17th World Congress on Ultrasound in Obstetrics and Gynecology Poster abstracts P47.04 Diagnosis of major fetal malformations in type 1 and type 2 diabetic women in a large multi-ethnic region in the UK N. Shah , P. Brydon, C. Shuter, P. McGeown, J. Gardosi West Midlands Perinatal Institute, United Kingdom Aims: To document the types of major fetal malformations present in pre-gestational diabetic women in pregnancy and the rate of antenatal diagnosis by second trimester ultrasound. Methods: Pre-gestational diabetes was defined as either type 1 or type 2 diabetes which had been diagnosed at least 1 year before the mothers estimated date of delivery (EDD). Data was collected any time from booking to delivery between 1 March 2002 and 28 February 2003, and followed through to include the outcome of the baby at 28 days postnatally. Major anomalies were coded according to the 10th revision of the International Classification of Diseases (ICD10). Results: The major congenital malformation rate is 82.1/1000 births. There were 29 major congenital anomalies in pregnancies beyond 16 weeks’ gestation and all of these had a second trimester fetal ultrasound scan. In 17 cases the anomalies were diagnosed antenatally (16 by ultrasound and 1 by amniocentesis) and in 12 cases the scan was reported as normal. Therefore the antenatal major congenital malformation detection rate is 59% in pregnancies beyond 16 weeks’ gestation. Congenital cardiac defects remain the most commonly occuring anomalies in diabetic pregnancies (11/29 malformations). Major central nervous system defects, as in the national dataset, are also over-represented. The nature of the anomalies undiagnosed was varied, ranging from hypoplastic left heart to hypospadias. However all of these cases with the exception of a case of facial dysmorphia, hypospadias and two cases of trisomy 21 might have been expected to have been detected by detailed fetal anomaly and cardiac scanning at 20–22 weeks’ gestation. Even allowing for these cases 40% of major malformations were undiagnosed antenatally. Conclusions: All women with pre-gestational diabetes should receive a detailed scan performed by a practitioner with at least UK RCR/RCOG Higher Level Obstetric scanning accreditation. P47.05 Our experience as third level center for prenatal diagnosis A. A. Simionescu , M. D. Teleman, D. Pelinescu-Onciul, R. Radulescu-Botica Filantropia Hospital, UMF Carol Davila, Romania Background: Filantropia hospital is the older maternity in Bucharest, a university hospital as well as a center for prenatal diagnosis. Part of the activities as a university hospital, Filantropia organizes ultrasound courses for obstetricians and sonographers who work in busy departments of obstetrics and obstetric ultrasound in the whole country as well as propose guidelines for prenatal diagnosis. Objectives: To improve the early detection of congenital abnormali- ties. Methods: A retrospective, descriptive study of cases of congenital abnormalities recorded in the hospital register of malformations, between 2004–2006. Results: 7,596 screening ultrasound were performed by six obstetricians with expertise in antenatal sonographic diagnosis of anomalies. Of these, 1.24% were congenital abnormalities which required therapeutic termination of pregnancy. Among the abnormalities detected, the most frequent were the abnormalities of central nervous system, followed by cardiac abnormalities and genetic syndromes. Of total deliveries, the percentage of congenital abnormalities per year of study was : 1.6% in 2004 vs. 1.4% in 2005 and 2006. As compared with the year 2004 when 67.7% of total abnormalities were detected in the third trimester of pregnancy, in 2006 most of them were detected earlier : 28.4% in the first trimester and 52.8% – second trimester. No case of a baby born with Down syndrome was recorded in our hospital during 2006. Conclusion: Following the courses conducted in our center in the last year, we improved the practice to use at least two ultrasound examinations during the first and the second trimester of pregnancy. Our future aim is to develop a proposal with regards to legal termination of pregnancy for congenital abnormalities. P47.06 Diagnosing of fetal anomalies: Jakarta’s experience A. Salim , B. Karsono, G. H. Wiknjosastro, S. Pudyastuti, A. Wibawa, N. Wibowo University of Indonesia, Indonesia Objectives: To evaluate the incidence of fetal anomalies and the type of anomalies mostly found. Method: Database of patient visits to our institution were reviewed from January 2002 until December 2006. All patients were examined by one of five sonographers. In case they found any abnormalities, the doctors in charge verified the findings. The machines we used were Aloka 3500, Medison 8000, Accuvix, Voluson 730 Expert. Either transabdominal or transvaginal probe were used according to the gestational age and accessibility. Result: The total number of patients were examined annually from 2002–2006 : 6840, 6910, 6722, 6832 and 7021. And the num- ber of fetal anomalies 201 (2.93%), 211 (3.05%), 227 (3.37%), 231 (3.38%), 241 (3.43%) respectively. The most frequent organ involved of the fetal anomalies were : (1) central nervous system, (2) multiple anomalies, (3) fetal hydrops, (4) urogenital system, (5) gastrointestinal system, (6) heart anomalies, (7) musculoskeletal sys- tem. Other anomalies such as congenital cystic malformation of the lung, acardiac twins. Conjoined twins and fetal tumors were among the rare cases found in our center. The patients referred mostly by obstetrician around 85%, institution out-patient department 7%, midwives 7%, and the rest from the emergency or labor ward. Discussion: Central nervous system involvement of fetal anomalies were the most frequent cases. In cases of multiple anomalies these usually were syndromic cases. In our institution, most cases of fetal hydrops were due to thalassemia. Conclusion: We report the incidence of fetal anomalies mostly found in our institution which is slightly different compared to most published literature. P47.07 Doctor attitude towards invasive prenatal diagnosis S. Pitukkijronnakorn , J. Manonai, A. Chittacharoen Ramathibodi Hospital, Thailand Objectives: To assess the influence of a doctor’s gender, age group and religion on his/her attitude towards invasive prenatal diagnosis (PND). Methods: All doctors, except Obstetricians and Gynecologists, were surveyed using a structured questionnaire. The questionnaire enquired about demographic information, their knowledge, attitude and experience regarding invasive prenatal diagnosis for themselves, their spouses, relatives, friends, colleagues and patients. Results: Responses from the 289 respondents (male : female, 139 : 150, respectively) revealed that two thirds of respondents knew little about invasive PND. Most males were in the 31–39 year old group. Whereas, those in the female group were ≤ 30 years old. There were no statistically significant differences in both the male and female groups in the recommendation of invasive PND for themselves, their relatives and their patients if indicated. With regard to gender, most of the females in the Buddhist group would terminate their pregnancies if they found major fetal anomalies, and the female group ≤ 30 years old indicated they would terminate their pregnancies if they found minor fetal anomalies. Whereas, the male group, with quite a lot of knowledge about PND would terminate their wives pregnancies if they found either major or minor 634 Ultrasound in Obstetrics & Gynecology 2007; 30: 547–653