11–14 October 2015, Montr´ eal, Canada Oral communication abstracts additional information affecting prognosis and/or counselling in 22.2% (4/18) of CNS anomalies; 3) 2DUS, 3DUS and MRI had similar sensitivity to diagnose non-CNS anomalies; 4) specificity was higher for 3DUS [MRI 85.6% (77/90), 3DUS 94.4% (85/90), 2DUS 92.2% (83/90), McNemar’s test: MRI vs. 3DUS p = 0.03, MRI vs. 2DUS p = 0.13, 2DUS vs. 3DUS p = 0.48]; 5) confidence to exclude subtle CNS findings by MRI was lower than confidence to diagnose abnormalities that were actually present. Conclusions: MRI was more sensitive than ultrasonography and provided additional information that changed prognosis, counselling or management in 22.2% of fetuses with CNS anomalies. False-positives for subtle CNS findings were higher by MRI. OC11.07 Towards automating the ISUOG ‘‘six-step basic ultrasound’’ scan M.A. Maraci 2 , C. Bridge 2 , J.A. Noble 2 , C. Aye 1 , M. Molloholli 1 , R. Napolitano 1 , A.T. Papageorghiou 1 1 Nuffield Department of Obstetrics and Gynecology, University of Oxford, Oxford, United Kingdom; 2 Department of Engineering Science, University of Oxford, Oxford, United Kingdom Objectives: Due to a global shortage of trained sonologists, it is important to develop simple but accurate scan protocols for the detection of pregnancy risks. Recent work has suggested a six-step protocol for basic fetal ultrasound (US) suitable for resource-constrained settings. Here we report progress towards automating the first two steps: detection of the fetal presentation and viability. We have approached this problem by combining the simple clinical protocol with machine learning solutions. Methods: Transabdominal 2D fetal US video clips were acquired to construct a database of 3806 fetal skull and 1237 heart frames from pregnant women participating in the Oxford arm of the INTERBIO-21st study (www.interbio21.org). The simple protocol involved a sweep starting maternal suprapubic area to the uterine fundus over 6–8 seconds. Data acquisition was carried out using a Philips HD9 machine with a V7-3 transducer. Machine learning techniques were utilised to detect structures of interest (fetal skull and heart activity in this case) in each video frame. Detecting the fetal skull in the first third of the video sequence indicates the fetus is in a cephalic presentation. Detecting cardiac activity patterns in a continuous video subsection of heart frames indicated that the fetus is viable. Results: Automatic head and heart frame detection were possible with an average accuracy of 98% and 88% respectively in all the videos obtained through our proposed protocol. Conclusions: We have proposed a framework to automate the first 2 steps of the six-step basic ultrasound scan, which couples simple scanning protocols with image analysis methods designed to extract pre-defined information from video sequences. Our database contained ultrasound data from live pregnancies only, so we could only confirm the presence of heart motion patterns in all scans. Future work is needed to expand to the other four steps; and include analysis of data from fetuses without fetal heart activity. OC11.08 Estimation of the cerebral metabolic rate of oxygen (CMRO 2 ) in the human fetus J. Neelavalli 1,2 , E.A. Hernandez-Andrade 3,4 , B. Yadav 1,2 , P. Jella 1,2 , U. Krishnamurthy 1,2 , L. Yeo 3,4 , S. Mody 1,4 , M. Cabrera 1 , E. Haacke 1,2 , S. Hassan 3,4 , R. Romero 4 1 Department of Radiology, Wayne State University, Detroit, MI, USA; 2 Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA; 3 Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA; 4 Perinatology Research Branch, NICHD, NIH, Detroit, MI, USA Objectives: The cerebral metabolic rate of oxygen (CMRO 2 ) is a robust measure used to differentiate between normal and damaged brain tissue in neonates and adults. The objective of this study was to estimate the CMRO 2 in the normal human fetus using quantitative measurements obtained from MRI and Doppler ultrasound (DUS) and to compare such values with those of neonates. Methods: Normal third trimester fetuses underwent both MRI and DUS. The CMRO 2 was calculated as: CBF (cerebral blood flow rate in ml/min/100 g) x OEF (oxygen extraction fraction in %) x Ca (oxygen carrying capacity of fetal blood). CMRO 2 was calculated based upon two approaches: 1) Method A: OEF obtained from MR blood oximetry and CBF from Doppler velocimetry of the middle cerebral artery, were used to estimate CMRO 2 in eight fetuses ([mean GA; ±SD]; 31.3 ± 4 weeks); 2) Method B: OEF and CBF were both obtained from fetal MRI data using a novel phase-contrast sequence and MR blood oximetry, respectively, in four fetuses at (mean GA; ±SD) 36.6 ± 2.4 weeks of gestation. Results: The estimated CMRO 2 using the two methods is presented in table 1. The CBF obtained from Doppler velocimetry of the middle cerebral artery (Method A) was similar to previously reported values; however, the CMRO 2 values were much higher than those reported in neonates. For Method B, the CMRO 2 was similar to previously reported values in normal neonates at term. Conclusions: We report for the first time the estimation of CMRO 2 in the human fetal brain using quantitative measurements derived from MRI and Doppler ultrasound. This parameter has promise to assess the metabolic status of the fetal brain. OC11.08: Table 1. CBF (ml/min/100 g) OEF (%) CMRO 2 (ml O 2 /min/100 g) Method A (mean, SD) 115.4 (57.4) 36.7 (11.5) 6.8 (3.2) Method B, (mean, SD) 30.0 (14.3) 29.5 (14.7) 1.7 (1.0) Previously reported values in neonates (mean, SD) 14.9 (4.9) 36.1 (8.2) 0.9 (0.43) CBF, Cerebral blood flow; OEF, oxygen extraction fraction: CMRO2, cerebral metabolic rate of oxygen. OC12: CONGENITAL HEART DISEASE OC12.01 Basic heart: feasibility of a simplified routine fetal echocardiography in the first trimester of pregnancy E. Quarello 1 , A. Lafouge 3 , N. Fries 2 , L.J. Salomon 4 1 Hˆ opital St Joseph/IMR, Marseille, France; 2 CFEF, Montpellier, France; 3 Cabinet M´ edical, Hyeres, France; 4 Hˆ opital Necker, Paris, France Objectives: The evaluation of the fetal heart in the first trimester of pregnancy differs in a low and in high-risk population. We aimed to evaluate the feasibility of achieving routinely a ‘‘basic’’ fetal echocardiography in low-risk population by trained operators. Methods: We conducted a national ‘‘flash study’’ (2 weeks time) on the feasibility of a simplified fetal echocardiography (basic heart examination) in the first trimester of pregnancy. Each sonographer was asked to try and achieve a simplified fetal echocardiography without modifying the time and the method they deemed necessary for the realisation of their examination. Basic heart assessment consisted of carrying through the use of colour and/or directional energy Doppler a four chamber (4C) and a three vessels and trachea (3VT) views. The feasibility of achieving those views was analysed Ultrasound in Obstetrics & Gynecology 2015; 46 (Suppl. 1): 1–53. 25