Comparison of first and second trimester ultrasound screening for fetal anomalies in the southeast region of Sweden

Hildebrand, E. M.; Selbing, Anders; Blomberg, Marie

doi:10.3109/00016349.2010.517307

Cited by 35 publications

(32 citation statements)

References 22 publications

(36 reference statements)

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“…Thirty minutes were allocated for each scan, irrespective of maternal BMI. The details of the scanning procedure and training of the personnel are described elsewhere [16]. …”

Section: Methodsmentioning

confidence: 99%

Maternal Obesity and Detection Rate of Fetal Structural Anomalies

2013

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Objective: To estimate the effects of maternal body mass index (BMI) on the sensitivity of detecting fetal anomalies by a routine ultrasound performed either in the first or in the second trimester. Methods: Unselected pregnant women (n = 19,140) were divided into four BMI groups: underweight (<18.5), normal weight (18.5-24.9, reference group), overweight (25.0-29.9), and obese (≥30.0). Fetal anomaly diagnoses were grouped according to their likely clinical consequences as suggested by the Royal College of Obstetricians and Gynaecologists. Minor anomalies were excluded. The detection rate of fetal anomalies in each BMI group was calculated and compared. Results: The prevalence of infants with structural anomalies in the study population was 4% and the prevalence of material obesity was 10%. The detection rates of fetal structural anomalies were 26% for normal-weight, 29% for overweight (odds ratio (OR) 1.15, 95% confidence interval (CI) 0.68-1.95), and 19% for obese women (OR 0.67, 95% CI 0.29-1.52). The detection rate of anomalies with long-term handicap was lower in the obese group (27.3%; OR 0.44, 95% CI 0.11-1.79) compared to normal-weight women (46.3%). Conclusion: The detection rate of fetal anomalies seems to be lower for obese women, but these findings need to be further investigated.

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“…Thirty minutes were allocated for each scan, irrespective of maternal BMI. The details of the scanning procedure and training of the personnel are described elsewhere [16]. …”

Section: Methodsmentioning

confidence: 99%

Maternal Obesity and Detection Rate of Fetal Structural Anomalies

2013

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“…It is possible to detect about 50% or more major malformations at 11-14 weeks of gestation (Rossi 2013). Further on, the majority of potentially lethal malformations like acrania, lethal skeletal dysplasia, megacystis, encephalocele and body stalk anomaly can be detected in the 11-14 week scan (Hildebrand 2010).…”

Section: F U T U R E P E R S P E C T I V E O F C L I N I C a L I M P mentioning

confidence: 96%

Prenatal diagnosis of structuralmal formations and chromosome anomalies : Detection, influence of Body Mass Index and ways to improve screening

Hildebrand¹

2014

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“…The study reported that this scan led to the diagnosis of around half of cases of double outlet right ventricle, hypoplastic left heart, and transposition of the great arteries, around onethird of cases of atrioventricular septal defect, coarctation of the aorta, tetralogy of Fallot, and pulmonary atresia, but none of the cases of ventricular septal defect, Ebstein anomaly, aortic or pulmonary stenosis, tricuspid atresia, or cardiac tumors. A recent review of the published series with more than 1,000 cases from 1993 to 2008, which included data from 36,237 pregnancies generated by eight centers, suggests that the overall detection rate of major CHD at 11-13 weeks is 29% (95% CI 25-33) [6] . The pooled detection rate of cardiac defects was 17% (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25).…”

Section: Clinical and Research Implicationsmentioning

confidence: 99%

“…Moreover, the detection of fetal CHD in the first trimester is even lower. A review of the published series with more than 1,000 cases from 1993 to 2008, which included data from 36,237 pregnancies generated by eight centers, suggests that the overall detection rate of major congenital anomalies at 11-13 weeks is 29% [6] . The detection rate of CHD in the first trimester has been estimated at around 30% [7] .…”

Section: Introductionmentioning

confidence: 99%

Fetal Tricuspid Regurgitation in the First Trimester as a Screening Marker for Congenital Heart Defects: Systematic Review and Meta-Analysis

Scala¹,

Morlando²,

Familiari³

et al. 2017

Fetal Diagn Ther

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Background: Assessment of tricuspid flow has been reported to improve the performance of screening for aneuploidies and congenital heart defects (CHD). However, the performance of tricuspid regurgitation (TR) as a screening marker for CHD in euploid fetuses is yet to be established. The main aim of this meta-analysis was to establish the predictive accuracy of TR for CHD. Methods: MEDLINE, Embase, and the Cochrane Library were searched electronically utilizing combinations of the relevant medical subject heading for “fetus,” “tricuspid regurgitation,” and “first trimester.” The outcomes explored were prevalence of TR in an euploid population, strength of association between TR and CHD, and predictive accuracy of TR for CHD in euploid fetuses. Summary estimates of sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio for the overall predictive accuracy of TR for the detection of CHD were computed using the hierarchical summary receiver-operating characteristics model. Results: A total of 452 articles were identified; 60 were assessed with respect to their eligibility for inclusion and a total of 4 studies were included in the study. TR was associated with an increased risk of CHD (RR: 9.6, 95% CI 2.8-33.5; I²: 92.7%). The strength of association between TR and CHD persisted when considering fetuses at risk for CHD, such as those with increased nuchal translucency (RR: 7.2, 95% CI 5.2-9.8; I²: 0%), while TR did not show any association with CHD when detected in a population at low risk for cardiac defects (RR: 9.3, 95% CI 0.8-111.8; I²: 93%). The overall diagnostic performance of TR in detecting CHD was poor in detecting CHD (sROC: 0.684, SE: 0.61) with a sensitivity of 35.2% (95% CI 26.9-44.1) and a specificity of 98.6% (95% CI 98.5-98.7). Detection of TR at the 11-14 weeks' scan showed a positive likelihood ratio of 7.2 (95% CI 5.3-9.8) in detecting CHD when applied to a population at risk for CHD such as fetuses with an increased nuchal translucency. Conclusion: The detection of TR in the first trimester increases the risk of CHD. However, isolated TR in the first trimester does not seem to be a strong predictor for CHD.

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Comparison of first and second trimester ultrasound screening for fetal anomalies in the southeast region of Sweden

Cited by 35 publications

References 22 publications

Maternal Obesity and Detection Rate of Fetal Structural Anomalies

Maternal Obesity and Detection Rate of Fetal Structural Anomalies

Prenatal diagnosis of structuralmal formations and chromosome anomalies : Detection, influence of Body Mass Index and ways to improve screening

Fetal Tricuspid Regurgitation in the First Trimester as a Screening Marker for Congenital Heart Defects: Systematic Review and Meta-Analysis

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