20–24 October 2018, Singapore Short oral presentation abstracts OP09.08 Laboratory, ultrasound and pregnancy outcomes among Zika-exposed travellers: initial experience with a centralised testing program B. Stifani, K. Aaron, A. Frisse, S. Klugman, P. Dar Obstetrics, Gynecology and Women’s Health, Montefiore Medical Centre, Albert Einstein College of Medicine, Bronx, NY, USA Objectives: In January 2016, in response to the CDC and NYS health department guidelines, we established a centralised screening, testing and counselling program for all pregnant women with possible travel exposure to Zika virus (ZIKV) infection. We report on ultrasound, laboratory and pregnancy outcome data in the midst of an unclear scenario of possible epidemic. Methods: Retrospective analysis of all pregnant women tested for ZIKV infection between 1/2016-1/2017 through a centralised testing program established within our academic medical centre. All data were collected from electronic medical records. Descriptive statistics were conducted using STATA 11. Results: 504 of 7320 screened (6.8%) had ZIKV testing. Mean age was 29 and 72% were Hispanic. 48% were exposed >14d mostly (76%) in 1st trimester. Only 8% reported ZIKV symptoms. Average end of exposure to testing time was 54d. 14 (3%) tested positive and 11 of them had symptoms. In 2 (14%) head circumference (HC)<2SD was seen in 2 nd trimester which later resolved. 8 (1.6%) had equivocal ZIKV testing and 2 of them had ZIKV symptoms. 2 had abnormal ultrasound findings: One with anencephaly terminated and another had a dysplastic corpus callosum, ventriculomegaly and small cerebellum. The findings were confirmed postnatally. 21 (4.1%) were ZIKV negative but had ultrasound findings that could be attributed to ZIKV. 14 had HC<2SD; one terminated, 3 lost to follow-up, one demise, 6 had normal postnatal scan, 2 had abnormal findings that resolved and one had persistent abnormal development. 7 had other CNS findings: one anencephaly, 2 were lost, 3 had normal postnatal scan and one had persistent abnormal development. 416 (82.5%) had negative testing and normal ultrasound. Pregnancy outcomes were available for 352 (84.6%) and no ZIKV related postnatal abnormalities were reported in this group. Conclusions: The yield of universal ZIKV testing for all travellers to ZIKV endemic areas is poor. The recent change in guidelines rec- ommending testing only symptomatic travellers appears reasonable. OP10: FETAL CARDIAC FUNCTION OP10.01 Perinatal left ventricular torsional mechanics in normal fetuses at term O. Patey 1,2 , J.S. Carvalho 1,2 , B. Thilaganathan 1,3 1 Molecular and Clinical Sciences Research Institute, St George’s University of London, London, United Kingdom; 2 Brompton Centre for Fetal Cardiology, Royal Brompton Hospital, London, United Kingdom; 3 Fetal Medicine Unit, St George’s University Hospital, London, United Kingdom Objectives: Left ventricular (LV) twist and torsion are important aspects of cardiac mechanics and fundamental to normal ventricular function. The myocardial rotational mechanics of perinatal adaptation have never been previously explored. The aim of this study was to evaluate perinatal left ventricular (LV) rotational mechanics in normal fetuses at term. Methods: A prospective study of 40 women with uncomplicated term pregnancies. Fetal and neonatal LV rotation data derived by 2D speckle tracking echocardiography in short axis views at the base and the apex of the heart were obtained days before and within hours of birth. Results: There are three patterns of LV twist in term fetuses, from the lowest torsional values in reversed apex-type, through to infant-type LV twist and highest values in adult-type LV twist. The patterns of LV twist were significantly associated with cardiac geometry and functional indices. The increased right ventricur (RV) dimensions and less globular ‘squashed’ left ventricle were significantly associated (p<0.0001) with an increased negative clockwise basal rotation with both adult-type and reversed apex-type LV twists. Perinatal evaluation revealed two patterns - the infant-type and the adult-type of LV twist - in neonatal heart in the first hours after birth resulting in a significant increase in LV torsion in fetuses exhibiting reversed apex-type LV twist (0.1degrees/cm vs. 2.9degrees/cm, p=0.01) and a significant decrease in fetuses with adult-type LV twist (4.4degrees/cm vs. 1.2degrees/cm, p=0.008) following birth. Conclusions: There are unique perinatal patterns of fetal LV twist that correlate to indices of ventricular geometry and myocardial function. Differences in patterns of LV twist may reflect compensatory myocardial adaptation to the physiological loading conditions of late gestation in fetuses and perinatal cardiac adjustments in neonates. The utility of the specific pattern of LV twist as a diagnostic marker of subclinical changes in fetal and neonatal myocardial performance might be a promising novel tool for monitoring high-risk pregnancies. OP10.02 Fetal TAPSE index (FTI): a novel fetal heart function index B. Messing 1 , M. Lipschuetz 2 , S.M. Cohen 2 , S. Yagel 2 1 Obstetrics and Gynecology, Ma’ayanei Hayeshua Medical Centre, Bnei Brak, Israel; 2 Obstetrics and Gynecology, Hadassah-Hebrew University Medical Centres, Jerusalem, Israel Objectives: Fetal heart functional evaluation enables identification of cardiac and extracardiac disorders, which are reflected in changes in heart function. One of the leading tests for assessing the right heart, which is dominant in the fetus, is f-TAPSE, which is based on motion of the tricuspid valve annulus. Despite its importance, its sensitivity is limited in cases where the heart is larger or smaller than normal. We sought to devise an index that would incorporate an adjustment to the size of the heart, which could, for example, identify fetuses with TAPSE within normal range, but whose enlarged or maldeveloped heart is dysfunctional. Methods: F-TAPSE was obtained for 433 fetuses with no known structural or cardiac functional defects, presenting for booked scans from 11 to 41 weeks’ gestation. In all cases, heart length and width were also measured in the 4CV plane on the pericardium at end diastole: length from the base to the apex, at the front or rear apex; width at the level of the atrioventricular valves. The f-TAPSE result was divided by heart length and by heart width, and both indices plotted against gestational age. In fetuses from 15 weeks, measures were also plotted against estimated fetal weight. Results: Both f-TAPSE divided by heart length and f-TAPSE divided by heart width, were fairly constant during pregnancy with interquartile range of 0.15-0.26 (mean 0.184, ± 0.03). The apex-to-base longitudinal index had the advantage of greater simplicity. It also appears to be more suitable to the right ventricle owing to the normal muscle fibers longitudinal structure and nature of the contraction. Inter- and intra-observer variation was tested on 20 cases by 2 testers for an intraclass coefficient score of 0.8-0.9. This novel metric of f-TAPSE/cardiac length was coined fetal TAPSE index (FTI).  The Authors 2018  Ultrasound in Obstetrics & Gynecology 2018; 52 (Suppl. 1): 66–137. 91