3D / 4D US in Fetal Malformations [Part 2. Second Trimester: Cephalic Pole Malformations]

ABSTRACT Screening for fetal malformations is one of the main aims of ultrasonography during pregnancy. In most cases fetal anomalies occur as an unexpected event in not at risk patients: For this reason the only way to rule out congenital malformations is to screen every pregnant patient with a systematic evaluation of the fetal anatomy. The ultrasonic screening of fetal malformations has to be based on a single examination that has to be planned at a gestational age which is advanced enough to visualize most fetal anomalies and early enough to plan further diagnostic tests and allow the termination of pregnancy in the case of severe malformation. The gestational age that constitutes the best compromise between the need of an early diagnosis and the natural history of most congenital malformations is the period ranging from 19 to 21 weeks of gestation. This ultrasonic examination is known as ‘fetal anomaly scan’ or ‘fetal morphology scan’. Some scientific societies suggest guidelines for the optimal performance of such examination. In this paper the minimal standards for an accurate ‘fetal morphology scan’ will be described. How to cite this article D'Addario V, Pinto V, Di Cagno L, Pintucci A, Rossi AC. Fetal Anatomical Survey during Second Trimester Screening Examination. Donald School J Ultrasound Obstet Gynecol 2012;6(1):43-54.

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Pregnancy outcomes regarding maternal serum AFP value in second trimester screening

Journal of Perinatal Medicine ◽

10.1515/jpm-2016-0101 ◽

2017 ◽

Vol 45 (7) ◽

Cited By ~ 1

Author(s):

Karolina Bartkute ◽

Dalia Balsyte ◽

Josef Wisser ◽

Juozas Kurmanavicius

Keyword(s):

Gestational Age ◽

Pregnancy Outcomes ◽

Maternal Serum ◽

Adverse Pregnancy Outcomes ◽

Fetal Malformation ◽

Second Trimester ◽

Second Trimester Screening ◽

Newborn Weight ◽

Fetal Malformations ◽

Adverse Pregnancy

AbstractAim:The aim of this study was to evaluate the predictive value of α-fetoprotein in maternal serum (MS-AFP) as a marker for diverse pregnancy outcomes.Methods:The study was based on pregnancy and delivery data from 5520 women between 1999 and 2014 at University Hospital of Zurich (UHZ). Inclusion criteria: both MS-AFP and pregnancy outcome were known for the same pregnancy. Pregnancy outcomes and characteristics such as fetal malformation, intrauterine fetal death (IUFD) and intrauterine growth retardation as well as maternal age, weight before pregnancy, gestational age (GA) at delivery, newborn weight, length and head circumference were analyzed with respect to the MS-AFP value. MS-AFP value was categorized into three groups: elevated MS-AFP>2.5 multiples of the median (MoM), normal 0.5–2.49 MoM and decreased <0.5 MoM.Results:Newborn weight (g) and length (cm) were significantly lower in the elevated MS-AFP (P<0.001) group, and infants had 1 week lower GA at delivery (P<0.05). In the group of elevated MS-AFP (n=46), 26.1% of pregnancies were significantly related to adverse pregnancy outcomes, such as fetal malformations, fetuses small for gestational age (SGA) and IUFD. Adverse pregnancy outcomes of 5.6% were registered in the group of normal MS-AFP and 7.3% in the group of low MS-AFP (P<0.05).Conclusion:MS-AFP level in the second trimester is still an important indicator of fetal surface malformations; however, ultrasound still outweighs as a screening method. Nevertheless, pregnant women with elevated MS-AFP values and with no sonographically detected fetal malformations should additionally receive the third trimester ultrasound examination to exclude other possible complications of pregnancy.

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