10–14 October 2010, Prague, Czech Republic Short oral presentation abstracts OP21.07: Table 1 Sensitivity Specificity* LR+ LR− CA 125 Postmenopausal (n = 526) 79.0% (73.5%–83.5%) 88.3% (83.8%–91.6%) 6.73 (4.81–9.42) 0.24 (0.19–0.30) Premenopausal (n = 1228) 75.9% (68.9%–81.8%) 60.5% (57.6%–63.4%) 1.94 (1.72–2.15) 0.39 (0.30–0.52) Sensitivity Specificity* LR+ LR− Ultrasonography Postmenopausal (n = 526) 98.5% (96.1%–99.4%) 76.1% (73.5%–83.5%) 4.13 (3.32–5.12) 0.02 (0.01–0.05) Premenopausal (n = 1228) 95.8% (91.5%–97.9%) 89.5% (87.6%–91.2%) 9.16 (7.66–10.96) 0.05 (0.02–0.09) *McNemar test: P < 0.01. 95% CI in parentheses. OP21.08 The value of pre-operative ultrasound in triaging women with adnexal pathology for advanced laparoscopic surgery D. Alhamdan 1 , T. Bignardi 1 , I. V. Casikar 1 , S. Reid 1 , J. Riemke 1 , M. Mongelli 2 , G. Condous 1 1 Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Nepean Clinical School, University of Sydney, Sydney, NSW, Australia; 2 Women and Children’s Health, Nepean Clinical School, Penrith, NSW, Australia Objectives: We aim to establish the benefit of pre-operative transvaginal scanning (TVS) in predicting the feasibility of advanced laparoscopic adnexal surgery. Methods: This is a prospective ongoing study (July 2006 until April 2010). All women who with a clinical or ultrasound diagnosis of an adnexal cyst were offered a detailed TVS. The adnexal lesions were classified as benign or malignant according to the IOTA pattern recognition method. The size, echogenicity and papillary structures of the mass were noted. An initial ultrasound classification of the mass was made; all benign and borderline lesions were booked for a laparoscopic approach and all malignant lesions were referred to gynaecological oncology for staging laparotomy. Results: 61 women (with 71 adnexal masses, 10 women with bilateral cysts at surgery) to date have been included in the study, 48 premenopausal and 13 postmenopausal. On histological examination, 85.91% (n = 61) of adnexal cysts were benign, 5.64% of cysts (n = 4) were borderline malignancy, 7.04% (n = 5) were primary malignancy and 1.41% (n = 1) was secondary malignancy. The advanced laparoscopic surgery was successfully completed in 56/57 cases. One had a huge hemorrhagic corpus luteal cyst which was delivered by mini-laparotomy. Four women had primary laparotomy for malignancy; one presented with an acute abdomen and a 20 week ovarian mass thought to have torted. Histology demonstrated secondary ovarian malignancy from the colon. The other three were referred to Gynaecology Oncology for a staging laparotomy with total abdominal hysterectomy and bilateral salpingo-oophrectomy for primary ovarian cancer. The pre-operative TVS assessment predicted the successful outcome of advanced laparoscopic surgery with a sensitivity of 75%, specificity of 100%, PPV 99% and NPV 96.2%. Conclusions: Although the numbers are very small, the pattern recognition of ovarian cysts is an essential part of the pre-operative work-up in women planned for laparoscopic adnexal surgery. OP22: FETAL HEART IV: 3D/4D ULTRASOUND OP22.01 Diagnosis of the complicated heart defect from STIC volumes J. H. Dangel 1 , A. Kolesnik 2 1 Perinatal Cardiology, 2 nd Dept. of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland; 2 Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland Objectives: STIC is the modern method for establish fetal heart anatomy. There were several papers to check it as a tool for screening the normal heart. However, its usefulness in cases of heart defects is not well described yet. The aim of our study was to evaluate, if it is possible to diagnose fetal heart defect on the basis just on off-line STIC volumes: 2D, color and high definition color. Methods: 4D volumes with various heart defects were recorded by the first author and evaluated blindly by the second one. The second author did not know any details about pregnancy, he did not the name of the patient and the history. Results: 30 volumes of the following defects: HLHS, TOF, TGA, AP&IVS, heterotaxy syndromes and more complicated were evaluated. The full proper diagnosis was made in 22 cases, in 6 the diagnosis was proper but without some details. In 2 cases the heart defect could not be diagnosed from the volumes due to their poor quality. Conclusions: STIC method can be used for the second opinion of diagnosis complicated heart defect off line. The good quality of the volume is the key for the proper diagnosis. According to our knowledge such blind study to diagnose off-line congenital complicated heart defect from the STIC volume has not been presented yet. OP22.02 Comparison of diagnostic ability of fetal echocardiography with and without 3D/4D ultrasound S. Yagel , S. M. Cohen, B. Messing, M. Lipschuetz, O. Shen, H. Avnet, D. V. Valsky Obstetrics and Gynecology, Hadassah-Hebrew University Medical Centers, Mt. Scopus, Jerusalem, Israel Objectives: We have published studies that showed that application of 3D/4D US modalities can improve certain aspects of fetal echocardiography, but left open the question whether these modalities improved prenatal detection of anatomical fetal cardiac malformations. We aimed to determine whether 3D/4D US improved diagnostic ability of CHD in fetal heart scanning. Methods: Women who booked in for early- or midtrimester targeted organ scans had complete fetal echocardiography according to our 5 planes protocol plus the ductus venosus and longitudinal aortic Ultrasound in Obstetrics & Gynecology 2010; 36 (Suppl. 1): 52–167 115