The Utility of Repeat Midtrimester Anatomy Ultrasound for Anomaly Detection

Wood, S. Lindsay; Owen, John; Jenkins, Sheri M.

doi:10.1055/s-0038-1626715

Cited by 7 publications

(6 citation statements)

References 13 publications

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“…Regarding the success rate of obtaining optimal 20 + 2 ISUOG planes between pregnant women with a GA ≥ 20 weeks and GA < 20 weeks, we found that those with a GA ≥ 20 weeks had a 1.2 times higher success rate for foetal US screening than women with a GA < 20 weeks. This is similar to previous studies, which found that a lower GA decreases the success rate of achieving optimal visualization [ 11 – 13 ]. We postulated that the smaller foetus and relatively smaller foetal size to amniotic fluid ratio may affect the possibility of achieving success, and hence the success rate.…”

Section: Discussionsupporting

confidence: 92%

“…This finding is different from a previous study, which reported that foetal position, oligohydramnios, prior abdominal surgery, and maternal obesity may account for suboptimal US visualization. We hypothesized that our different result may be caused by the definition of each variable, number of sample size calculation which based on GA only and small proportion of some maternal characters such as presence of myoma, obese or abdominal scar, etc [ 11 , 14 – 16 ]. The most common suboptimal planes in our study were the facial profile and thoracic planes.…”

Section: Discussionmentioning

confidence: 99%

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Success rate to complete optimal 20 + 2 ISUOG planes for foetal ultrasonographic structural screening during early second trimester pregnancy in Thailand

Chaichanalap

Hanprasertpong

2021

Ultrasound J

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Objective To compare the success rates of obtaining optimal 20 + 2 (2 overview + 20 planes) International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG) planes for foetal ultrasound structural screening between pregnant women at gestational age (GA) 18–20 weeks and 20–22 weeks 6 days Methods A prospective descriptive study was conducted. Singleton pregnant women at GA 18–22 weeks + 6 days attending antenatal clinic between December 2019 and March 2020 were invited to participate in the study. Women whose foetuses had obvious structural anomalies were excluded. The ultrasound screening using 20 + 2 ISUOG protocol was performed by 21 operators who had completed the online ISUOG basic training programme with an experience of ultrasound scanning of at least 30 cases. The success rates of achieving optimal planes between GA 18–20 weeks and 20–22 weeks 6 days were compared using Chi-square test. Common suboptimal planes in the ultrasound scan were also presented. Results Optimal 20 + 2 ISUOG planes were successfully assessed in 97/126 (77%) and 112/126 (88.9%) patients in the group with a GA < 20 weeks and in the group with a GA ≥ 20 weeks, respectively. Overall success rate was 82.9%. The success rate for the GA < 20 weeks group was significantly lower than that for the GA ≥ 20 weeks group. The group with a GA ≥ 20 weeks had a 1.2 times higher success rate than the group with a GA < 20 weeks. The most common suboptimal planes were the facial planes, especially the median facial profile, and foetal thoracic planes. Conclusions We prefer to perform foetal structural screening using US with the 20 + 2 ISUOG protocol at a GA 20 to 22 weeks and 6 days with the aim reducing the need for repeat scans.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Success rate to complete optimal 20 + 2 ISUOG planes for foetal ultrasonographic structural screening during early second trimester pregnancy in Thailand

Chaichanalap

Hanprasertpong

2021

Ultrasound J

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“…Recently, a study analyzing the utility of repeat ultrasounds for anomaly detection suggested the yield of repeat ultrasounds may be low, with over 90% of anomalies detected on initial surveys and appreciably more scans required for detection of remaining anomalies. 22 Yet, in our cohort, of the total anomalous fetuses identified, 38.0% were noted in a follow-up ultrasound after the first was suboptimal or incomplete. As one in five individuals with an identified anomaly went on to terminate their pregnancy, we support repeating ultrasounds in an attempt to work toward complete views.…”

Section: Discussionmentioning

confidence: 61%

“…Based on a prior study where an initial ultrasound was incomplete in 14% of individuals at a median gestational age of 18.5-week gestation, 22 a power calculation for a two-sided unpaired t -test determined we would need 826 patients per group to exclude a clinically meaningful difference of more than 5% in incomplete views comparing greater than 20-week gestation to less than 20-week gestation.…”

Section: Methodsmentioning

confidence: 99%

Impact of a Potential 20-Week Abortion Ban on Likelihood of Completing Required Views in Second-Trimester Fetal Anatomy Ultrasound

et al. 2022

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Objective The aim of this study was to quantify the likelihood of assessing all mandated fetal views during the second-trimester anatomy ultrasound prior to the proposed federal 20-week abortion ban. Study Design Retrospective cohort study of a random sample of 1,983 patients undergoing anatomy ultrasound in 2017 at a tertiary referral center. The difference in proportion of incomplete anatomic surveys prior compared with after 20-week gestation was analyzed using X 2 and adjusted logistic regression; difference in mean days elapsed from anomaly diagnosis to termination tested using t-tests and survival analysis. Results Incomplete views were more likely with initial ultrasound before 20 weeks (adjusted relative risk: 1.70; 95% confidence interval: 1.50–1.94); 43.5% versus 26.1% were incomplete before and after 20 weeks, respectively. Fetal structural anomalies were identified in 6.4% (n = 127/1,983) scans, with 38.0% (n = 49) identified at follow-up after initial scan was incomplete. 22.8% (n = 29) with an anomaly terminated. Conclusions A complete assessment of fetal views during an anatomy ultrasound prior to 20-week gestation is often not technically feasible. Legislation limiting abortion to this gestational age would greatly impact patient's ability to make informed choices about their pregnancies. Key Points

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“…First Author: S. Lindsay Wood, MD, University of Alabama, Birmingham, AL Wood and colleagues examined the utility of repeated ultrasound examinations to identify anomalies following an incomplete anatomic survey. 1 In this retrospective cohort study of 13,740 patients, 11,828 (86%) women had the fetal anatomic survey completed on the first attempt, 1,796 (13%) on the second attempt, and 116 (1%) had a third attempt. Overall, 324 (2.4%) anomalies were detected.…”

Section: Featured Manuscripts the Utility Of Repeat Midtrimester Anatmentioning

confidence: 92%

Society for Maternal-Fetal Medicine's Fellow Research Series 2018: Manuscripts of the Year

2019

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The Utility of Repeat Midtrimester Anatomy Ultrasound for Anomaly Detection

Abstract: Over 90% of anomalies are detected on the initial fetal anatomic survey. The incremental diagnostic yield then decreases, requiring appreciably more repeat scans to detect one anomaly.

Cited by 7 publications

References 13 publications

Success rate to complete optimal 20 + 2 ISUOG planes for foetal ultrasonographic structural screening during early second trimester pregnancy in Thailand

Success rate to complete optimal 20 + 2 ISUOG planes for foetal ultrasonographic structural screening during early second trimester pregnancy in Thailand

Impact of a Potential 20-Week Abortion Ban on Likelihood of Completing Required Views in Second-Trimester Fetal Anatomy Ultrasound

Society for Maternal-Fetal Medicine's Fellow Research Series 2018: Manuscripts of the Year

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