Reappraising the Value of Fetal First-Trimester Ultrasonography
Abstract. In the last few years, the introduction of cell-free DNA has rapidly altered prenatal screening regimens and is increasingly offered as the second- or, at times, even the first-tier screening test. Should an early anomaly scan also be part of an up-to-date screening policy? This paper reap...
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Wolters Kluwer Health
2023-04-01
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| Series: | Maternal-Fetal Medicine |
| Online Access: | http://journals.lww.com/10.1097/FM9.0000000000000138 |
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| author | Huirong Tang Mingming Zheng Yang Pan |
| author_facet | Huirong Tang Mingming Zheng Yang Pan |
| author_sort | Huirong Tang |
| collection | DOAJ |
| description | Abstract. In the last few years, the introduction of cell-free DNA has rapidly altered prenatal screening regimens and is increasingly offered as the second- or, at times, even the first-tier screening test. Should an early anomaly scan also be part of an up-to-date screening policy? This paper reappraises the value of fetal first-trimester ultrasonography. The primary aims of the first-trimester scan are to establish gestational age based on the measurement of fetal crown-rump length, to detect multiple pregnancy and chorionicity, and to measure fetal nuchal translucency thickness as part of a combined screening test for chromosomal abnormalities. With recent advancements in ultrasound technology, there is compelling evidence that a majority of fetuses with major structural abnormalities and almost half of them without chromosomal abnormalities can be detected in the first trimester. We focused on the first-trimester screening of fetal major defects, especially including fetal congenital heart disease and cleft lip and palate by ultrasound markers and views. Moreover, it is critical to highlight that after a detailed anomaly scan in the first trimester without major structural anomalies and positive genetic tests, the residual chance of favorable outcome in fetuses with isolated increased nuchal translucency is relatively high. The discussion on the role of cell-free DNA in prenatal screening is still ongoing. Even in the event of it becoming a first-line screening test for aneuploidies, the importance of a first-trimester fetal scan, including assessment of markers for other anomalies, remains undisputed. |
| format | Article |
| id | doaj-art-e6e8a0c92a014a8c900bbd87d0b15239 |
| institution | OA Journals |
| issn | 2096-6954 2641-5895 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Maternal-Fetal Medicine |
| spelling | doaj-art-e6e8a0c92a014a8c900bbd87d0b152392025-08-20T02:29:12ZengWolters Kluwer HealthMaternal-Fetal Medicine2096-69542641-58952023-04-015211511810.1097/FM9.0000000000000138202304000-00009Reappraising the Value of Fetal First-Trimester UltrasonographyHuirong Tang0Mingming Zheng1Yang Pan2Department of Obstetrics and Gynecology, The Affiliated Drum and Tower Hospital of Medical School of Nanjing University, Nanjing, Jiangsu 210000, China.Department of Obstetrics and Gynecology, The Affiliated Drum and Tower Hospital of Medical School of Nanjing University, Nanjing, Jiangsu 210000, China.Department of Obstetrics and Gynecology, The Affiliated Drum and Tower Hospital of Medical School of Nanjing University, Nanjing, Jiangsu 210000, China.Abstract. In the last few years, the introduction of cell-free DNA has rapidly altered prenatal screening regimens and is increasingly offered as the second- or, at times, even the first-tier screening test. Should an early anomaly scan also be part of an up-to-date screening policy? This paper reappraises the value of fetal first-trimester ultrasonography. The primary aims of the first-trimester scan are to establish gestational age based on the measurement of fetal crown-rump length, to detect multiple pregnancy and chorionicity, and to measure fetal nuchal translucency thickness as part of a combined screening test for chromosomal abnormalities. With recent advancements in ultrasound technology, there is compelling evidence that a majority of fetuses with major structural abnormalities and almost half of them without chromosomal abnormalities can be detected in the first trimester. We focused on the first-trimester screening of fetal major defects, especially including fetal congenital heart disease and cleft lip and palate by ultrasound markers and views. Moreover, it is critical to highlight that after a detailed anomaly scan in the first trimester without major structural anomalies and positive genetic tests, the residual chance of favorable outcome in fetuses with isolated increased nuchal translucency is relatively high. The discussion on the role of cell-free DNA in prenatal screening is still ongoing. Even in the event of it becoming a first-line screening test for aneuploidies, the importance of a first-trimester fetal scan, including assessment of markers for other anomalies, remains undisputed.http://journals.lww.com/10.1097/FM9.0000000000000138 |
| spellingShingle | Huirong Tang Mingming Zheng Yang Pan Reappraising the Value of Fetal First-Trimester Ultrasonography Maternal-Fetal Medicine |
| title | Reappraising the Value of Fetal First-Trimester Ultrasonography |
| title_full | Reappraising the Value of Fetal First-Trimester Ultrasonography |
| title_fullStr | Reappraising the Value of Fetal First-Trimester Ultrasonography |
| title_full_unstemmed | Reappraising the Value of Fetal First-Trimester Ultrasonography |
| title_short | Reappraising the Value of Fetal First-Trimester Ultrasonography |
| title_sort | reappraising the value of fetal first trimester ultrasonography |
| url | http://journals.lww.com/10.1097/FM9.0000000000000138 |
| work_keys_str_mv | AT huirongtang reappraisingthevalueoffetalfirsttrimesterultrasonography AT mingmingzheng reappraisingthevalueoffetalfirsttrimesterultrasonography AT yangpan reappraisingthevalueoffetalfirsttrimesterultrasonography |