<scp>ISUOG</scp> Practice Guidelines: performance of first‐trimester fetal ultrasound scan

Lj, Salomon; Alfirević, Z̄arko; Cm, Bilardo; Ge, Chalouhi; Ghi, T.; Kagan, K. O.; Tk, Lau; Papageorghiou, Aris T.; Nj, Raine-Fenning; Stirnemann, J.; Suresh, S.; Tabor, Ann; Timor‐Tritsch, I. E.; A, Toi; Yeo, G

doi:10.1002/uog.12342

Cited by 491 publications

(149 citation statements)

References 91 publications

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“…Our study showed that the additional use of a HFLT did not significantly increase the completion rate of basic anatomical screen basing on the ISUOG guidelines on first trimester scan [2] as the completion rate had already been achieved in 95% using a CCT alone, compared with 98% for the combined use of CCT and HFLT (p value = 0.500) ( Table 3). Although the combined use of HFLT and CCT improved successful examination of some optional anatomical structures including lens, three-vessel view, left ventricular outflow tract, umbilical artery and kidneys, the final success rate of cardiac examination was just around 50% which was not high.…”

Section: Discussionmentioning

confidence: 70%

“…Both the basic and optional fetal anatomical structures were examined according to the guidelines of the Fetal Medicine Foundation, London and ISUOG (International Society of Ultrasound in Obstetrics and Gynaecology) for early anomaly scan before 13 + 6 weeks [2].…”

Section: Examination Of the Fetal Structuresmentioning

confidence: 99%

“…In the era of non-invasive prenatal testing (NIPT), all pregnant women should still be offered an ultrasound examination in the first trimester [1] with the benefits of early detection and exclusion of many major anomalies [2]- [4], some of which are either lethal or associated with severe handicap that may warrant the discussion of an earlier and safer termination of pregnancy with the pregnant women [5] [6]. Combining transvaginal approach with transabdominal sonography had increased the successful visualization rate of fetal anatomy from 72% to 86% [7].…”

Section: Introductionmentioning

confidence: 99%

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The Use of a High Frequency Linear Transducer in the Assessment of Fetal Anatomy at the Routine 11 to 13 + 6-Week Scan among Chinese Population

Mak¹,

Kou²,

Poon³

et al. 2015

OJOG

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Objectives: To determine if the use of high frequency linear transducer (HFLT) in addition to conventional curvilinear transducer (CCT) aids assessment of fetal cardiac and non-cardiac anatomy in the first trimester. Methods: Transabdominal CCT (4 -8 MHz) followed by HFLT (9 MHz) was used to study prospectively the visualization rate of basic and optional anatomical structures according to international guidelines. McNemar and Chi-square test were used to compare correlated and independent proportions respectively. Postnatal outcomes were traced. Results: Comparing with CCT alone, additional use of HFLT did not improve the completion rate of basic anomaly screen (95.0% vs. 97.0%, p = 0.5) in the 101 women studied, but it improved the visualization rate of some optional structures including lens (57.4% vs. 73.3%), three-vessel view (3 VV) (17.8% vs. 48.5%), left ventricular outflow tract (17.8% vs. 51.5%), kidneys (8.9% vs. 47.5%), and umbilical artery (86.1% vs. 93.1%) (all p < 0.05). Favourable fetal position was associated with a better visualisation of four-chamber view and 3VV (p < 0.05). Conclusions: Our findings supported that the use of HFLT in addition to CCT does not improve the completion of basic anomaly screen, nor does it achieve a high visualisation rate of different cardiac views in the first trimester.

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Section: Discussionmentioning

confidence: 70%

Section: Examination Of the Fetal Structuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Use of a High Frequency Linear Transducer in the Assessment of Fetal Anatomy at the Routine 11 to 13 + 6-Week Scan among Chinese Population

Mak¹,

Kou²,

Poon³

et al. 2015

OJOG

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“…We also identified 70 specific situations guidelines published between 2002 and 2014. Of these, 91% were from the USA,25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59 UK60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76 and Canada 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88. The remaining were from Australia,89 Brazil,90 Mexico,91 Poland,92 Spain93 and Uruguay 94…”

Section: Resultsmentioning

confidence: 99%

Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care

Ábalos

Chamillard

Díaz

et al. 2015

BJOG

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BackgroundThe World Health Organization (WHO) is in the process of updating antenatal care (ANC) guidelines.ObjectivesTo map the existing clinical practice guidelines related to routine ANC for healthy women and to summarise all practices considered during routine ANC.Search strategyA systematic search in four databases for all clinical practice guidelines published after January 2000.Selection criteriaTwo researchers independently assessed the list of potentially eligible publications.Data collection and analysisInformation on scope of the guideline, type of practice, associated gestational age, recommendation type and the source of evidence were mapped.Main resultsOf 1866 references, we identified 85 guidelines focusing on the ANC period: 15 pertaining to routine ANC and 70 pertaining to specific situations. A total of 135 interventions from routine ANC guidelines were extracted, and categorised as clinical interventions (n = 80), screening/diagnostic procedures (n = 47) and health systems related (n = 8). Screening interventions, (syphilis, anaemia) were the most common practices. Within the 70 specific situation guidelines, 102 recommendations were identified. Overall, for 33 (out of 171) interventions there were conflicting recommendations provided by the different guidelines.ConclusionMapping the current guidelines including practices related to routine ANC informed the scoping phase for the WHO guideline for ANC. Our analysis indicates that guideline development processes may lead to different recommendations, due to context, evidence base or assessment of evidence. It would be useful for guideline developers to map and refer to other similar guidelines and, where relevant, explore the discrepancies in recommendations and others.Tweetable abstractWe identified existing ANC guidelines and mapped scope, practices, recommendations and source of evidence.

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“…It is currently offered at week 12 or around week 18, or both. The general purpose of the ultrasound examination is to determine the location of the fetus and the placenta, the number of fetuses, the gestational age (GA) and estimated day of delivery (EDD) and to detect anomalies as a basis for further fetal medical management [2].…”

Section: Introductionmentioning

confidence: 99%

Automatic Detection and Measurement of Fetal Biparietal Diameter and Femur Length —Feasibility on a Portable Ultrasound Device

Khan¹,

Tegnander²,

Dreier³

et al. 2017

OJOG

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An automatic method able to recognize a presented section through the biparietal plane of the fetal head and a section through the fetal femur in ultrasound images is developed. Once the correct anatomical section for measurement is identified by the machine, the placement of the measurement calipers is automatically determined by fitting an active contour model to the structure of interest. The fetal biparietal diameter (BPD) and femur length (FL) are then measured automatically. The validation data set contained 167 and 197 Bmode images for BPD and FL measurements, respectively. The images were acquired using 4 different ultrasound scanners, which resulted in varied image quality and gain settings. The mean gestational age (GA) of the fetuses was 19.4 weeks, range 16 to 41 weeks. A measurement success rate of 90% was achieved for both BPD and FL. The correlation coefficients between the manual and automatic measurements were 0.995 (BPD) and 0.967 (FL), mean errors were 0.5 mm (BPD) and -1.7 mm (FL) and error range with 95% confidence interval (CI) were −3.8 -4.8 mm (BPD) and −11.4 -8.1 mm (FL). The automatic measurement results were consistent in both high and low gain settings. The intraclass correlation coefficients between manual and automatic measurements were 0.995 (95% CI; 0.981 -0.999) for BPD in high gain, 1.0 (95% CI; 0.998 -1.0) for BPD in low gain, 0.998 (95% CI; 0.991 -0.999) for FL in high gain and 0.999 (95% CI; 0.996 -1.0) for FL in low gain settings. The method was implemented on a prototype, portable ultrasound machine designed to be used in low-and middle-income countries (LMIC). The overall performance of the method supports our hypothesis that automated methods can be used and are beneficial in a clinical setting.

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ISUOG Practice Guidelines: performance of first‐trimester fetal ultrasound scan

Cited by 491 publications

References 91 publications

The Use of a High Frequency Linear Transducer in the Assessment of Fetal Anatomy at the Routine 11 to 13 + 6-Week Scan among Chinese Population

The Use of a High Frequency Linear Transducer in the Assessment of Fetal Anatomy at the Routine 11 to 13 + 6-Week Scan among Chinese Population

Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care

Automatic Detection and Measurement of Fetal Biparietal Diameter and Femur Length —Feasibility on a Portable Ultrasound Device

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