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The fetal nasal bone (NB) was measured by ultrasound in 16346 pregnant women with singleton euploid fetuses at 16-38 weeks of gestation from January 2010 to December 2019. The distribution of fetal nasal bone length (NBL) from 16-38 weeks of gestation was established and 5th and 2.5th centiles calculated for each gestational age (GA). The purpose of this study was to update previously established Indian reference for normal fetal nasal bone length from 16 to 38 weeks of gestation and compare our nomogram to other ethnicities. [Extracted from the article]

Introduction: Twin reversed arterial perfusion (TRAP) sequence is a phenomenon seen in 1-3% of monochorionic twin pregnancies, where the acardiac fetus is found to have multiple anomalies. The normal pump twin maintains its own perfusion in addition to that of its acardiac co-twin. As a result, if the acardiac twin increases in size, the burden on the pump twin is increased, leading to cardiac failure, hydrops fetalis, polyhydramnios, premature delivery, and perinatal death. The outcome of pregnancy is largely dependent on the growth of the acardiac twin. In view of high perinatal loss, surgical techniques to interrupt the blood flow to the acardiac twin have been evaluated.Methods: We evaluated interstitial laser therapy, which is the main mode of therapy in our unit, of TRAP pregnancies referred over a 5-year period. Interstitial laser was offered if the blood flow in the acardiac twin was found to be persistent at 2 consecutive examinations or if there were cardiac or hydropic changes in the pump twin at the first examination.Results: A total of 18 cases of TRAP were referred during this period and all were counselled regarding fetal therapy if the situation were to deteriorate; 5 couples (27.7%) opted for termination of pregnancy; of the remaining 13, 7 (53.8%) agreed to perform intervention following confirmation of a normal karyotype. Six (85.7%) and 1 (14.3%) lasers were performed in the second and third trimesters, respectively; all 7 had a normal outcome of the pump twin. There were 6/13 (46.2%) in the expectant group who continued the pregnancy with no intervention, with 2 term live births (33.3%).Conclusions: Our study confirms that there is a high risk of spontaneous loss in untreated pregnancies with TRAP, primarily due to polyhydramnios and fetal hydrops. In the pregnancies that underwent interstitial laser, there was a more favourable outcome. Interstitial laser is minimally invasive, safe, and feasible in experienced hands. [ABSTRACT FROM AUTHOR]

Among 17 fetuses with DVA with other associated structural defects, 1 had a cardiac, 7 had extracardiac, 9 had both cardiac and extracardiac defects. To evaluate and prognosticate fetuses diagnosed to have ductus venosus agenesis (DVA). [Extracted from the article]

All the fetuses were categorised into 5 groups according to NT > 95th centile and outcomes were summarised in the table. To assess the presence of fetal aneuploidies, structural defects, fetal loss and delivery of a normal live baby in fetuses with Nuchal Translucency (NT) above the 95th percentile at the 11 SP +0 sp -13 SP +6 sp week scan Methods This is a retrospective study from a single tertiary fetal care centre in South India from August 2009 to December 2019. [Extracted from the article]

In G1, 11/18 (61.1%) with known karyotype had aneuploidies (9 Trisomy 21, one Trisomy 18 and one 13) and in G2, 2/14 (14.2%) had Trisomy 21. 42 (97.7%) had balanced,1 (2.3%) had an unbalanced cAVSD in G1.43 (76.8%) and 13 (23.2%) fetuses in G2 had balanced and unbalanced cAVSD respectively. Commonest additional cardiac defect was obstructive outflow tract lesions and extracardiac defects involved brain, urinary tract, and limbs in both the groups. To assess the prevalence of chromosomal, cardiac and extracardiac abnormalities in fetuses with complete atrioventricular septal defect (cAVSD). [Extracted from the article]

Prevalence of cardiac defect in fetuses with NT between 95-99th centile was 8/110 (7.3%), between 3 and 3.9 mm was 19/256 (7.4%), between 4 and 4.9 mm was 9/50 (18%), between EP17.25: Table 1. To analyse the prevalence of cardiac defects according to the nuchal translucency (NT) thickness measured at the 11 SP +0 sp -13 SP +6 sp weeks' scan in euploid fetuses. [Extracted from the article]

This article discusses a study conducted in a fetal care center in South India on fetuses with Fetal aberrant right subclavian artery (ARSA). The aim of the study was to determine the presence or absence of additional soft markers, structural and/or chromosomal anomalies, and postnatal outcomes in these fetuses. The study analyzed 559 fetuses and found that 16.8% had additional soft markers, 17.2% had associated anomalies, and 66% had no other anomalies/markers. The most common additional soft markers were EIF, nuchal edema, and hypoplastic nasal bone. The study concludes that ARSA is an important soft marker for chromosomal anomalies, and once other markers and anomalies are excluded, the prognosis for these babies appears to be excellent. [Extracted from the article]

To study the predictive value of different abdominal circumference (AC) cut-offs for low birthweight (LBW) < 5th centile for gestational age at delivery in structurally normal and euploid fetuses in a South Indian population. Conclusions Our study confirms that prediction by fetal AC < 3rd centile for LBW < 5th centile has the relatively highest detection rate of 56.3%. Fetal AC cut-offs of < 3rd, 5th and 10th centile were compared to predict LBW of < 5th centile for the gestational age at delivery as an isolated marker. [Extracted from the article]

Results 204 fetuses with CTEV, including 15 from 14 twin pregnancies were evaluated. To evaluate the antenatal association and postnatal prognosis of congenital talipes equinovarus deformity (CTEV). [Extracted from the article]

34 (40.5%) had a longitudinal bladder diameter (LBD) between 7-15 mm (G1) and 50 (59.5%) had an LBD of equal or more than 16 mm (G2). All fetuses with diagnosis of 1st trimester megacystis must be categorised according to the LBD and offered karyotyping. To study the incidence of associated anomalies and assess the possibility of spontaneous resolution according to the longitudinal bladder diameter (LBD) in fetuses with megacystis. [Extracted from the article]

To evaluate the association of genetic, extracardiac anomalies and postnatal outcome of fetuses with prenatal diagnosis of tetralogy of Fallot (ToF). With comprehensive post-natal cardiac care 75% of euploid, isolated ToF had favourable outcomes. [Extracted from the article]

Background: Multifetal pregnancies are considered high-risk pregnancies compared to singleton pregnancies. Monochorionic diamniotic (MCDA) twin pregnancies tend to have a more complicated intrauterine course than their dichorionic counterparts. The most common complications are twin-to-twin transfusion syndrome (TTTS), selective fetal growth restriction (sFGR), and unexplained intrauterine fetal demise (IUFD). Early recognition of pregnancies at risk of developing complications will be helpful for counselling the parents and preparing them for necessary interventions in case a complication arises.Objectives: The aim of our study was to assess the role of discordant crown-rump length (dCRL), discordant nuchal translucency (dNT), and discordant abdominal circumference (dAC) measurements in isolation and in combination at the 11-13+6 weeks' scan in predicting the development of TTTS, sFGR, and IUFD.Methods: All MCDA twin pregnancies with structurally normal, both live fetuses at the 11-13+6 weeks' scan were followed up by FMF (Fetal Medicine Foundation)-certified operators for development of TTTS, sFGR, and single/double IUFD until delivery. Discordance of CRL, NT, and AC of more than or equal to 10% was considered a "marker," and its presence was correlated with the occurrence of specific antenatal complications, i.e., TTTS, sFGR, and single or double IUFD.Results: Combination of two markers predicted MCDA-related complications in the majority of cases (70.8% positive predictive value). Combination of dNT and dAC was the strongest predictor (80% positive predictive value).Conclusions: In our population of MC twin pregnancies, dCRL, dNT, and dAC at the 11+0-13+6 weeks' scan, in isolation, had a low predictive value for antenatal complications, i.e., TTTS, sFGR, and single/double IUFD. However, the presence of at least two markers in the first trimester could predict complications in the majority of these pregnancies. The combination of dNT and dAC appears to be the best. [ABSTRACT FROM AUTHOR]

Introduction: Peak systolic velocity (PSV) of the middle cerebral artery (MCA) shows 100% sensitivity for predicting fetal anemia before the first intrauterine transfusion (IUT). However, its ability to predict subsequent transfusions has remained mostly controversial.Objectives: To assess if there is a need to change the threshold of MCA-PSV from 1.5 to 1.69 multiples of the median (MoM) to predict fetal anemia and the need for subsequent IUT.Methods: This is a retrospective audit, wherein case records of mothers who underwent IUT at the Bangalore Fetal Medicine Centre between April 2008 and May 2017 were reviewed; 86 cases were included, and the data were analyzed using MS Excel. The MCA-PSV and pretransfusion Hb were converted into MoM. 40 fetuses that had more than 1 IUT were included in the analysis. -Results: 31/40 fetuses that had >1 IUT had an MCA-PSV >1.5 MoM, of which 29 were anemic according to the post-IUT Hb MoM. 20/29 (69%) had an MCA-PSV >1.69, whereas 9/29 (31%) had an MCA-PSV between 1.5 and 1.69 MoM. Our study shows that changing the MCA-PSV threshold from 1.5 to 1.69 MoM will reduce the detection of fetal anemia and hence the need for repeat IUT by 31%.Conclusions: Increasing the fetal MCA-PSV threshold from 1.5 to 1.69 will miss out one-third of the fetuses that will require a 2nd, 3rd, or 4th IUT. This is more relevant in geographical areas where the parents must travel long distances for IUTs, which are performed in tertiary fetal care centers. [ABSTRACT FROM AUTHOR]

OP06.08: Prediction of single and double fetal loss by discordancy in CRL, NT and AC at the 11+0-13+6 week scan in dichorionic and monochorionic twin pregnancies Results 658 twin pregnancies with double live, euploid & structurally normal fetuses were studied, of which 535(81.3%) were DC &123(18.7%) were MC. To assess the significance of discordant Crown-rump length (dCRL), discordant nuchal translucency (dNT) & discordant abdominal circumference (dAC) between twins, in isolation & in combination at the 11 SP +0 sp -13 SP +6 sp weeks' scan in predicting single & double fetal loss. [Extracted from the article]