TY - JOUR
TI - Challenges in sonographic detection of fetal major structural abnormalities at the first trimester anomaly scan
AU - Iliescu, D.
AU - Cara, M.
AU - Tudorache, S.
AU - Antsaklis, P.
AU - Ceausu, I.
AU - Paulescu, D.
AU - Novac, L.
AU - Cernea, N.
AU - Antsaklis, A.
JO - Donald School Journal of Ultrasound in Obstetrics and Gynecology
PY - 2015
VL - 9
TODO - 3
SP - 239-259
PB - Jaypee Brothers Medical Publishers (P) Ltd
SN - null
TODO - 10.5005/jp-journals-10009-1411
TODO - Article;  central nervous system disease;  color Doppler flowmetry;  congenital heart malformation;  counseling;  diagnostic accuracy;  diagnostic imaging;  diagnostic value;  fetus disease;  fetus heart;  first trimester pregnancy;  genetic analysis;  gestational age;  good laboratory practice;  heart ventricle septum defect;  human;  karyotype;  M mode echocardiography;  meta analysis (topic);  obstetric ultrasound transducer;  patient safety;  perinatal period;  practice guideline;  prenatal screening;  second trimester pregnancy;  sensitivity and specificity;  skill;  spontaneous abortion;  study design;  transabdominal echography;  transvaginal echography;  ultrasound scanner
TODO - First-trimester (FT) ultrasound examination appears to have a very good sensitivity in the detection of fetal abnormalities, especially when an extended protocol that is achievable with reasonable resources of time, personnel and ultrasound equipment, is used. It has been shown that the efficiency of the routine anomaly scan varies widely between the studies performed both in early or mid-pregnancy. The analysis of technique and study designs reveals that in each gestational age, the extension of the investigational protocol is the most important factor in modulating the detection rate. Moreover, the use of similar basic checklists at the FT and second trimester (ST) examinations revealed comparable anomaly detection rates in large population groups. First trimester combined test have been demonstrated as a useful screening tool for genetic syndromes and consecutively the FT ultrasound scan became a routine examination in most prenatal diagnostic centers. Its performance in structural abnormalities detection has been communicated in high-, medium-risk populations or unselected low-risk variable number of patients and compared to the ST anomaly scan effectiveness. A detailed first-trimester anomaly scan using an extended protocol is an efficient screening method to detect major fetal structural abnormalities in lowrisk pregnancies. It is a method that it is feasible at 12 to 13 + 6 weeks with ultrasound equipment and personnel already used for routine first-trimester screening. Rate of detection of severe malformations is greater in early- than in mid-pregnancy and on postnatal evaluation. Early heart investigation could be improved by an extended protocol involving use of color Doppler. © 2015, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved.
ER -