P01.03: Screening for non chromosomic fetal malformations using first-trimester followed by second-trimester detailed ultrasound examination: evaluation of the performance

Abstract Background In recent years it has become clear that fetal anomalies can already be detected at the end of the first trimester of pregnancy by two-dimensional (2D) ultrasound. This is why increasingly in developed countries the first trimester anomaly scan is being offered as part of standard care. We have developed a Virtual Reality (VR) approach to improve the diagnostic abilities of 2D ultrasound. Three-dimensional (3D) ultrasound datasets are used in VR assessment, enabling real depth perception and unique interaction. The aim of this study is to investigate whether first trimester 3D VR ultrasound is of additional value in terms of diagnostic accuracy for the detection of fetal anomalies. Health-related quality of life, cost-effectiveness and also the perspective of both patient and ultrasonographer on the 3D VR modality will be studied. Methods Women in the first trimester of a high risk pregnancy for a fetus with a congenital anomaly are eligible for inclusion. This is a randomized controlled trial with two intervention arms. The control group receives ‘care as usual’: a second trimester 2D advanced ultrasound examination. The intervention group will undergo an additional first trimester 2D and 3D VR ultrasound examination. Following each examination participants will fill in validated questionnaires evaluating their quality of life and healthcare related expenses. Participants’ and ultrasonographers’ perspectives on the 3D VR ultrasound will be surveyed. The primary outcome will be the detection of fetal anomalies. The additional first trimester 3D VR ultrasound examination will be compared to ‘care as usual’. Neonatal or histopathological examinations are considered the gold standard for the detection of congenital anomalies. To reach statistical significance and 80% power with a detection rate of 65% for second trimester ultrasound examination and 70% for the combined detection of first trimester 3D VR and second trimester ultrasound examination, a sample size of 2800 participants is needed. Discussion First trimester 3D VR detection of fetal anomalies may improve patients’ quality of life through reassurance or earlier identification of malformations. Results of this study will provide policymakers and healthcare professionals with the highest level of evidence for cost-effectiveness of first trimester ultrasound using a 3D VR approach. Trial registration Dutch Trial Registration number NTR6309, date of registration 26 January 2017.

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Screening for Down syndrome using first-trimester combined screening followed by second-trimester ultrasound examination in an unselected population

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2006.02.046 ◽

2006 ◽

Vol 195 (5) ◽

pp. 1379-1387 ◽

Cited By ~ 69

Author(s):

Patrick Rozenberg ◽

Laurence Bussières ◽

Sylvie Chevret ◽

Jean Pierre Bernard ◽

Lydia Malagrida ◽

...

Keyword(s):

Down Syndrome ◽

Ultrasound Examination ◽

First Trimester ◽

Second Trimester ◽

Unselected Population

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First trimester ultrasound identifies more cases of Down syndrome than second trimester maternal serum screening and is more cost effective

PsycEXTRA Dataset ◽

10.1037/e556492006-009 ◽

2003 ◽

Keyword(s):

Down Syndrome ◽

Cost Effective ◽

First Trimester ◽

Maternal Serum ◽

Second Trimester ◽

Maternal Serum Screening ◽

Serum Screening ◽

First Trimester Ultrasound

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95-OR: Plasma miRNAs Levels at First Trimester of Pregnancy Predict Insulin Sensitivity Estimated at the Second Trimester of Pregnancy

Diabetes ◽

10.2337/db20-95-or ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 95-OR

Author(s):

CÉCILIA LÉGARÉ ◽

VÉRONIQUE DESGAGNÉ ◽

FRÉDÉRIQUE WHITE ◽

MICHELLE S. SCOTT ◽

PATRICE PERRON ◽

...

Keyword(s):

Insulin Sensitivity ◽

First Trimester ◽

Second Trimester ◽

First Trimester Of Pregnancy ◽

Plasma Mirnas

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The case of prenatal ultrasound diagnosis of fibular hemimelia, type I associated with oligodactyly of the foot in the second trimester of gestation

10.21516/2413-1458-2020-19-1-68-72 ◽

2020 ◽

Author(s):

I.N. Daminov

Keyword(s):

Ultrasound Examination ◽

Lower Extremities ◽

Lower Leg ◽

Prenatal Ultrasound ◽

Ultrasound Diagnosis ◽

Type I ◽

Second Trimester ◽

Prenatal Counseling ◽

External Examination ◽

Fibular Hemimelia

A case of prenatal ultrasound diagnosis of fibular hemimelia, type I associated with oligodactyly of the foot at 22 weeks of gestation is presented. Ultrasound examination at 22 weeks of gestation revealed hypoplasia of the left fibula and the foot oligodactyly. After prenatal counseling, the patient opted for termination of pregnancy. During external examination of the abortus asymmetry of the lower extremities due to shortening of the left lower leg and oligodactyly of the left foot were noted, those confirmed prenatal ultrasound data.

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Plasma retinol-binding protein 4 in the first and second trimester and risk of gestational diabetes mellitus in Chinese women: a nested case-control study

Nutrition & Metabolism ◽

10.1186/s12986-019-0425-9 ◽

2020 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Chuyao Jin ◽

Lizi Lin ◽

Na Han ◽

Zhiling Zhao ◽

Zheng Liu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Binding Protein ◽

First Trimester ◽

Retinol Binding Protein ◽

Second Trimester ◽

Retinol Binding Protein 4 ◽

Plasma Retinol

Abstract Background To assess the association between plasma retinol-binding protein 4 (RBP4) levels both in the first trimester and second trimester and risk of gestational diabetes mellitus (GDM). Methods Plasma RBP4 levels and insulin were measured among 135 GDM cases and 135 controls nested within the Peking University Birth Cohort in Tongzhou. Multivariable linear regression analysis was conducted to assess the influence of RBP4 levels on insulin resistance. Conditional logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval (CI) between RBP4 levels and risk of GDM. Results The GDM cases had significantly higher levels of RBP4 in the first trimester than controls (medians: 18.0 μg/L vs 14.4 μg/L; P < 0.05). Plasma RBP4 concentrations in the first and second trimester were associated with fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI) in the second trimester (all P < 0.001). With adjustment for diet, physical activity, and other risk factors for GDM, the risk of GDM increased with every 1-log μg/L increment of RBP4 levels, and the OR (95% CI) was 3.12 (1.08–9.04) for RBP4 in the first trimester and 3.38 (1.03–11.08) for RBP4 in the second trimester. Conclusions Plasma RBP4 levels both in the first trimester and second trimester were dose-dependently associated with increased risk of GDM.

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