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REPORT FROM ISUOG CONGRESS
IN SYDNEY 2013
To Mai Xuan Hong

Dr. To Mai Xuan Hong

1
1st trimester assessment of aneuploidy
• US markers
–
–
–
–

NT, NB, Facial angle
Doppler of DV (a-wave)*
Doppler of tricu...
1st trimester assessment of aneuploidy

Dr. To Mai Xuan Hong

3
1st trimester assessment of aneuploidy
• Oral presentations
– Screening for adverse pregnancy outcomes at 12ws
(Audibert, ...
1st trimester assessment of growth and Doppler
• Crown-rump length measurement
• Increased Uterine artery Doppler indices ...
1st trimester assessment of growth and Doppler
• Oral presentations
– Assessment of crown-rump length measurement variabil...
2nd trimester assessment
• Ratio of prenasal thickness (PT) and nasal bone length (NBL) (Down
syndrome)
• Fetal facial sha...
2nd trimester assessment

Dr. To Mai Xuan Hong

8
2nd trimester assessment
• Oral presentations
– The prenasal thickness to nasal bone length ratio: 2D versus 3D ultrasound...
IUGR: detection and management
• Late-onset IUGR = SGA+(EFW<P3, Abnormal
MCA-UtA-UA)
– Poor outcome (neonatal morbility)
–...
IUGR: detection and management
• Oral presentations
– Are all late-onset IUGR the same? (E Gratacos)
– Clinical lessons fr...
Cervical assessment
• Preterm delivery
– Intra-amniotic sludge

• Induction of labor
– TVS assessment
– Comparison of funn...
Cervical assessment
• Oral presentations
– Intra-amniotic sludge observed at cervical ultrasound
and the risk of preterm d...
Fetal neurosonography
• Probst Bundle
– Agenesis of the corpus callosum

• Pericallosal lipoma
– Shows in 3rd trimester
– ...
Fetal neurosonography
• Oral presentations
– Disorders of axonal guidance as visualised by fetal MRI
(D Prayer)
– Perivent...
IOTA classification
(International Ovarian Tumor Analysis)

• Main IOTA model

Dr. To Mai Xuan Hong

16
Dr. To Mai Xuan Hong

17
Simple rule for identifying a benign or malignant tumor

Dr. To Mai Xuan Hong

18
Simple rule for identifying a benign or malignant tumor

Dr. To Mai Xuan Hong

19
IOTA classification
(International Ovarian Tumor Analysis)

• Oral presentations
– Predictive value of subjective assessme...
Thank you!

Dr. To Mai Xuan Hong

21
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Report from ISSUOG CONGRESS, SYDNEY, 2013

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Report from ISSUOG CONGRESS, SYDNEY, 2013

  1. 1. REPORT FROM ISUOG CONGRESS IN SYDNEY 2013 To Mai Xuan Hong Dr. To Mai Xuan Hong 1
  2. 2. 1st trimester assessment of aneuploidy • US markers – – – – NT, NB, Facial angle Doppler of DV (a-wave)* Doppler of tricuspid valve* Intra-cranial translucency (IT)* • Biochemical markers – Fß-hCG and PAPP-A • Non-invasive prenatal test (NIPT) – Decision of invasive test in the intermediate risk (<1/10-1/1000 followed CFTS) Dr. To Mai Xuan Hong 2
  3. 3. 1st trimester assessment of aneuploidy Dr. To Mai Xuan Hong 3
  4. 4. 1st trimester assessment of aneuploidy • Oral presentations – Screening for adverse pregnancy outcomes at 12ws (Audibert, Francois) – Combined first trimester biochemistry, NIPT or both? (Johnson, Jo-An) – Sequencing for NIPT: techniques, technologies, applications and limitations (Johnson, Jo-An) – First trimester screening for neural tube defect (Meaghen, Simon) Dr. To Mai Xuan Hong 4
  5. 5. 1st trimester assessment of growth and Doppler • Crown-rump length measurement • Increased Uterine artery Doppler indices (PI > 90th or 95th centile) associated with – Reduced fetal movement – Superimposed pre-eclampsia – SGA < 10th centile – SGA < 3rd centile – Still birth • Low PAPP-A level (<0.3 MoM) or both of PAPP-A and free ß-hCG (<0.5MoM) – related to poor placentation (low birth weight and still birth) Dr. To Mai Xuan Hong 5
  6. 6. 1st trimester assessment of growth and Doppler • Oral presentations – Assessment of crown-rump length measurement variability (McLennan, Andrew) – Clinical evaluation of a first trimester algorithm predicting the risk of hypertension disease of pregnancy (Park, Felicity) – First trimester screening of pregnancy complication (Hyett, Jon) – Assessment of 1st trimester uterine artery pulsatility index in Hongkong Chinease pregnant women(Sahota, Daljit) – Pulsatility index of the uterine arteries between 11 and 13.6 weeks: comparison of measurement by transvaginal and transabdominal Doppler ultrasound (Cafici, Daniel) – Reduced fetal movement at term association to first trimester uterine artery Doppler assessment (G Pagani) – Reduced fetal movement at term: association to first trimester PAPP-A level (G Pagani) – Outcomes in cases of low PAPP-A and free ß-hCG in maternal serum at 1st trimester screening (Deloison) Dr. To Mai Xuan Hong 6
  7. 7. 2nd trimester assessment • Ratio of prenasal thickness (PT) and nasal bone length (NBL) (Down syndrome) • Fetal facial shape – Facial height (FH) and facial width (FW) (FH/FW ratio) – Forehead assessment (Profile line) (Down syndrome) • Short femur length associated with – Chromosomal abnormalities – SGA – Early preterm delivery • Increased 2nd trimester uterine artery Doppler indices (> 90th centile) associated with placental dysfunction) • Femoral metaphyseal-epiphyseal angle (> 130◦ in achondroplasia) • Asymptomatic short cervix length is a predictor of intra-amniotic inflammation Dr. To Mai Xuan Hong 7
  8. 8. 2nd trimester assessment Dr. To Mai Xuan Hong 8
  9. 9. 2nd trimester assessment • Oral presentations – The prenasal thickness to nasal bone length ratio: 2D versus 3D ultrasound (E de Jong) – Fetal facial shape: 3D study of height and width in the 2nd and 3rd trimester of pregnancy (A De Boagent) – Forehead assessment in normal and pathological fetuses by the fetal profile line (E de Jong) – Outcome of fetuses with short femur length detected at 2nd trimester malformation scan: a national survey (JM Mathiesen) – Reduced fetal movement at term: association to second trimester uterine artery Doppler assessment (G Pagani) – Femoral metaphyseal-epiphyseal angle: a new prenatal ultrasound finding in achondroplasia (A Khalil) – Non-invasive prediction of intra-amniotic infection and/or inflammation in patient with cervical insufficiency or an asymptomatic short cervix (<15mm) (E Jung) Dr. To Mai Xuan Hong 9
  10. 10. IUGR: detection and management • Late-onset IUGR = SGA+(EFW<P3, Abnormal MCA-UtA-UA) – Poor outcome (neonatal morbility) – Possible choosing an induction • TRUFFLE study (Trial of Umbilical and Fetal Flow in Europe) – Decision the best timing of delivery in preterm pregnancies complicated IUGR – Surveillance test: CTG, UA and DV Doppler • Aortic intima-media thickness (aIMT) (> 0.8mm) – Higher SBP and glomerular dysfuction Hong Dr. To Mai Xuan 10
  11. 11. IUGR: detection and management • Oral presentations – Are all late-onset IUGR the same? (E Gratacos) – Clinical lessons from the TRUFFLE study (C Bilardo) – The use of charts in detecting late-onset IUGR (A Papageorghiou) – Prenatal scale for cardiovascular risk in IUGR (E Cosmi) Dr. To Mai Xuan Hong 11
  12. 12. Cervical assessment • Preterm delivery – Intra-amniotic sludge • Induction of labor – TVS assessment – Comparison of funneling, length and Bishop’s score Dr. To Mai Xuan Hong 12
  13. 13. Cervical assessment • Oral presentations – Intra-amniotic sludge observed at cervical ultrasound and the risk of preterm delivery (F. Audibert) – Sonographic funneling of uterine cervix as predictor for success of labor induction (E Kim) – Pre and post-ripening sonographic assessment of cervix for predicting successful induction of labor (M Cordoba) Dr. To Mai Xuan Hong 13
  14. 14. Fetal neurosonography • Probst Bundle – Agenesis of the corpus callosum • Pericallosal lipoma – Shows in 3rd trimester – Increased echogenicity in corpus callosum – Invisualised corpus callosum • MRI in conjunction with US – www.fetalmri2014.org ( 15-20 Mars 2014, Canada) Dr. To Mai Xuan Hong 14
  15. 15. Fetal neurosonography • Oral presentations – Disorders of axonal guidance as visualised by fetal MRI (D Prayer) – Periventricular leukomalacia in fetus: prenatal imaging and diagnostic features (D Pugash) – US volume navigation with fusion MRI imaging: a novel approach for prenatal diagnosis (G Malinger) Dr. To Mai Xuan Hong 15
  16. 16. IOTA classification (International Ovarian Tumor Analysis) • Main IOTA model Dr. To Mai Xuan Hong 16
  17. 17. Dr. To Mai Xuan Hong 17
  18. 18. Simple rule for identifying a benign or malignant tumor Dr. To Mai Xuan Hong 18
  19. 19. Simple rule for identifying a benign or malignant tumor Dr. To Mai Xuan Hong 19
  20. 20. IOTA classification (International Ovarian Tumor Analysis) • Oral presentations – Predictive value of subjective assessment, IOTA simple rule, IOTA logistic regression model 1 (LR1), Alcazar’s GI-RAD model and risk of malignancy (RMI) model in the preoperative discrimination of adnexal mass (A Czekierdowski) – The additive value of HE4 novel tumor marker to the IOTA simple rules in the management of ovarian masses (B Erdoli) Dr. To Mai Xuan Hong 20
  21. 21. Thank you! Dr. To Mai Xuan Hong 21

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