Standardized First-Trimester Ultrasound Screening for Fetal Structural Abnormalities in A Non-Selective Population: A Single-Center Experience

Lingling Sun; Xuedong Deng; Linliang Yin; Jian Sun; Chunya Ji; Qi Pan; Jun Zhang; Zhong Yang; Chen Ling

doi:10.31083/j.ceog5008174

Clinical and Experimental Obstetrics & Gynecology (Aug 2023)

Standardized First-Trimester Ultrasound Screening for Fetal Structural Abnormalities in A Non-Selective Population: A Single-Center Experience

Lingling Sun,
Xuedong Deng,
Linliang Yin,
Jian Sun,
Chunya Ji,
Qi Pan,
Jun Zhang,
Zhong Yang,
Chen Ling

Affiliations

Lingling Sun: Center for Medical Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 215002 Suzhou, Jiangsu, China
Xuedong Deng: Center for Medical Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 215002 Suzhou, Jiangsu, China
Linliang Yin: Center for Medical Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 215002 Suzhou, Jiangsu, China
Jian Sun: Center for Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 215002 Suzhou, Jiangsu, China
Chunya Ji: Center for Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 215002 Suzhou, Jiangsu, China
Qi Pan: Center for Medical Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 215002 Suzhou, Jiangsu, China
Jun Zhang: Center for Medical Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 215002 Suzhou, Jiangsu, China
Zhong Yang: Center for Medical Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 215002 Suzhou, Jiangsu, China
Chen Ling: Center for Medical Ultrasound, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 215002 Suzhou, Jiangsu, China

DOI: https://doi.org/10.31083/j.ceog5008174
Journal volume & issue: Vol. 50, no. 8
p. 174

Abstract

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Background: To explore the effectiveness of standardized first-trimester ultrasound screening (FTS) in detecting fetal structural abnormalities in a non-selective population. Methods: A retrospective study was performed on 7523 fetuses (6376 single and 569 twin pregnancies) who underwent FTS between 11 and 13+6 weeks’ gestation. All fetuses received anatomy scans using a standardized protocol. Results: 147 fetuses (133 single and 7 twin pregnancies) were lost to follow up. Of the remaining 7376 fetuses, 119 (1.61%, 119/7376) developed structural malformations, with 64 cases (53.8%, 64/119) identified during the first trimester. The remaining cases were detected during the second trimester (24.4%, 29/119), the third trimester (1.68%, 2/119), and postnatally (20.2%, 24/119). There were 4 cases of suspected ventricular septal defect (VSD) by FTS, which were later confirmed to be normal. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for FTS were 54.2%, 99.9%, 94.1%, and 99.3%, respectively. Forty eight fetuses, accounting for 10.6% of the total (452), with thickened nuchal translucency (NT) (above the 95th percentile) showed structural malformations. This was significantly higher than the prevalence of structural abnormalities found in fetuses with normal NT (1.0%, 71/6924) (p < 0.01). Conclusions: Standardized FTS is highly effective in detecting fetal structural malformations early, with impressive specificity, PPV, and NPV. Increased NT suggests detailed anatomy screening and helps guide treatment. However, while standardized FTS is an invaluable tool, it cannot fully replace the sensitivity of second- and third-trimester ultrasound screening. Clinical Trial Registration: The study was registered at https://www.chictr.org.cn (registration number ChiCTR-SOC-17010976).

Published in Clinical and Experimental Obstetrics & Gynecology

ISSN: 0390-6663 (Print); 2709-0094 (Online)
Publisher: IMR Press
Country of publisher: Hong Kong
LCC subjects: Medicine: Gynecology and obstetrics
Website: https://www.imrpress.com/journal/CEOG

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