OP18.11: Prenatal diagnosis and follow-up of fetal vascular ring: OP18.11: Prenatal diagnosis and follow-up of fetal vascular ring

To study the clinical significance of prenatal diagnosis and follow-up of fetal vascular ring by fetal echocardiography, MRI and genetics tests. 95 pregnant women (aged 21–39 yr, in 22–35 gestation week) diagnosed with fetal vascular ring by fetal echocardiography (GE Voluson E8) were studied. MRI (Siemens Syngo Aera1.5) were performed in 31 cases, chromosome screenings in 72 cases, whole genome sequencing in 5 cases. Prenatal and postnatal ultrasound follow-ups were regularly performed. The incidence of fetal vascular ring was 0.39% in our centre, about 7.0% of detected total cardiovascular anomalies. Isolated vascular rings were detected in 66 cased, while VSD,TOF, DORV, single ventricle deformity were detected accompanied with fetal vascular ring in other 29 cases. Tracheal compressions with luminal stenosis were detected by ultrasound and MRI in 5 cases and 4 cases, respectively. The stenosis rates were all less than 30%. 4 cases of Trisomy 21 were detected by chromosome screening. 1 cases of gene sequence anomaly with molecular cell karyotype 46, XY, del (22) (q11.21, 2.57Mbp) was detected by genome sequencing. In the 95 cases, 53 fetuses were born, among them 2 fetuses died after birth (one with gene sequence abnormalities, another with DORV and pulmonary artery stenosis), 2 fetuses had underwent surgical operation (with TOF or VSD), 2 fetuses had a slight wheeze after birth, but gradually disappeared in 1 month. In other cases, 9 cases have not yet been born, 6 cases have lost follow-up and pregnancy have been terminated in 27. Isolated fetal vascular rings was more often than those accompanied with other cardiovascular malformation. The most common accompanied malformation was TOF. Combined application of ultrasound and MRI can improve the detection rate of mild tracheal compression. Fetal vascular ring with high risk of chromosome and gene abnormalities. Regular follow-up during gestation period and after birth by ultrasound can help to assess the severity or development and choose treatment for vascular ring.