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P04.08: Serpentine‐like syndrome in a fetus presenting with abnormal median diaphragmatic hernia

Objectives: Analyse the prenatal diagnosis, management and long term prognosis of fetal abdominal cystic masses. Methods: Retrospective analysis of fetal abdominal hipoecogenic cystic masses diagnosed in prenatal ultrasound imaging for the last three years (January 2016-December 2018) in a terciary centre. Ultrasound pathological images were stored and reviewed by two expert sonographers. All infants were examined at birth and followed up by pediatricians with abdominal ultrasound. Results: Out of 5451 fetus analysed, there were 85 cases of fetal toraco-abdominal hipoecogenic masses at gestational ages ranging from 12-37 weeks of gestation. 8 of them (9.41%) were cysts located in the abdomen (2 mesenteric, 1 intestinal duplication cyst, 1 liver, 3 ovarian, 1 adrenal, 1 pancreas annulare with double bubble sign). All of them were isolated findings except for the hepatic cyst that was assiciated with ascitis, liver calcifications and a meconial peritonitis syndrome, that resolved spontaneously. The diagnosis was confirmed postnatally in all cases. In the period of follow up (6 months2 years, N: 6) only two of the babies needed surgery: one anexectomy for a growing ovarian cyst at 6 moths of live and one new born decompression of the duodenum of the pancreas annulare. Conclusions: Fetal abdominal cysts are relatively uncommon. Isolated cases have a good prognosis. However, ultrasound follow up is needed in all cases postnatally to confirm the diagnosis and discard possible complications.