Perinatal Journal 2011;19(1):35-50 e-Adress: http://www.perinataljournal.com/20110191009 doi:10.2399/prn.11.0191009 The Conclusion Report of 13th National Perinatology Congress Ayfle Kafkasl›1, Alper Tanr›verdi2, Yeflim Baytur3, Özlem Pata3, Ertan Adal›3, Hakan Camuzcuo¤lu3, Arif Güngören3, ‹lker Ar›kan3 1Head of the Congress, 13th National Perinatology Congress, ‹stanbul Türkiye 2Congress Secretary, 13th National Perinatology Congress, ‹stanbul Türkiye 3Congress Reporter, 13th National Perinatology Congress, ‹stanbul Türkiye The Conclusion Report of 13th The subject of “Fetal Postmortem Examination National Perinatology Congress and Chromosomal Analysis of Abortion Material” 13th National Perinatology Congress was held was presented by Dr. Gülay Ceylaner. According in ‹stanbul Military Museum and Culture Site in to the results of this presentation, postmortem between 13th and 16th April, 2011. examination should be performed on congenital anomalies, intrauterine growth retardation, non- Before the congress, 3 pre-congress courses immune hydrops fetalis, fetal-neonatal death histo- were held on 13th April, 2011. ry of unknown etiology or in fetuses with unknown death reason or maser (high frequency 1. Perinatal Genetic and Postmortem of chromosomal disorder). Findings should cer- Diagnosis Course tainly be recorded during examination, pho- In the first session, Assoc. Prof. Serdar Ceylaner tographs and X-ray should be taken and skin biop- made a presentation about “Basic Genetics and sy should be done. Fetus evaluation is really an Management of Genetic Diseases for the Clinician” easy and convenient examination method. and he explained that chromosomal analysis indi- In the presentation of “Fetal Autopsy: The cations are recurrent gestational losses, intrauterine Influence on Perinatal Mortality”, Prof. Dr. Erdener death, stillbirth of unknown etiology, neonatal Özer emphasized the importance of perinatal death, congenital malformations, suspicious genital autopsy and stated that perinatal autopsy is essen- structure, mental-motor retardation, growth retar- tial for verifying the results of fetal maturity and dation, primary amenorrhea and some secondary diagnostic processes, reviewing clinical approach- amenorrhoea. He also suggested performing chro- es and establishing national perinatal death statis- mosomal analysis if chromosomal disorder was tics. found in previous children, one of the spouses has balanced chromosomal disorder, fetal anomaly is Dr. Nefle Karada¤ specified in her presentation detected in ultrasonographic follow-ups, if there “Placenta: The Importance of Pathological are high risk rates in triple screen test and com- Examination” that evaluating placenta provides bined tests, history of recurrent gestational loss, important information in terms of care and health history of intrauterine and postnatal death of of mother and baby during and after delivery as unknown etiology, and if mosaicism is detected in well as creating medicolegal support in terms of CVS sample during chromosomal analysis study. physician when compared to unexpected fetal or Correspondence: Yeflim Baytur, Celal Bayar Üniversitesi T›p Fakültesi, Kad›n Hastal›klar› ve Do¤um Anabilim Dal›, Manisa, Türkiye e-mail: [email protected] 36 Kafkasl› A et al. The Conclusion Report of 13th National Perinatology Congress maternal results and she emphasized that evaluat- patient’s history and to check some systems more ing placenta is an inseparable part of autopsies for carefully accordingly and he emphasized the fetal and neonatal deaths. importance of systematic evaluation and the use of a check list. It was underlined that at least 20 min- utes should be spared for examination and he sug- 2. Perinatal Ultrasonography Course gested the importance of carrying on physician Assoc. Prof. Yeflim Baytur talked on “Normal training and technical competency of the device. Sonographic Findings in Early Pregnancy” and He also indicated that anomalies could be missed emphasized the importance of determining gesta- even in the best clinics; skeletal system and KVS tional age, viability and chorionicity within first defects were those mostly missed, and CNS and three months. She stated that yolk sac had to be GUS anomalies were those easily detected. He also observed at 5th week and fetal heart beat had to remarked following topics: be observed when the sac reached 25 mm. She emphasized that some of fetal anomalies such as a. The evaluation of fetal biometry, placenta anencephaly and omphalocele can be detected and amnion fluid, and the systematic and she also said that fetal anatomy should be paid screening of fetal anatomy should be per- attention. She indicated that week 14 should be formed. waited for heart screening and that anencephaly, b. If necessary, Doppler ultrasonography omphalocele and Dandy-Walker can not be diag- should be included. nosed before 11th week. c. During systematic evaluation of the anatomy, “Fetal Anatomical Examination in 11-14 Weeks orbitas on face, lips, nasopalatine, fetal pro- Gestation” was presented by Prof. Dr. Yakup Erata. file, extremities, 4 cardiac chambers, major By the developed technique and the perinatology vessel outlets, 3 vessel images, falx cerebri being a sub-branch, it was begun to do anatomical on central nervous system, ventricular sys- evaluation in earlier weeks and therefore ultra- tem, posterior fossa, choroids plexuses, sonographic imaging became important. stomach, bladder, diaphragm and kidneys “Fetal Chromosomal Anomaly Markers in 11-14 should be checked. Weeks Gestation” was explained by Prof. Dr. d. Indications such as heart anomaly of Down Turgay fiener. He stated that the major anomalies syndrome, duodenal atresia that may be among sonographic identifiers that may cause seen at 2nd trimester should be paid atten- chromosomal anomalies were anatomical defects tion. such as omphalocele, megacystitis, holoprosen- In the same session, Prof. Dr. Lütfü Öndero¤lu cephaly, and that the tests such as NT measure- emphasized in his presentation “Which Fetal ment, nasal bone, ductus venosus, and tricuspid Anomalies Should Not Be Overlooked in the regurgitation should be used for screening purpos- Second Trimester?” that there is confusion about es. Though it is known that chromosomal anomaly who should perform the ultrasonographic evalua- risk increases as maternal age increases, it was tion due to the increase in medicolegal events and remarked by him that it is possible to decrease stated that there is 60% chance to detect in ultra- invasive tests performed and to increase Down sonography and expectation of patient should not Syndrome diagnoses detected by various screening be raised. He expressed that all those normally to strategies. The importance of training was empha- be checked between 18th and 22nd weeks could sized and it was also stated that it should certainly be possibly found in all books and internet, and be certified for effective use of screening tests. everybody who got ultrasonography training can On the session of second trimester, Prof. Dr. perform standard and detailed ultrasonography. Alper Tanr›verdi made a speech about “Fetal He noted that regular care of devices, reporting Anatomical Examination in the Second Trimester”. and image recording should be provided, and It was stated that the examination was done from obese patients should be registered. He stated that the point of fetal anatomy during ultrasonography 83% of lethal anomalies were detected; however, evaluation and it was important to question we can detect 54% of lethal anomalies such as Perinatal Journal 2011;19(1):35-50 37 hypoplastic heart and 90% of renal agenesia, but gestational week. He indicated that intervillous lethal musculoskeletal anomalies can be missed. blood flow can be measured by 3D and it can be He pointed out that the actual problem is in babies utilized in hypoxic cases. He also gave information with serious morbidity and chance of living. He about placental anomalies. It was talked about pla- expressed that neural tube defects, hydrocephaly, cental tumors, chorioangioma and placental complex heart abnormalities, abdominal anterior infarcts. Though placental calcifications are accept- wall defects, diaphragmatic hernia, small intestine ed as physiological, it was asked to pay attention obstructions and bladder extrophies should be that they may be the indication of infections at detected (and also they can be missed). early pregnancy. It was stated that there may be Assoc. Prof. Dr. Ebru Tar›m presented the hyperechoic image at 0th-48th hours in ablatio pla- “Anomalies that can be detected during late preg- centae, isoechoic image at 3rd-7th days, hypoe- choic image at 1st-2nd weeks and anechoic image nancy period” and she stated that anomaly can after 2nd week. It was emphasized that umbilical become apparent at 3rd trimester (diaphragmatic vessels blocks servical channel at vasa praevia, it is hernia) though it exists at 2nd trimester since frequent at velamentous insertion, and membrane anomaly appears lately and there is a pause in the rupture and abnormal bleeding may occur if not development of anatomical structure (micro- diagnosed. It was underlined that inferior uterine cephalia). It was said that normal anatomic devel- segment is formed at 28th week at placenta prae- opment continues during pregnancy and some via diagnosis and therefore it should not be diag- anomalies such as central nervous system anom- nosed before this week. It was expressed that alies may arise late. It was emphasized