan at admittance showed an hyper-

echogenic, blood well-supplied 8 cm-sized mass that demonstrated

a polyhydramnios. Umbilical artery and median cerebral artery Doppler

were within normal range. After 3 days, spontaneous rupture of the am-

niochorial membranes was ascertained. Ultrasound scan showed fetal

hepatomegaly, small pericardial effusion, tachycardia and enlargement

of fetal right heart cavities. Umbilical artery pulsatility index was 1.35

and median cerebral artery VmaxMoM was 1.45. Therefore, an urgent

caesarean section was carried out at 26 weeks + 5days, resulting in

the birth of a male child, weighing 1084 g, APGAR 2/5/7, with anaemia

and low platelets count. Kleihauer-Betke test was negative. After the

placenta separation, a parenchymal, 10 cm-sized mass was removed

and it resulted to be histologically a chorangioma.

Conclusion: In the absence of a clear feto-maternal haemorrhage or

bleeding, anaemia may be due to the entrapment of red blood cells

and platelets in the tumorous capillaries. The fetus may suffer from

IUGR, transient cardiomegaly, bleeding disorders, anemia, hydrops fe-

talis, and also intrauterine death may occur. Therefore, it is very impor-

tant to promptly diagnose chorangioma.

GYN / Prenatal Medicine

P 189 se

Ultrasound Diagnosis of Fetal Partial Atrioventricular

Septal Defect

L. Jie, Y. Xu, Q. Liu

Department of Ultrasound, RiZhao people’s Hospital, RiZhao/CN

Purpose: To investigate the clinical value of fetal echocardiography in

prenatal diagnosis of partial atrioventricular septal defect (pAVSD).

Material & Methods: Ultrasound images of 11 cases of pAVSD

confirmed by postnatal echocardiography were retrospectively analysed

and summarized.

Results: Eleven cases of pAVSD showed the ostium primum atrial

septal defect and the mitral and tricuspid valves attaching at the same

level on the interventricular septum. The image of tricuspid valve attach-

ment point was nearer to the cardiac apex than mitral valve disappear-

ance. Atrio-ventricular valves took on a straight, bar-like appearance

when closed, and constituted a ‘‘T’’ shape with the interventricular

septum. There were four cases associated with mitral regurgitation:

one was associated with mitral and tricuspid regurgitation; another

showed a left ventricle-right auricle canal; and one case was associated

with absence of bilateral radius.

Conclusion: A ‘‘T’’-shaped image is of great clinical value in the

prenatal diagnosis of fetal pAVSD. It is noteworthy that coronary sinus

may cause a false-positive diagnosis.

P 190 se

A Case of Undiagnosed Cloacal Exstrophy

R. Wada,1 Y. Ikeda,1 Y. Wakimoto,1 T. Kato,1 Y. Ito,1 H. Sawai,1

T. Sasaki,2 H. Okuyama,2 S. Komori1

1Obst. & gine., Hyogo college of medicine, Nishinoiya-city/JP,2Pedatrics Surgery, Hyogo College of Medicine, Nishinomiya-City/JP

Purpose:Cloacal abnormality is difficult to diagnose prenatally.We had

a case of cloacal exstrophy that could not be diagnosed by ultrasound

and MRI examinations. This case was analyzed retrospectively with

the aim of improving CE diagnosis.

Material & Methods: The patient was referred to our department after

a cyst was detected in the midline of the fetal abdomen in the 17th week

of gestation. She was followed up by ultrasound and MRI examinations.

Results: In the 22nd week of gestation, the cystic lesion disappeared,

and at the same time, a solid tumor of about 30 mm in diameter was de-

tected in the midline of the lower abdomen. In the 35th week, a bladder-

like cyst in the pelvis, downward shift of both kidneys and enlargement

of uretero-renal pelvis were detected. In the 36th week of gestation,

a caesarean section was performed to deliver a female baby (2632 g, Ap-

gar score 3/6). Hemibladders confluent caudal to the bowel [cloacal exs-

trophy, I-C type in Hurwitz classification] were confirmed and surgery

was performed on the first day of birth in the Department of pediatrics

surgery.

Conclusion: This case was not diagnosed positively before birth. If

a cystic lesion in which a median abdominal cyst observed in early

gestation disappears in the second trimester, it is recognized as persistent

cloacal membrane and prenatal diagnosis may be possible. It is impor-

tant to conduct ultrasound examinations of the fetus with this possibility

in mind.

P 191 se

Skin Edema in First Trimester Fetuses

N. Jenewein, C. Lattrich, D. Allgayer, V. Holschbach, O. Ortmann,

U. Germer

Klinik f€ur Frauenheilkunde und Geburtshilfe Am Caritaskrankenhaus

St. Josef, Universit€at Regensburg, Regensburg/DE

Purpose: The aim of this study was to prove the association between

generalized skin edema and the nuchal translucency thickness (NT)

and its predictive value for aneuploidy and structural anomalies.

Material & Methods: We included all fetuses with detailed first

trimester scan between 11 and 14 weeks of gestation with an NT above

2.2 mm from our data bank since 2004. Statistical significance was

calculated with Chi-squared test (p , 0.05).

Results:A total of 212 fetuses with a median CRL of 69.4 mm (range:

40-84 mm) and NT of 3.1 mm (range: 2.3-14.2 mm) were included;

19.8% presented with skin edema and 21.2% had aneuploidy. The

rate of skin edema was 3.9% in the group with NT between the 95

and 99th percentile, 15.8% with NT of 3.5-4.4 mm, 46.2% with NT

of 4.5-5.4 mm, 55.5% with NT of 5.5-6.4 mm and 95.5% with NT

above 6.5 mm. The rate of aneuploidy was significantly higher in the

group with skin edema (59.5%) compared to those without (11.8%)

(p 5 0.0001). 12.0% fetuses with normal karyotype had structural

anomalies. The rate of anomalies was significantly higher in the group

with skin edema (30.0%) compared to those without (9.5%) (p5 0.02).

Of 17 fetuses, 9 with skin edema and normal karyotype were born

alive.