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

Abstract

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

Ultrasound Patterns in the First Trimester Diagnosis of Congenital Heart Disease

“…The table we constructed based on our observations of color doppler flow patterns of individual types of CHD can serve to orient the examiner to the most likely type of CHD. We chose to analyze images from two transverse planes: the four-chamber plane and the three-vessel and trachea plane, to comply with the recent AIUM recommendations [ 15 ]. These images offer valuable information about the four chambers of the heart, the two ventricles and two atria, the tricuspid and mitral valves, and the great arteries at the base of the heart, the aorta and pulmonary trunk [ 1 , 19 , 20 , 21 ].…”

“…While the technique used for the ultrasound examination of the fetal heart in the second trimester is clearly described and standardized [ 1 , 24 , 25 , 26 ], the technique for ultrasound examination of the fetal heart in the first trimester has been less defined [ 27 ]. Only recently, the AIUM issued a guideline recommending the use of the four-chamber and the three-vessel and trachea views to screen for CHD in the first trimester of pregnancy [ 15 ].…”

“…Very recently, the AIUM (American Institute of Ultrasound in Medicine) published a guideline recommending the use of the four-chamber and the three-vessel and trachea views to screen for CHD in the first trimester of pregnancy [ 15 ]. Presently, there is limited information on the appearance of the four-chamber and the three-vessel and trachea views in cases of specific structural cardiac anomalies in the first trimester.…”

First trimester examination of fetal anatomy: clinical practice guideline by the World Association of Perinatal Medicine (WAPM) and the Perinatal Medicine Foundation (PMF)

“…Adopting an anatomical protocol with standard sonographic views also seems associated with higher detection rates for fetal structural anomalies, [18] even if different protocols have been described in the literature. [5,15,16,[45][46][47][48] In 2013, a comprehensive first-trimester anatomic protocol has been proposed [48] combining the data from four different studies, [49][50][51][52] suggesting a list of fetal structures to be evaluated in the first trimester, and briefly describing their normal appearance, with only a few details about the methodology to obtain an adequate ultrasound evaluation. Moreover, the same guideline remarked that the second-trimester scan remains the standard of care for fetal anatomical evaluation.…”

Applications of Advanced Ultrasound Technology in Obstetrics

“…ISUOG and recently, AIUM published the practice guidelines on first-trimester fetal ultrasound scan [ 24 , 25 ]. High-resolution ultrasonography allows the early assessment of fetal anatomy [ 11 ] ( Figure 5 a–d, Video S5a,b ) and fetal malformations [ 12 ].…”