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P27.09: Diagnostic accuracy of basic fetal heart examination at 11–13 weeks' gestation of pregnancy

Objectives: To assess the performance of first trimester screening for cardiac anomalies using transabdominal examination with power Doppler of atrioventricular flow and aorto-pulmonary flow without extending the time of exam. Methods: The study was conducted in a retrospective manner in single centre, single operator, GE Voluson E8 ultrasound machine, period 01.01.2015 31.12.2016, 665 patients (615 single, 50 multiple) examined with first trimester screening for chromosomal and fetal structural abnormalities and were without chromosomal anomaly. Results: Good visibility with confident assigning of normal or suspect imaging was obtained in 530 patients (25 multiple). Normal images were obtained in 525. Three were confirmed on later echocardiography and 1 with Fallot pathology was missed. Aspects associated with poor visibility were adiposity, uterine pathology, previous pelvic surgery (including Caesarean), multiple pregnancy and advancing age. 3 major CV anomalies were in this group. For twin pregnancies extension of examination time was necessary in order to acquire interpreting images. In triplets (3) we were unable to have interpreting images for all fetuses using just the transabdominal exam. Conclusions: First trimester cardiac screening for major CV anomalies is feasible. In this rather short series major CV anomalies were more frequent in unsatisfactory images using transabdominal examination. This observation would argue in favour of transvaginal examination in the cases with suboptimal images on transabdominal exam.