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- Title
Early Detection of Structural Anomalies in a Primary Care Setting in the Netherlands.
- Authors
Bardi, Francesca; Smith, Eric; Kuilman, Maja; Snijders, Rosalinde J.M.; Bilardo, Caterina Maddalena; Snijders, Rosalinde J M; Bilardo, Caterina Maddalena
- Abstract
<bold>Objective: </bold>This study assessed the percentage and type of congenital anomalies diagnosed at first-trimester ultrasound (US) scan in a primary care setting without following a standardized protocol for fetal anatomical assessment.<bold>Materials and Methods: </bold>US scans performed between 11+0 and 13+6 weeks of gestation in pregnancies with estimated date of delivery between January 1, 2012 and January 1, 2016 were searched. Data were supplemented with results of 20-week scans and pregnancy outcome.<bold>Results: </bold>Of all scans, 38.6% were dating scans and 61.4% were part of first-trimester screening. Anomalies were diagnosed prenatally in 200 (1.8%) fetuses; 81 (0.7%) were chromosomal and 119 (1.1%) were structural. Of all prenatally detected anomalies, 27% (n = 32) were detected at first-trimester scan, with a false-positive rate of 0.04%. All cases of anencephaly (n = 4), encephalocele (n = 2), exomphalos (n = 9), megacystis (n = 4), and limb reduction (n = 1) were diagnosed. First-trimester detection of gastroschisis and congenital heart defects was 67 and 19%, respectively.<bold>Conclusion: </bold>In a primary care setting, global fetal anatomical assessment at first-trimester scan without following a standardized protocol detects about 30% of all structural anomalies and most of the severe anomalies, with an extremely low false-positive rate. We hypothesize that additional training and use of a systematic protocol would improve early detection of structural anomalies.
- Subjects
PRIMARY care; ULTRASONIC imaging; ANENCEPHALY; GASTROSCHISIS; ENCEPHALOCELE
- Publication
Fetal Diagnosis & Therapy, 2019, Vol 46, Issue 1, p12
- ISSN
1015-3837
- Publication type
journal article
- DOI
10.1159/000490723