Likelihood ratio for trisomy 21 in fetuses with tricuspid regurgitation at the 11 to 13 + 6-week scan

Faiola, S.; Tsoi, E; Huggon, I. C.; Allan, Lindsey D.; Nicolaides, Kypros H.

doi:10.1002/uog.1922

Cited by 141 publications

(103 citation statements)

References 14 publications

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“…Study of ductus venosus (DV) flow patterns in these fetuses may improve the selection of those requiring specialized echocardiography as absent or reversed flow during the a-wave is associated with a three-fold increase in the likelihood of a major CHD (Maiz et al, 2008a,b). Tricuspid regurgitation (TR) at 11-13 + 6 weeks' gestation may also play a role in identifying fetuses with CHD as those with TR have an 8-fold increased risk (Faiola et al, 2005).…”

Section: Congenital Heart Defectsmentioning

confidence: 99%

Increased nuchal translucency in euploid fetuses—what should we be telling the parents?

et al. 2010

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Nuchal translucency (NT) measurement between 11 and 14 weeks' gestation is an undisputed marker for aneuploidies. When conventional karyotyping is normal, enlarged NT is a strong marker for adverse pregnancy outcome, associated with miscarriage, intrauterine death, congenital heart defects, and numerous other structural defects and genetic syndromes. The risk of adverse outcome is proportional to the degree of NT enlargement. Although the majority of structural anomalies are amenable to ultrasound detection, unspecified genetic syndromes involving developmental delay may only emerge after birth. Concern over these prenatally undetectable conditions is a heavy burden for parents. However, following detection of enlarged NT the majority of babies with normal detailed ultrasound examination and echocardiography will have an uneventful outcome with no increased risk for developmental delay when compared to the general population. Counseling should emphasize this to help parents restore hope in normal pregnancy outcome and infant development. Copyright © 2010 John Wiley & Sons, Ltd.

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Section: Congenital Heart Defectsmentioning

confidence: 99%

Increased nuchal translucency in euploid fetuses—what should we be telling the parents?

et al. 2010

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“…First-trimester evaluation of the fetal heart is a steady ultrasound examination, performed in a small window with the size of the fetal thorax and at a relatively fixed, small deep (mean transducer -heart distance, 6 cm). Additionally, tricuspid flow and DV are assessed through well-defined protocols [23,24]. These restricted, relatively stable conditions could also explain the very small variability of the TI and MI values we found along the learning curve.…”

Section: Figmentioning

confidence: 89%

“…The operator could choose to switch on a transvaginal approach, if the image quality was poor, but these cases were not included in the study. The tricuspid and DV flows were evaluated as previously described [23,24].…”

Section: Methodsmentioning

confidence: 99%

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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“…Absence of the nasal bone, reversed a-wave in the ductus venosus and tricuspid regurgitation are observed in about 60, 66 and 55% of fetuses with trisomy 21 and in 2.5, 3.0 and 1.0%, respectively, of euploid fetuses. (Matias et al, 1998;Cicero et al, 2001Cicero et al, , 2006Huggon et al, 2003;Nicolaides, 2004;Faiola et al, 2005;Falcon et al, 2006;Kagan et al, 2009bKagan et al, , 2009cMaiz et al, 2009).…”

Section: Additional First-trimester Sonographic Markersmentioning

confidence: 99%

Aneuploidy and Anomaly Screening

Elkady¹,

Dawlatly²,

Ahmed³

et al. 2017

Mastering Single Best Answer Questions for the Part 2 MRCOG Examination

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Effective screening for major aneuploidies can be provided in the first trimester of pregnancy. Screening by a combination of fetal nuchal translucency and maternal serum free-β-human chorionic gonadotrophin and pregnancy-associated plasma protein-A can identify about 90% of fetuses with trisomy 21 and other major aneuploidies for a false-positive rate of 5%. Improvement in the performance of first-trimester screening can be achieved by firstly, inclusion in the ultrasound examination assessment of the nasal bone and flow in the ductus venosus, hepatic artery and across the tricuspid valve, and secondly, carrying out the biochemical test at 9 to 10 weeks and the ultrasound scan at 12 weeks.

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Likelihood ratio for trisomy 21 in fetuses with tricuspid regurgitation at the 11 to 13 + 6-week scan

Abstract: Objective To determine the likelihood ratio for trisomy 21 in fetuses with tricuspid regurgitation at the 11 to 13 + 6-week scan. Methods

Cited by 141 publications

References 14 publications

Increased nuchal translucency in euploid fetuses—what should we be telling the parents?

Increased nuchal translucency in euploid fetuses—what should we be telling the parents?

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

Aneuploidy and Anomaly Screening

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