Analysis of secondary ultrasound markers in the first trimester before chorionic villus sampling

Abstract

Assessment of secondary ultrasound markers is feasible in clinical practice and their use could reduce the number of unnecessary invasive procedures by 30%.

Screening performance for trisomy 21 comparing first trimester combined screening and a first trimester contingent screening protocol including ductus venosus and tricuspid flow

“…We found that inclusion of the markers in a contingent screening set up can reduce the number of women who are screened positive by the combined screening strategy. This is in accordance with a number of reports from similar studies . In the majority of the published work the study populations are small subpopulations often with high risk for trisomy 21.…”

“…This first trimester combined screening strategy is associated with a detection rate of about 90% for a false positive rate of 5% . Several authors have studied ductus venosus flow and tricuspid flow as additional ultrasound markers for trisomy 21 . Fetuses with trisomy 21 more often have abnormal ductus venosus blood flow and/or abnormal tricuspid flow (tricuspid regurgitation) compared with euploid fetuses.…”

Likelihood Ratios to Apply for Nasal Bone, Ductus Venosus and Tricuspid Flow at the 11-13 Weeks' Scan in Down Syndrome Screening

“…Regarding the expanded combined test, an improved screening efficacy has been reported in previous studies, obtaining both an increased DR and a reduced FPR (10-29%) [15,25]. In our series, only the addition of DV or NB ± DV to the combined test resulted in a reduction of FPR by about one fourth (25-29%), similar to that reported in a previous study [14]. Concerning the contingent screening approach, in our series the use of DV ± TF resulted in a significant 42% FPR reduction (from 6.9 to 4.0%) with a marginal DR increase.…”

“…They can be concurrently assessed in all pregnancies (expanded combined test), or sequentially in selected pregnancies, with either lower (stepwise sequential screening) or intermediate risk (contingent screening) [11,12,13]. Typically these additional markers may decrease the false positive rate resulting from the combined test [14,15]. …”

First Trimester Tricuspid Regurgitation: Clinical Significance

“…Screening for fetal anomalies earlier and more accurately will be the goal in the future [ 88 - 90 ]. Bearing this objective in mind, the evaluation of secondary ultrasound markers is essential [ 91 ]. Visualization of tricuspid blood flow in the first trimester is possible in most cases [ 49 ].…”