Since 2008, training courses have been conducted in Romania, with the purpose of raising the recognition of congenital heart defects (CHD). Our objective was to detect the main reasons of referral for fetal echocardiography to our tertiary centre, from Targu Mures, Romania and to coroborate them with our sonographic findings. We performed a retrospective study on 717 patients, who were referred to our centre between 2007-2018. We devided this time span into two equal periods of 6 years, namely 2007-2012 and 2013-2018, due to the ongoing training process, and compared them in terms of referral reasons and ultrasonographical findings of the cardiac screening, using Fisher's exact test. We observed an approximately fivefold increase in the number of cases referred for fetal echocardiography between 2013-2018, as compared to 2007-2012 (599 versus 118). In both periods, the main reason for refferal was the suspicion of cardiac anomaly, raised by abnormal cardiac views (71% of cases between 2007-2012, 76% between 2013-2018), followed by failure of fetal cardiac screening (17% between 2007 and 2012, 11% between 2013 and 2018). Arrythmia, isolated (almost 5% in the first period, 4.5% in the second period) or in association with other possible cardiac anomalies (under 2% in both groups) were other important findings which required detailed cardiac imaging. Other indications (<6%) included aneuploidies, intracardiac echogenic foci, maternal diabetes, family history of CHD, extracardiac anomalies and increased nuchal translucency. When compairing the two groups in terms of detection of cardiac anomalies, we obtained a statistically significant, higher depiction rate in the 2013-2018 period (OR = 2.148, CI 95%: 1.261-3.659; p = 0.003). Training of the examiners regarding ultrasonographical cardiac views can lead to a considerable increase in prenatal detection rates, as seen from our study. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Tetralogy of Fallot has many forms and is frequently associated with other fetal malformations. The evaluation of this pathology's variants, the structural anomalies associations and the fetal or neonatal evolution are observed on a series of cases. A series of 18 fetuses were diagnosed with tetralogy of Fallot, through a period of 7 years, in a tertiary centre from Romania. The gestational age at the time of the echocardiography ranged between 21 and 38 weeks. An amniocentesis was performed in 7 fetuses, out of which one had Down syndrome, two had DiGeorge syndrome, while the remaining four fetuses had a normal karyotype. In three of the fetuses, the tetralogy of Fallot had an extreme variant: one case had a pulmonary valve atresia with severe hypoplasia of the pulmonary branches and MAPCA's, the other was diagnosed with severe pulmonary valve stenosis and pulmonary branch hypoplasia (DiGeorge syndrome) and one fetus had an absent pulmonary valve. Other structural anomalies associations were described in 8 fetuses: bilateral pyelectasis in two of the cases (one with Down, the other with an absent inferior vena cava), hypoplastic thymus in two of the fetuses (with Down and DiGeorge syndrome), unique kidney in one fetus (absence of the pulmonary valve), one fetus with early IUGR and unique umbilical artery (normal karyotype), one case with polycystic bilateral kidney and 2 cases with LPSVC (one of them with MAPCA's). Out of the 18 fetuses, four underwent an TOP (the cases with Down, early IUGR, bilateral polycystic kidney and absence of the pulmonary valve). A number of 7 pregnancies came back to our clinic, and the 7 newborns underwent a cardiac evaluation, followed by surgical interventions which included a systemic-pulmonary shunt. An additional MAPCA's was diagnosed after birth. In conclusion the associations between tetralogy of Fallot and other structural anomalies are frequent, and the MAPCA's diagnosis can't always be intrauterinally established. This research was partially supported by the Collective Research Grants of the University of Medicine and Pharmacy Tîrgu Mureş, Romania (“The role of mother's genetic determinism in child's obesity correlated with bioimpedance and anthropometric parameters” no.275/4/11.01.2017).

Introduction: The present study proposes the follow up of intrauterine tracked fetuses with uni-or bilateral pyelectasis. Material and method: In the period April 2006-May 2008 in the Gynecology Clinic I Tg. Mures 27 second trimester pregnancies were tracked with fetuses having uni, bilateral pyelectasis. We followed the increase of pylon dilation, calyx and urinary bladder. Newborns underwent ultrasounds evaluation after birth and at the age of 3-6 months. Results and discussions: In our cohort needed surgical procedures in the first year 5 children (20%), concerning in bilateral nephrostomy, resection of urethral valve and ureterocele resection. Of the 25 infants with hydronephrosis, 11 (44%) had nephrosis of 3(rd) or 4(th) degree. Conclusions: The growth of pyelectasis or fetal hydronephrosis is not a predictive factor for severity of fetal hydronephrosis. Our study emphasizes the importance of fetal pyelectasis disclosure and of tracking the new born during their first life months with regards to preservation of renal functions.