Does transvaginal ultrasound at 13–15 weeks improve anatomic survey completion rates in obese gravidas?

Toscano, Marika; Grace, Daniel; Pressman, Eva; Thornburg, Loralei L.

doi:10.1080/14767058.2019.1618825

Cited by 8 publications

(13 citation statements)

References 34 publications

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“…6,7,22 A promising alternative assessment protocol involves late first-trimester transvaginal ultrasound (15 AE 1 weeks) in combination with routine transabdominal ultrasound in the second trimester. 16,[23][24][25] Although study samples have been relatively small compared to the literature on ultrasound delays, this stepwise approach has resulted in anatomy completion rates of 78% to 90% for general anatomy and 96% for cardiac anatomy. 15,16,24 This approach has an advantage over delaying the assessment, in that it allows for earlier detection and counseling of fetal anomalies for pregnancies with obesity.…”

Section: Discussionmentioning

confidence: 99%

“…A promising alternative assessment protocol involves late first‐trimester transvaginal ultrasound (15 ± 1 weeks) in combination with routine transabdominal ultrasound in the second trimester . Although study samples have been relatively small compared to the literature on ultrasound delays, this stepwise approach has resulted in anatomy completion rates of 78% to 90% for general anatomy and 96% for cardiac anatomy .…”

Section: Discussionmentioning

confidence: 99%

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Delay of Fetal Anatomy Ultrasound Assessment Based on Maternal Body Mass Index Does Not Reduce the Rate of Inadequate Visualization

Khaikin

Bishop

Munawar

et al. 2020

J of Ultrasound Medicine

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Objectives-To determine whether delay of initial anatomy ultrasound based on the maternal body mass index (BMI) reduces the rate of inadequate visualization compared to standard timing at 18 0/7 to 19 6/7 weeks. Methods-A retrospective study of singleton anatomy assessments was conducted at a tertiary care center in the 2-year period before (A, 2012-2014) and after (B, 2014-2016) protocol initiation. Assessments in period B were scheduled on the basis of the BMI in the first trimester: lower than 25 kg/m 2 , 18 0/7 to 19 6/7 weeks; 25 to 29.9 kg/m 2 , 19 0/7 to 20 6/7 weeks; 30 to 34.9 kg/m 2 , 20 0/7 to 21 6/7 weeks; 35 to 39.9 kg/m 2 , 21 0/7 to 22 6/7 weeks; and 40 kg/m 2 or higher, 22 0/7 to 23 6/7 weeks. In period A, assessments were scheduled between 18 0/7 and 19 6/7 weeks. The rate of inadequate visualization and repeated assessments in periods A and B were compared. Multivariable logistic regression, per-protocol, and BMI subgroup analyses were completed. Results-In total, 3491 pregnancies in period A and 3672 in period B were included. In period B, 74% were scheduled per protocol; however, this rate decreased for higher-BMI categories (52% for BMI ≥40 kg/m 2). The inadequate visualization rate was slightly higher in period B versus A (16.9% versus 15.0%; P = .03) and exceeded 35% for a BMI of 40 kg/m 2 or higher, with or without delay. After adjusting for maternal age and fetal presentation, period B had small increased odds of inadequate visualization versus period A (adjusted odds ratio, 1.2; 95% confidence interval, 1.02-1.38). Repeated assessment rates were similar in periods B and A (14.0% versus 13.1%; P = .25). Conclusions-In pregnancies with obesity, a protocol delaying the initial assessment beyond 19 6/7 weeks based on the maternal BMI does not reduce the rate of inadequate visualization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Delay of Fetal Anatomy Ultrasound Assessment Based on Maternal Body Mass Index Does Not Reduce the Rate of Inadequate Visualization

Khaikin

Bishop

Munawar

et al. 2020

J of Ultrasound Medicine

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“…This was also shown by Toscano at al. who compared the effectiveness of the first and second trimester anatomical assessment in women with a BMI > 35 kg/m2 [35]. Fetal anatomic survey was completed in 62 % using the second trimester assessment versus 78 % with the addition of early transvaginal assessment.…”

Section: Obesitymentioning

confidence: 99%

“…Dies wurde auch von Toscano at al. gezeigt, die den Erfolg der anatomischen Beurteilung im ersten und zweiten Trimester bei Frauen mit einem BMI > 35 kg/m2 verglichen haben [35]. Die anatomische Untersuchung des Feten konnte bei 62 % der Frauen im 2.…”

Section: Adipositasunclassified

Ten reasons why we should not abandon a detailed first trimester anomaly scan

Kagan

Tercanli²,

Hoopmann

2021

Ultraschall Med

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“…Other conditions possibly affecting the pregnancy/fetus, including: a. Maternal body mass index of 30 kg/m 2 or higher. [53][54][55] b. Placental implantation covering the internal cervical os under a cesarean scar site or cesarean scar pregnancy diagnosed in index gestation. 56,57 Specifications of the Examination…”

Section: Request For the Examinationmentioning

confidence: 99%

AIUM Practice Parameter for the Performance of Detailed Diagnostic Obstetric Ultrasound Examinations Between 12 Weeks 0 Days and 13 Weeks 6 Days

2020

J of Ultrasound Medicine

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This practice parameter is intended to provide the medical ultrasound community with recommendations for the performance and recording of high-quality ultrasound examinations. The parameter reflects what the AIUM considers the appropriate criteria for this type of ultrasound examination but is not intended to establish a legal standard of care. Examinations performed in this specialty area are expected to follow the parameter with recognition that deviations may occur depending on the clinical situation.This specialized diagnostic examination is an extension of the standard sonographic fetal assessment described in the AIUM-ACR-ACOG-SMFM-SRU Practice Parameter for the Performance of Standard Diagnostic Obstetric Ultrasound Examinations and the American College of Obstetricians and Gynecologist practice bulletin Ultrasound in Pregnancy. 1,2 The detailed obstetric ultrasound examination in the late first trimester is an indication-driven examination for women at increased risk for fetal or placental abnormalities that are potentially detectable between 12 weeks 0 days and 13 weeks 6 days' gestation. Performance and interpretation of this examination require advanced training, knowledge, and imaging

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Does transvaginal ultrasound at 13–15 weeks improve anatomic survey completion rates in obese gravidas?

Cited by 8 publications

References 34 publications

Delay of Fetal Anatomy Ultrasound Assessment Based on Maternal Body Mass Index Does Not Reduce the Rate of Inadequate Visualization

Delay of Fetal Anatomy Ultrasound Assessment Based on Maternal Body Mass Index Does Not Reduce the Rate of Inadequate Visualization

Ten reasons why we should not abandon a detailed first trimester anomaly scan

AIUM Practice Parameter for the Performance of Detailed Diagnostic Obstetric Ultrasound Examinations Between 12 Weeks 0 Days and 13 Weeks 6 Days

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