Ultrasound findings and detection of fetal abnormalities before 11 weeks of gestation. (21st October 2021)

• Record Type: Journal Article
• Authors: Brown, Imogen; Rolnik, Daniel Lorber; Fernando, Shavi; Menezes, Melody; Ramkrishna, Jayshree; da Silva Costa, Fabricio; Meagher, Simon
• Is Part Of: Prenatal diagnosis. Volume 41:Number 13(2021)
• Page Start: 1675
• Page End: 1684
• Publication Date: 2021-10-21
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.6055
• Languages: English
• ISSNs: 0197-3851

Abstract

Abstract: Objective: To determine the proportion of major fetal structural abnormalities that can be detected before 11 gestational weeks. Methods: We conducted a retrospective study of individual patient files at a tertiary provider of obstetric and gynecological ultrasound in Melbourne, Australia. All women who had a pre‐cell‐free DNA ultrasound with a crown‐rump length of less than 45 mm and had one or more ultrasounds at a later gestation were included in the analysis. The primary outcome was the incidence of a fetal structural abnormality. Results: A total of 3333 cases were included in the final analysis. Overall, 316 fetuses (9.5%) had a structural abnormality detected at any point throughout gestation, of which 86 were major structural abnormalities (2.6%). Sixteen fetal abnormalities were detected before 11 weeks of gestation, including 15 major abnormalities (17.4% of the major anomalies). All major fetal abnormalities detected before 11 gestational weeks were confirmed at later ultrasound examinations or the pregnancy did not continue (in four cases due to termination of pregnancy and in one case spontaneous miscarriage before first trimester morphology ultrasound). Conclusion: Detection of fetal abnormalities is possible before 11 weeks of gestation. Early suspicion is more likely in cases of major structural abnormalities. Key points: What is already known about this topic? Many fetal structural abnormalities are detectable in the antenatal period using obstetric ultrasound. Fetal structural abnormalities are usually detected at the mid‐trimester morphology ultrasound (performed at 18–24 weeks' gestation) or the first trimester morphology ultrasound (11–14 weeks' gestation). Abnormalities are more likely to be diagnosed at a later gestation. What does this study add? There has been little study to date on the detection of fetal structural abnormalities before 11 weeks of gestation. This study investigates the proportion of fetal structural abnormalities detected at less than 11 weeks of gestation as compared with detection at a later gestation. It is demonstrated that some fetal structural abnormalities can be detected at a very early gestation (less than 11 weeks of gestation), and this is more likely to occur with major abnormalities.