ISUOG statement on the safe use of Doppler in the 11 to 13 +6‐week fetal ultrasound examination

Salvesen, K. Å.; Lees, C.; Abramowicz, Jacques S.; Brezinka, Christoph; Haar, Gail ter; Maršál, Karel

doi:10.1002/uog.9026

Cited by 95 publications

(54 citation statements)

References 8 publications

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“…Overall, Doppler examinations of the fetal heart while in the first-trimester screening, either color flow or pulsed-wave Doppler imaging, are associated with low values of TI, significantly below the limit of actual recommendations [8].…”

Section: Figmentioning

confidence: 81%

“…Depth, focus, overall gain (post-processing) and power were adjusted as necessary. The sonographer was unaware of the data followed by the study and fully complied with the guidelines on the safe use of ultrasound at this gestational age [8].…”

Section: Methodsmentioning

confidence: 99%

“…Besides probes' power, these indices are continuously influenced by scanning parameters such as window size, probe frequency, depth, position, and number of the focus, velocity scale and sample volume (gate) size [7]. The current recommendation is that TI should not exceed 1.0; the exposure time should be kept as short as possible (usually no longer than 5-10 minutes) and should not exceed 60 minutes for the firsttrimester color Doppler examinations [8,9]. In the case of the obstetric ultrasound (up to or after 10 weeks), in the absence of ultrasound contrast agents, for MI values less than 0.3, there is no known reason to restrict scanning times.…”

mentioning

confidence: 99%

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Variation of safety indices during in the learning curve for color Doppler assessment of the fetal heart at 11+0 to 13+6 weeks’ gestation

2015

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Aims: The aim of our study was to analyze the variation of acoustic output, as expressed by the thermal (TI) and mechanical index (MI), during the learning curve for a fetal heart scan at 11-13 gestational weeks, with the introduction of a new ultrasound system. Material and methods: This was a prospective, observational study on 303 normal fetuses. The fetal heart was examined transabdominally using B-Mode and high definition (HD) color Doppler to obtain standard parameters: fourchamber, outflow tracts and three-vessel-trachea views. Data were analyzed in groups of 20 consecutive examinations and the percentage of successful examinations was calculated. TI and MI were retrieved from HD color Doppler examinations of the fetal heart and from pulsed-wave Doppler assessment of the tricuspid flow and ductus venosus. Results: MI values from the color Doppler examination of the fetal heart showed a continuous decrease (0.81 to 0.75, p<0.001), along the learning phase. TI and MI indices from pulsed-wave Doppler evaluation of the tricuspid flow increased at the beginning of the learning phase and stabilized afterwards (0.34 to 0.36, p<0.05 and 0.37 to 0.4, p<0.001, respectively). TI from color Doppler exam of the heart and indices from ductus venosus assessment were very constant and did not change along the studied periods. The length of Doppler examination of the heart increased after about 80 cases by 25%, to a mean of 4 minutes (p<0.05). Conclusions: Safety indices from Doppler evaluation of the fetal heart and tricuspid flow vary during the learning curve for fetal heart assessment. Also, the occurrence of constant values suggests the potential for their supplementary active reduction. For a better adaptation to a new ultrasound technology, the sonographer should scan the fetal heart longer in the first trimester and follow displayed safety indices along the first 80 cases.

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Section: Figmentioning

confidence: 81%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Variation of safety indices during in the learning curve for color Doppler assessment of the fetal heart at 11+0 to 13+6 weeks’ gestation

2015

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“…A prospective study to evaluate the efficacy of [11][12][13] +6 weeks anatomy scan in detecting fetal structural anomalies compared to traditional 18-22 weeks scan. Int J Reprod Contracept Obstet Gynecol 2017;6:2431-7.…”

Section: Funding: No Funding Sources Conflict Of Interest: None Declamentioning

confidence: 99%

“…Since most of the major fetal structures complete its development by 12 weeks, proper visualization of the anatomy is possible at the time of routine NT scan at [11][12][13] +6 weeks. 5 Visualizing the complete fetal anatomy during 11-13 +6 weeks scan needs high resolution ultrasound machine, well trained and experienced Sonographer.…”

mentioning

confidence: 99%

A prospective study to evaluate the efficacy of 11-13+6 weeks anatomy scan in detecting fetal structural anomalies compared to traditional 18-22 weeks scan

Elamaran

Daniel

George

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Congenital anomalies are one of the leading causes of infant mortality. Traditional TIFFA scan done at 18-22 weeks leads to delay in diagnosis, referral and management. With high resolution ultrasound and TVS probe, normal and abnormal fetal anatomy could be visualized in early gestation with good accuracy. Objective of present study was to evaluate the efficacy of 11-13+6 weeks anatomy scan in detecting fetal structural anomalies compared to traditional 18 -22weeks scan and in visualizing the complete normal fetal anatomyMethods: An Observational study of 300 antenatal patients at Jubilee Mission Medical College for 1 year (Jan-Dec2014) was done. The scan was performed at 11-13+6 weeks by TAS first, if a full fetal anatomy survey not achieved, TVS added. A mid-trimester fetal anatomy scan was then performed in patients who had not dropped out, miscarried or undergone pregnancy termination at 18-22weeks.Results: The incidence of anomalies in our study was 3.67% -11 cases; 9 detected at 11-13+6 weeks, 2 were newly detected at 18-22 weeks. At 11-13+6 weeks anatomy scan, the detection rate of anomalies was 81.8% and complete fetal anatomy survey was achieved in 92%. Heart and kidneys were not properly visualized in 4% and 12.7%, at 11‐13+6 weeks compared with 0.7% and 0% at 18‐22 weeks.Conclusions: The 11-13+6 weeks anatomy scan is an important diagnostic tool which is underutilized and should be offered to all women as a routine standard of antenatal care. However as fetal anomalies can present at varying gestational age, standard 18-22 weeks anatomy scan cannot be abandoned.

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Association of Prenatal Ultrasonography and Autism Spectrum Disorder

et al. 2018

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The prevalence of autism spectrum disorder (ASD) has been increasing rapidly, with current estimates of 1 in 68 children affected. Simultaneously, use of prenatal ultrasonography has increased substantially, with limited investigation into its safety and effects on brain development. Animal studies have demonstrated that prenatal ultrasonography can adversely affect neuronal migration. OBJECTIVE To quantify prenatal ultrasound exposure by the frequency, timing, duration, and strength of ultrasonographic scans in children with later ASD, developmental delay, and typical development.

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ISUOG statement on the safe use of Doppler in the 11 to 13 +6‐week fetal ultrasound examination

Cited by 95 publications

References 8 publications

Variation of safety indices during in the learning curve for color Doppler assessment of the fetal heart at 11+0 to 13+6 weeks’ gestation

Variation of safety indices during in the learning curve for color Doppler assessment of the fetal heart at 11+0 to 13+6 weeks’ gestation

A prospective study to evaluate the efficacy of 11-13+6 weeks anatomy scan in detecting fetal structural anomalies compared to traditional 18-22 weeks scan

Association of Prenatal Ultrasonography and Autism Spectrum Disorder

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