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Objective To compare prenatal findings, associated genetic anomalies and postnatal outcome in fetuses with tetralogy of Fallot (TOF) with normal cardiac axis (CAx) and those with abnormal CAx. Methods In this retrospective cohort study, 85 cases diagnosed with TOF by prenatal ultrasound at our clinic between 2005 and 2015 were reviewed. Follow-up ultrasound and postnatal outcome were available for 68 cases. One case complicated with absent pulmonary valve syndrome and a further seven cases diagnosed postnatally with anomalies other than TOF were excluded from the study. The remaining 60 cases of postnatally confirmed TOF were divided according to CAx into two groups: those with normal CAx (n = 33) and those with abnormal CAx (n = 27). CAx was defined as the angle between the interventricular septum and midline of the fetal thorax at the level of the four-chamber view. CAx > 65° or

Objective This study aims to compare completion rates and reproducibility of myocardial performance index (MPI) using conventional spectral Doppler versus tissue Doppler in an unselected high-risk third trimester population.Study Design This was a prospective cross-sectional study of high-risk pregnancies at ≥28 + 0 weeks’ gestation. Conventional spectral and tissue Doppler MPI of the left ventricle (LV) and right ventricle (RV) was attempted on all patients.Results Seventy-nine pregnancies were evaluated. LV tissue Doppler MPI was completed more frequently than LV conventional spectral Doppler MPI (63/79, 79.7% vs. 45/79, 55.7%), p-value Conclusion Tissue Doppler had statistically higher completion rates than conventional spectral Doppler, including the obese subgroup, with evidence of strong reproducibility in the third trimester.

772 Maternal death in the maternal-fetal medicine unit cesarean registry Lea Porche, Ibrahim Hammad, Malgorzata Mlynarczyk, James Hill, Bonnie Dattel, Suneet Chauhan Eastern Virginia Medical School, Obstetrics and Gynecology, Norfolk, VA OBJECTIVE: The primary purpose was to describe maternal death (MD) in the Maternal-Fetal Medicine Units (MFMU) Network Cesarean Registry; secondary purposes compared MD between African American (AA) vs. Caucasian (C); and MD vs. 24 hours after delivery. STUDY DESIGN: This is a secondary analysis of prospectively collected data for MFMU. Medical problems included asthma, cardiac, renal or connective tissue disease, chronic hypertension (HTN), or pregestational diabetes. Obstetric complications included abruption, gestational HTN, preeclampsia, eclampsia, HELLP, chorioamnionitis, or placenta accreta. Fisher exact test with approximation of Woolf or odd ratio (OR) with 95% confidence intervals (CI) was used. RESULTS: Of 73,257 births, there were 37 MD (50/100,000 births). All were singletons, 8% were 20 years old, 38% were nulliparous, and 41% were obese (body mass index 30 kg/m). Modes of delivery were: 57% primary cesarean, 35% repeat, and 8% trial of labor after cesarean. While 68% had no prior medical problems, 46% had no obstetric complications. The 3 leading initiating events for MM were hypertensive disease (32%), infection (16%) and cesarean delivery (16%); the 3 leading causes of death were cardiopulmonary arrest (43%), amniotic fluid embolism (13%) and intracranial hemorrhage (11%). The perinatal mortality was 81/1000 births. Maternal mortality rate among AA (79) was higher than C (44) but similar (OR 0.55; 95%CI 0.25, 1.20). Other factors did not differ significantly. Almost half of maternal deaths (49%) were 24 hours of delivery. Comparison of those who died vs. 24 hours of birth differed significantly for ethnicity (p 0.009) and ICU admission (28% vs. 63%, respectively; OR 0.16; 95% CI 0.04, 0.69). Other factors were not significantly different. CONCLUSION: Despite the small sample size, this prospectively collected database provides reliable data on the rate as well as causes of maternal death related to cesarean delivery in the US. Futures studies that include data from non-tertiary centers are needed.