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tion with normal presentation. However, hydrocephalus of fetus was incidentally found by sonography at 37 weeks gestation. Level II Sonography revealed BPD of 10.07 cm with bilateral ventriculo- megaly. Under the impression of hydrocephalus and macrocephaly of fetus, Cesarean section was arranged. The male baby was delivered and weighing 2700 gm with large head circumstance noted (36 cm). Post- natal MRI revealed hemorrhage of right germinal matrix, hemorrhage with diffuse IVH, SAH, cisternal compartmentation and resultant hy- drocephalus. 3414 Various prenatal sonographic findings of normal and abnormal fetal genitalia Jung SI, Cho JY, Moon MH, Lee YH, Kim J-A, Song MJ, Min JY, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Korea Advances in prenatal US now enable one to diagnose first trimester gender. Also, gender assignment has significant clinical implications in fetus at risk for x-linked diseases as hemophilia, Duchenne’s muscular dystrophy. Ambiguous genitalia are seen as a component of chromo- some anomaly as trisomy 13, triploidy, 13q syndrome. Structurally abnormal genitalia may occur as single malformation, or as compo- nents of congenital or inherited syndromes. We demonstrate normal sonographic fetal genital development as gestational age, abnormal male genital malformations as hypospadia, penile chordee, hydrocele, undescended testes, urethral valve, urethral atresia and abnormal fe- male genital malformations as clitomegaly, hydrometrocolpos, recto- vestibular fistula with imperforate anus, ovarian cyst with or without torsion. This sonographic acknowledge for fetal genitalia can be helpful in diagnosis and prenatal counseling of gender specific fetal anomalies. 3415 Nephro-amniotic shunt therapy in fetal obstructive uropathy Cho YK, Kim MY, Chung JH, Yang JH, Cho JY, Lee YH, Han SW, Dept. of Obstetrics and Gynecology, Samsung Cheil Hospital and Women’s Healthcare Center, Sungkyunkwan University School of Medicine, Korea; Dept. of Radiology, Samsung Cheil Hospital and Women’s Healthcare Center, Sungkyunkwan University School of Medicine, Korea; Dept. of Urology, Severance Hospital, Yonsei University College of Medicine, Korea Due to the widespread use of obstetric ultrasound an increasing number of congenital malformations are diagnosed prenatally. Some of these can be treated in utero. The use of nephro-amniotic shunt in the case of obstructive uropathy was described. A 27-week old fetus with a pos- terior urethral valve was diagnosed due to a dilated bladder, bilateral hydronephrosis and oligohydramnios. An ultrasonically guided left nephro-amniotic shunt was successfully placed in utero at 29 weeks of gestation in order to prevent development of dysplastic kidneys and hypoplastic lungs. He was born in good condition without any bio- chemical features of renal damage as well as signs of hypoplastic lung. Transurethral valvotomy was performed 4 weeks postnatally. The 4-month old infant is now well and has normally functioning kidney. 3416 Measurement of transverse cerebellar diameter in assessment of fetal growth restriction by 24 weeks of gestation Park S-H, Gachon Medical School Gil Medical Center, Korea Objectives: In cases of growth restriction, the cerebellum is the least affected parameters. The purpose of this study was to evaluate the prediction of fetal growth restriction and perinatal outcomes using transverse cerebellar diameter (TCD) at 24 weeks of gestation. Methods: Between January 1998 and October 2005, ultrasonographic measurements including head circumference (HC), abdominal circum- ference (AC), TCD and TCD/AC ratio from 313 fetuses at 24 weeks gestation when was performed level II ultrasonographic evaluation during gestation. We produced the normal range of TCD at 24 weeks and assessed fetal growth and perinatal outcomes according to the percentiles for TCD values (fifth, 10th, 50th, 90th and 95th). And we compared the validity of TCD and TCD/AC to predict the fetal growth restriction and adverse pregnancy outcomes. Results: The 50th percentile of TCD at 24 weeks of gestation was 2.67 cm in our study. Below fifith percentile of TCD, there was increased fetal growth restriction, and adverse perinatal outcomes compared with above fifth percentile of TCD (p 0.05); and between TCD/AC ratio and TCD, there was no significant difference to predict the fetal growth restriction. Conclusions: Reduced TCD in second trimester are suspicious fetal growth restriction and adverse perinatal outcomes. 3417 Ultrasound findings of fetal gastrointestinal tract obstruction Yi BH, Park S-J, Lee H-K, Lee Y-H, Lee K-H, Kim T-H, Soonchunhyang University Bucheon Hospital, Korea; Samsung Cheil Hospital, Korea Fetal gastrointestinal tract obstruction is relatively common in fetal GI anomalies. Sonographic abnormalities of the fetus with GI obstructions usually definite in third trimester except few conditions such as duo- denal atresia. Knowing second trimester and third trimester US findings of fetal GI obstruction can help early diagnosis of anomalies and making postnatal treatment plan. We would like to present typical and minute clue US findings of fetal GI obstruction with postnatal radio- logic images. 3418 Fetal blood flow preceding intrauterine demise Nishihara R, Motohisa C, Tahara M, Nishimoto S, Tachibana D, Yamamasu SI, Iwanaga N, Nishio J, Nakai Y, Ishiko O, Osaka City University, Graduate School of Medicine, Japan; Izumi-otsu Municipal Hospital, Japan Only few report the consecutive observation of fetal flow pattern until fetal demise. We report here a case of intra-uterine growth restriction resulting in fetal death whose blood flow pattern was closely moni- tored. A 28-primiparous woman was diagnosed intra-uterine growth restriction at 20 gestational weeks. Ultrasonographic examination failed to detect any remarkable structural anomalies. The estimated fetal weight remained at 330 to 350 g, instead of repeated fetometry until fetal death at 28 weeks. Interruption of fetal growth and severe oligohydramnios (amniotic pocket 1 cm) were observed 41 and 10 days before fetal death, respectively. Absent or reversed end-diastolic flow patterns of umbilical artery and umbilical venous pulsations were preceded 31 and 27 days. But, a pulsatile reversed flow of umbilical vein appeared only 2 days before the death. Nevertheless, absent or reversed end-diastolic flow pattern of umbilical artery is well-known as alarm signs, which might appear several weeks before fetal death. 3419 Application of three-vessel view in the diagnosis of fetal complex congenital heart disease Zhou Q, Second Xiangya Hospital, China Objectives: The purpose of this study was to investigate the clinical significance of the echocardiographic diagnosis with three-vessel view in fetal complex congenital heart disease. Abstracts P261

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tion with normal presentation. However, hydrocephalus of fetus wasincidentally found by sonography at 37 weeks gestation. Level IISonography revealed BPD of 10.07 cm with bilateral ventriculo-megaly. Under the impression of hydrocephalus and macrocephaly offetus, Cesarean section was arranged. The male baby was delivered andweighing 2700 gm with large head circumstance noted (36 cm). Post-natal MRI revealed hemorrhage of right germinal matrix, hemorrhagewith diffuse IVH, SAH, cisternal compartmentation and resultant hy-drocephalus.

3414

Various prenatal sonographic findings of normal and abnormalfetal genitaliaJung SI, Cho JY, Moon MH, Lee YH, Kim J-A, Song MJ, Min JY,Samsung Cheil Hospital, Sungkyunkwan University School ofMedicine, Korea

Advances in prenatal US now enable one to diagnose first trimestergender. Also, gender assignment has significant clinical implications infetus at risk for x-linked diseases as hemophilia, Duchenne’s musculardystrophy. Ambiguous genitalia are seen as a component of chromo-some anomaly as trisomy 13, triploidy, 13q syndrome. Structurallyabnormal genitalia may occur as single malformation, or as compo-nents of congenital or inherited syndromes. We demonstrate normalsonographic fetal genital development as gestational age, abnormalmale genital malformations as hypospadia, penile chordee, hydrocele,undescended testes, urethral valve, urethral atresia and abnormal fe-male genital malformations as clitomegaly, hydrometrocolpos, recto-vestibular fistula with imperforate anus, ovarian cyst with or withouttorsion. This sonographic acknowledge for fetal genitalia can be helpfulin diagnosis and prenatal counseling of gender specific fetal anomalies.

3415

Nephro-amniotic shunt therapy in fetal obstructive uropathyCho YK, Kim MY, Chung JH, Yang JH, Cho JY, Lee YH, Han SW,Dept. of Obstetrics and Gynecology, Samsung Cheil Hospital andWomen’s Healthcare Center, Sungkyunkwan University School ofMedicine, Korea; Dept. of Radiology, Samsung Cheil Hospital andWomen’s Healthcare Center, Sungkyunkwan University School ofMedicine, Korea; Dept. of Urology, Severance Hospital, YonseiUniversity College of Medicine, Korea

Due to the widespread use of obstetric ultrasound an increasing numberof congenital malformations are diagnosed prenatally. Some of thesecan be treated in utero. The use of nephro-amniotic shunt in the case ofobstructive uropathy was described. A 27-week old fetus with a pos-terior urethral valve was diagnosed due to a dilated bladder, bilateralhydronephrosis and oligohydramnios. An ultrasonically guided leftnephro-amniotic shunt was successfully placed in utero at 29 weeks ofgestation in order to prevent development of dysplastic kidneys andhypoplastic lungs. He was born in good condition without any bio-chemical features of renal damage as well as signs of hypoplastic lung.Transurethral valvotomy was performed 4 weeks postnatally. The4-month old infant is now well and has normally functioning kidney.

3416

Measurement of transverse cerebellar diameter in assessment offetal growth restriction by 24 weeks of gestationPark S-H, Gachon Medical School Gil Medical Center, Korea

Objectives: In cases of growth restriction, the cerebellum is the leastaffected parameters. The purpose of this study was to evaluate theprediction of fetal growth restriction and perinatal outcomes usingtransverse cerebellar diameter (TCD) at 24 weeks of gestation.

Methods: Between January 1998 and October 2005, ultrasonographicmeasurements including head circumference (HC), abdominal circum-ference (AC), TCD and TCD/AC ratio from 313 fetuses at 24 weeksgestation when was performed level II ultrasonographic evaluationduring gestation. We produced the normal range of TCD at 24 weeksand assessed fetal growth and perinatal outcomes according to thepercentiles for TCD values (fifth, 10th, 50th, 90th and 95th). And wecompared the validity of TCD and TCD/AC to predict the fetal growthrestriction and adverse pregnancy outcomes.Results: The 50th percentile of TCD at 24 weeks of gestation was 2.67cm in our study. Below fifith percentile of TCD, there was increasedfetal growth restriction, and adverse perinatal outcomes compared withabove fifth percentile of TCD (p � 0.05); and between TCD/AC ratioand TCD, there was no significant difference to predict the fetal growthrestriction.Conclusions: Reduced TCD in second trimester are suspicious fetalgrowth restriction and adverse perinatal outcomes.

3417

Ultrasound findings of fetal gastrointestinal tract obstructionYi BH, Park S-J, Lee H-K, Lee Y-H, Lee K-H, Kim T-H,Soonchunhyang University Bucheon Hospital, Korea; Samsung CheilHospital, Korea

Fetal gastrointestinal tract obstruction is relatively common in fetal GIanomalies. Sonographic abnormalities of the fetus with GI obstructionsusually definite in third trimester except few conditions such as duo-denal atresia. Knowing second trimester and third trimester US findingsof fetal GI obstruction can help early diagnosis of anomalies andmaking postnatal treatment plan. We would like to present typical andminute clue US findings of fetal GI obstruction with postnatal radio-logic images.

3418

Fetal blood flow preceding intrauterine demiseNishihara R, Motohisa C, Tahara M, Nishimoto S, Tachibana D,Yamamasu SI, Iwanaga N, Nishio J, Nakai Y, Ishiko O, Osaka CityUniversity, Graduate School of Medicine, Japan; Izumi-otsuMunicipal Hospital, Japan

Only few report the consecutive observation of fetal flow pattern untilfetal demise. We report here a case of intra-uterine growth restrictionresulting in fetal death whose blood flow pattern was closely moni-tored. A 28-primiparous woman was diagnosed intra-uterine growthrestriction at 20 gestational weeks. Ultrasonographic examinationfailed to detect any remarkable structural anomalies. The estimatedfetal weight remained at 330 to 350 g, instead of repeated fetometryuntil fetal death at 28 weeks. Interruption of fetal growth and severeoligohydramnios (amniotic pocket � 1 cm) were observed 41 and 10days before fetal death, respectively. Absent or reversed end-diastolicflow patterns of umbilical artery and umbilical venous pulsations werepreceded 31 and 27 days. But, a pulsatile reversed flow of umbilicalvein appeared only 2 days before the death. Nevertheless, absent orreversed end-diastolic flow pattern of umbilical artery is well-known asalarm signs, which might appear several weeks before fetal death.

3419

Application of three-vessel view in the diagnosis of fetal complexcongenital heart diseaseZhou Q, Second Xiangya Hospital, China

Objectives: The purpose of this study was to investigate the clinicalsignificance of the echocardiographic diagnosis with three-vessel viewin fetal complex congenital heart disease.

Abstracts P261