Value of routine ultrasound examination at 35–37 weeks' gestation in diagnosis of fetal abnormalities

Ficara, Anthony J.; Syngelaki, Argyro; Hammami, A.; Akolekar, Ranjit; Nicolaides, Kypros H.

doi:10.1002/uog.20857

Cited by 72 publications

(78 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, late detected fetal abnormalities (or a combination of fetal abnormalities with other indications) are the most common indication of late amniocentesis. It has accounted for 86.2% in our cohort, consistent with a recent study (9), the central nervous system abnormalities (16.3%, 184/1130) was the most common ones.…”

Section: Discussionsupporting

confidence: 93%

“…Nevertheless, the natural history of several kinds of genetic syndromes necessitates genetic evaluation late in the pregnancy since the evolving abnormal ndings can be gradually detected by ultrasound examination (9). The chances of late-onset abnormalities after routine 1st and 2nd trimester ultrasound examinations are estimated at 5.5%-17% (10).…”

Section: Introductionmentioning

confidence: 99%

“…The chances of late-onset abnormalities after routine 1st and 2nd trimester ultrasound examinations are estimated at 5.5%-17% (10). A recent study demonstrated that a large number of fetal abnormalities, especially central nervous system (CNS) abnormalities, are detected for the rst time during the ultrasound scan at 35-37 gestation (9). Recent studies suggested that late amniocentesis is safe and effective to be performed after 24 gestational weeks onwards (1,11).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Application of Late Amniocentesis: A Retrospective Study in a Tertiary Fetal Medicine Center in China

Yan

Chen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: To assess the indications and complications of late amniocentesis, and the advantage of advanced genetic test results in a tertiary university fetal medical medicine unit.Methods: In this retrospective study, women that underwent amniocentesis at 24+0 to 39+4 weeks, between January 2014 and December 2019, were recruited. Indications, complications, genetic test results, and pregnancy outcomes were reported for each pregnancy. Information was retrieved from patient medical records, checked by research staff, and analyzed. Results: Of the 1277 women (1311 fetuses) included, late detected sonographic abnormalities (86.2%) were the most common indication. The overall preterm birth and intrauterine demise rate were 2.6% and 1.2%, respectively, after amniocentesis. Sixty-six fetuses with aneuploidy (5.1%) and sixty-seven fetuses with pathogenic copy number variations (5.1%) were identified by chromosomal microarray analysis. One pathogenic copy number variation was detected by whole-exome sequencing. The maximal diagnostic yield (36.1%) was in the subgroup of fetuses with the abnormal noninvasive prenatal test, following by multiple abnormalities (23.8%). And 35.8% of the pregnancies were finally terminated.Conclusions: Due to the high detection rates of advanced genetic technologies and safety of the invasive procedure, it is reasonable to recommend late amniocentesis as an effective and credible method to detect late-onset fetal abnormalities. However, chromosomal microarray and whole-exome sequencing may result in uncertain results like variants of uncertain significance. Therefore, comprehensive genetic counseling is necessary.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Application of Late Amniocentesis: A Retrospective Study in a Tertiary Fetal Medicine Center in China

Yan

Chen

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Syngelaki et al [6] reported that they could not detect aorta stenosis, pulmonary stenosis, truncus arteriosus, ventricular aneurysm, cardiomyopathy, rhabdomyoma and arrythmia cases although they detected all tricuspid atresia and pulmonary atresia cases in the first trimester. Also, Ficara et al [15] highlighted that aorta coarctation, aorta stenosis, pulmonary stenosis, tricuspid valve defect and rhabdomyoma cases could be diagnosed in the third trimester.…”

Section: Discussionmentioning

confidence: 99%

The importance of four-chamber and three-vessel (3-V) views in the screening of fetal cardiac anomalies in the first trimester

Erenel¹,

Karslı²,

Özel³

et al. 2019

Perinatal J

View full text Add to dashboard Cite

Birinci trimesterde fetal kalp anomalilerinin taramas›nda dört odac›k ve üç damar (3-V) görüntüsünün önemi Amaç: Bu çal›flmada birinci trimester fetal kalp muayenesinin et-kinli¤inin araflt›r›lmas› amaçlanm›flt›r. Yöntem: Bu çal›flma prospektif olarak, A¤ustos 2016-fiubat 2018 tarihleri aras›nda perinatoloji klini¤inde, ilk trimester kromozomal anomali taramas› için baflvuran gebeliklerde yap›ld›. Kardiyak muayene abdominal situs incelemesi, dört odac›k ve üç damar (3-V) görüntüleri elde edilerek yap›ld›. Kalp anomalisi saptanan olgular takip edildi. Hasta verileri ve sonuçlar› kay›t edildi. Tan›mlay›c› istatistiksel analizler yap›ld›. Bulgular: Bu çal›flmada 693 gebelik olgusunda 707 fetüs muayene edildi. 661 olguda fetal kalp muayenesi transabdominal ultrasonografi ile tamamlan›rken, 32 olgunun (%4.6) muayenesinde gerekli görüntüler elde edilemedi ve transvajinal ultrasonografi ile de¤erlendirme yap›ld›. 10 olguda anormal kalp bulgusu saptand›. Üç olguda tan› do¤rulanamayarak normal kalp olarak de¤erlendirildi ve %0.4 (3/698) yanl›fl pozitiflik saptand›. Birinci trimester muayenesinde normal olarak de¤erlendirilen iki olguda da restriktif foramen ovale anevrizmas› saptand›. Birinci trimester kalp muayenesinde dört odac›k, üç damar (3-V) görüntüsünün kalp anomalilerini yakalamadaki duyarl›l›¤› %77, özgüllü¤ü %99.5, pozitif prediktif de¤eri %70 ve negatif prediktif de¤eri %99.7 olarak sap-tand›. Sonuç: Birinci trimesterde dört odac›k ve üç damar (3-V) kesitleri ile kalp anomalilerinin önemli bir k›sm› tan› alabilir. Ayr›ca birinci trimester kalp muayenelerinde düflük de olsa yanl›fl pozitiflik ve negatiflik olabilece¤i unutulmamal› ve baz› kalp anomalilerinin ancak gebeli¤in ilerleyen haftalar›nda görünür veya tan›nabilir olabilece¤i ak›lda tutulmal› ve aileler bu konuda bilgilendirilmelidir.

show abstract

“…Routine ultrasound examination at 35 + 0 to 36 + 6 weeks' gestation is beneficial for the diagnosis of previously undetected fetal abnormalities, prediction of pre‐eclampsia, prediction of small‐ and large‐for‐gestational‐age neonates and assessment of fetal oxygenation. Another potential benefit of a routine scan at 35 + 0 to 36 + 6 weeks' gestation is the diagnosis of non‐cephalic presentation.…”

Section: Introductionmentioning

confidence: 99%

Value of routine ultrasound examination at 35–37 weeks' gestation in diagnosis of non‐cephalic presentation

Castro

Ciobanu

Formuso

et al. 2020

Ultrasound in Obstet & Gyne

Self Cite

View full text Add to dashboard Cite

CONTRIBUTIONWhat are the novel findings of this work? This study reports the incidence of non-cephalic presentation at a routine ultrasound examination at 35 + 0 to 36 + 6 weeks' gestation and subsequent management of such pregnancies. What are the clinical implications of this work?Routine ultrasound examination at 35 + 0 to 36 + 6 weeks' gestation detects non-cephalic presentation in about 5% of pregnancies. Such diagnosis could potentially improve pregnancy outcome by preventing unexpected abnormal presentation in labor and, through external cephalic version, reducing the incidence of non-cephalic presentation. ABSTRACTObjective Undiagnosed non-cephalic presentation in labor carries increased risks for both the mother and baby. Routine pregnancy care based on maternal abdominal palpation fails to detect the majority of cases of non-cephalic presentation. The aim of this study was to report the incidence of non-cephalic presentation at a routine scan at 35 + 0 to 36 + 6 weeks' gestation and the subsequent management of such pregnancies. MethodsThis was a retrospective analysis of prospectively collected data in 45 847 singleton pregnancies that had undergone routine ultrasound examination at 35 + 0 to 36 + 6 weeks' gestation. Patients with breech or transverse/oblique presentation were divided into two groups; first, those who would have elective Cesarean section for fetal or maternal indications other than the abnormal presentation, and, second, those who would potentially require external cephalic version (ECV). The latter group was reassessed after 1-2 weeks and, if there was persistence of abnormal presentation, the parents were offered the option of ECV or elective Cesarean section at 38-40 weeks' gestation. Multivariable logistic regression analysis was carried out to determine which of the factors from maternal and pregnancy characteristics provided a significant contribution in the prediction of, first, non-cephalic presentation at the 35 + 0 to 36 + 6-week scan, second, successful ECV from non-cephalic to cephalic presentation, and, third, spontaneous rotation from non-cephalic to cephalic presentation that persisted until delivery.Results First, at 35 + 0 to 36+ 6 weeks, the fetal presentation was cephalic in 43 416 (94.7%) pregnancies, breech in 1987 (4.3%) and transverse or oblique in 444 (1.0%). Second, multivariable analysis demonstrated that the risk of non-cephalic presentation increased with increasing maternal age and weight, decreasing height and earlier gestational age at scan, was higher in the presence of placenta previa, oligohydramnios or polyhydramnios and in nulliparous than parous women, and was lower in women of South Asian or mixed racial origin than in white women. Third, 22% of cases of non-cephalic presentation were not eligible for ECV because of planned Cesarean section for indications other than the malpresentation. Fourth, of those eligible for ECV, only 48.5% (646/1332) agreed to the procedure, which was successful in 39.0% (252/646) of cases. Fifth, the chance of successful...

show abstract

Value of routine ultrasound examination at 35–37 weeks' gestation in diagnosis of fetal abnormalities

Cited by 72 publications

References 21 publications

The Application of Late Amniocentesis: A Retrospective Study in a Tertiary Fetal Medicine Center in China

The Application of Late Amniocentesis: A Retrospective Study in a Tertiary Fetal Medicine Center in China

The importance of four-chamber and three-vessel (3-V) views in the screening of fetal cardiac anomalies in the first trimester

Value of routine ultrasound examination at 35–37 weeks' gestation in diagnosis of non‐cephalic presentation

Contact Info

Product

Resources

About