Fetal anomalies, First trimester, Nuchal translucency, Ultrasound
Citation Information :
Singh A, Kaur R, Gupta K, Singh G, Pahwa S. Ultrasound Detection of Fetal Structural Anomalies during First Trimester Nuchal Translucency Scan in Conjunction with Traditional 18–22 Weeks Anomaly Scan. Int J Infertil Fetal Med 2022; 13 (1):18-22.
Aim and objective: The purpose of this study is to assess the value of performing a detailed examination of the fetus for structural anomalies in a two stage screening process at first trimester nuchal translucency (NT) scan and mid trimester anomaly scan in general population.
Materials and methods: An observational study was conducted on 400 pregnant females referred to Department of Radiodiagnosis and Imaging in our hospital for NT scan at 11–13+6 weeks of gestational age. All women enrolled in the study were again subjected to traditional 18–22 weeks anatomy scan on follow up.
Results: In our study, total 400 pregnant women were enrolled. Overall congenital anomaly prevalence in study population was 6.7%. Out of which 66.6% anomalies were detected in first trimester. While 35.7% of the anomalies were detected in second trimester anomaly scan. Combined use of NT and second trimester scan detected almost all of the congenital anomalies. However, many of the total anomalies among them were detected earlier in first trimester NT scan.
Conclusion: Early scan can be very helpful in early diagnosis of fetal anomalies. But as many abnormalities cannot be evident in early pregnancy due to ongoing fetal development, second trimester anomaly scan should also be performed along with early screening as two stage screening process.
Rumack CM, Levine D. Diagnostic ultrasound. 5th ed. Philadelphia, PA: Elsevier; 2018
Edwards L, Hui L. First and second trimester screening for fetal structural anomalies. Semin Fetal Neonatal Med 2018;23(2):102–111. DOI: 10.1016/j.siny.2017.11.005
Illescas T, Sepulveda W, Adiego B et al. Prenatal detection of fetal anomalies at the 11- to 13-week scan—part I: brain, face and neck. Donald Sch J Ultrasound Obstet Gynecol 2013:7(4):359–368. DOI: 10.5005/jp-journals-10009-1307
Whitlow B, Chatzipapas I, Lazanakis M, et al. The value of sonography in early pregnancy for the detection of fetal abnormalities in an unselected population. BJOG 1999;106(9):929–936. DOI: 10.1111/j.1471-0528.1999.tb08432.x
Economides D, Whitlow B, Braithwaite J. Ultrasonography in the detection of fetal anomalies in early pregnancy. BJOG 1999;106(6):516–523. DOI: 10.1111/j.1471-0528.1999.tb08317.x
Chen M, Lam Y, Lee C, et al. Ultrasound screening of fetal structural abnormalities at 12 to 14 weeks in Hong Kong. Prenat Diagn 2004;24(2):92–97. DOI: 10.1002/pd.798
Becker R, Wegner R. Detailed screening for fetal anomalies and cardiac defects at the 11–13-week scan. Ultrasound Obstet Gynecol 2006;27(6):613–618. DOI: 10.1002/uog.2709
ISUOG Practice Guidelines: performance of first-trimester fetal ultrasound scan. 2020.
Foundation T. Nuchal translucency scan | Certificates of competence | FMF certification | Welcome to the Fetal Medicine Foundation [Internet]. Fetalmedicine.org. 2020
ACOG Committee on Practice Bulletins. ACOG Committee on practice Bulletin No. 77: screening for fetal chromosomal abnormalities. Obstet Gynecol 2007;109(1):217–227. DOI: 10.1097/00006250-200701000-00054
Kashyap N, Pradhan M, Singh N, et al. Early detection of fetal malformation, a long distance yet to cover! present status and potential of first trimester ultrasonography in detection of fetal congenital malformation in a developing country: experience at a Tertiary Care Centre in India. J Pregnancy 2015;2015:1–9. DOI: 10.1155/2015/623059
Iliescu D, Tudorache S, Comanescu A, et al. Improved detection rate of structural abnormalities in the first trimester using an extended examination protocol. Ultrasound Obstet Gynecol 2013;42(3):300–309. DOI: 10.1002/uog.12489
Castro-Aragon I, Levine D. Ultrasound detection of first trimester malformations: a pictorial essay. Radiol Clin N Amer 2003;41(4):681–693. DOI: 10.1016/s0033-8389(03)00045-9
Oztekin O, Oztekin D, Tınar S, et al. Ultrasonographic diagnosis of fetal structural abnormalities in prenatal screening at 11–14 weeks. Diagn Interv Radiol 2009;15:221–225. DOI: 10.4172/2572-4983.1000141
Rossi AC, Prefumo F. Accuracy of ultrasonography at 11–14 weeks of gestation for detection of fetal structural anomalies: A systematic review. Obstet Gynecol 2013;122:1160–1167. DOI: 10.1097/AOG.0000000000000015
Syngelaki A, Hammami A, Bower S, et al. Diagnosis of fetal non–chromosomal abnormalities on routine ultrasound examination at 11–13 weeks’ gestation. Ultrasound Obstet Gynecol 2019;54(4):468–476. DOI: 10.1002/uog.20844
Saltvedt S, Almström H, Kublickas M, et al. Detection of malformations in chromosomally normal fetuses by routine ultrasound at 12 or 18 weeks of gestation—a randomised controlled trial in 39 572 pregnancies. BJOG 2006;113(6):664–674. DOI: 10.1111/j.1471-0528.2006.00953.