First-Trimester Morphological Evaluation of Fetuses and Medical Law Implications
<b>Background/Objectives:</b> Over the years, the potential of the first-trimester (FT) ultrasound in the detection of fetal structural defects has increased. The main objectives of the first-trimester fetal screening evaluation are the detection of major structural anomalies and the dia...
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2025-05-01
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| author | Răzvan Grigoraș Căpitănescu Marius Cristian Marinaș Larisa Pătru Dragoș George Popa Elena Cristina Andrei Aura Iuliana Popa Gabriel Florin Răzvan Mogoș Nicolae Dragoș Mărgăritescu Ciprian Laurențiu Pătru |
| author_facet | Răzvan Grigoraș Căpitănescu Marius Cristian Marinaș Larisa Pătru Dragoș George Popa Elena Cristina Andrei Aura Iuliana Popa Gabriel Florin Răzvan Mogoș Nicolae Dragoș Mărgăritescu Ciprian Laurențiu Pătru |
| author_sort | Răzvan Grigoraș Căpitănescu |
| collection | DOAJ |
| description | <b>Background/Objectives:</b> Over the years, the potential of the first-trimester (FT) ultrasound in the detection of fetal structural defects has increased. The main objectives of the first-trimester fetal screening evaluation are the detection of major structural anomalies and the diagnosis of additional sonographic markers for chromosomal disorders. When a fetal anomaly is diagnosed, patients have the right to be informed about the risks, necessary interventions, or alternatives. Depending on the severity of the anomalies and the pregnancy period, the legality of the pregnancy termination was evaluated. The aim of this study was to assess the impact of the first-trimester morphological screening of the fetus using an ultrasound protocol according to the latest international protocols (the ISUOG protocol). <b>Methods:</b> Between 1 January 2024 and 31 December 2024, 854 pregnancies with gestational ages between 11 weeks and 13 weeks + 6 days were morphologically evaluated during the nuchal scan in the Obstetrics and Gynecology Department of the Emergency County Hospital from Craiova. Both transabdominal and transvaginal ultrasound in 2D and in a color Doppler mode were used in the scanning technique. The ultrasound findings were correlated with the genetic testing results and pregnancy outcome. The medical law implications were related to the cases where the ultrasound was performed at about 13 weeks of gestation, and the screening genetic results showed an increased pregnancy risk, which arose during the FT. In these cases, we performed amniocentesis at about 16–17 weeks of gestation, and especially, the Non-Invasive Prenatal Testing (NIPT)-positive cases were confirmed by karyotyping. Still, at this gestational age of diagnosis, the Romanian law would not allow abortions. <b>Results</b>: By using this extended FT ultrasound protocol, we detected 58 cases with fetal structural anomalies. Eighteen cases were also associated with genetic syndromes after performing chorionic villous sampling (CVS). Three cases detected with minor structural anomalies (two cases with club foot and one case with a cleft upper lip) were lost to follow-up. <b>Conclusions:</b> Fetal morphological ultrasound evaluation is feasible in the late first trimester. By using an extended ultrasound protocol, we can detect most of the fetal structural anomalies and contribute to better medical counseling and improve pregnancy outcomes. |
| format | Article |
| id | doaj-art-fee806aefc4d4c7ca6e4919aad76b7ab |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj-art-fee806aefc4d4c7ca6e4919aad76b7ab2025-08-20T03:47:48ZengMDPI AGDiagnostics2075-44182025-05-011510127710.3390/diagnostics15101277First-Trimester Morphological Evaluation of Fetuses and Medical Law ImplicationsRăzvan Grigoraș Căpitănescu0Marius Cristian Marinaș1Larisa Pătru2Dragoș George Popa3Elena Cristina Andrei4Aura Iuliana Popa5Gabriel Florin Răzvan Mogoș6Nicolae Dragoș Mărgăritescu7Ciprian Laurențiu Pătru8Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Human Anatomy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment 9, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Plastic Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment 9, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDoctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of General Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of General Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania<b>Background/Objectives:</b> Over the years, the potential of the first-trimester (FT) ultrasound in the detection of fetal structural defects has increased. The main objectives of the first-trimester fetal screening evaluation are the detection of major structural anomalies and the diagnosis of additional sonographic markers for chromosomal disorders. When a fetal anomaly is diagnosed, patients have the right to be informed about the risks, necessary interventions, or alternatives. Depending on the severity of the anomalies and the pregnancy period, the legality of the pregnancy termination was evaluated. The aim of this study was to assess the impact of the first-trimester morphological screening of the fetus using an ultrasound protocol according to the latest international protocols (the ISUOG protocol). <b>Methods:</b> Between 1 January 2024 and 31 December 2024, 854 pregnancies with gestational ages between 11 weeks and 13 weeks + 6 days were morphologically evaluated during the nuchal scan in the Obstetrics and Gynecology Department of the Emergency County Hospital from Craiova. Both transabdominal and transvaginal ultrasound in 2D and in a color Doppler mode were used in the scanning technique. The ultrasound findings were correlated with the genetic testing results and pregnancy outcome. The medical law implications were related to the cases where the ultrasound was performed at about 13 weeks of gestation, and the screening genetic results showed an increased pregnancy risk, which arose during the FT. In these cases, we performed amniocentesis at about 16–17 weeks of gestation, and especially, the Non-Invasive Prenatal Testing (NIPT)-positive cases were confirmed by karyotyping. Still, at this gestational age of diagnosis, the Romanian law would not allow abortions. <b>Results</b>: By using this extended FT ultrasound protocol, we detected 58 cases with fetal structural anomalies. Eighteen cases were also associated with genetic syndromes after performing chorionic villous sampling (CVS). Three cases detected with minor structural anomalies (two cases with club foot and one case with a cleft upper lip) were lost to follow-up. <b>Conclusions:</b> Fetal morphological ultrasound evaluation is feasible in the late first trimester. By using an extended ultrasound protocol, we can detect most of the fetal structural anomalies and contribute to better medical counseling and improve pregnancy outcomes.https://www.mdpi.com/2075-4418/15/10/1277fetal anomaliesfirst trimesterultrasound |
| spellingShingle | Răzvan Grigoraș Căpitănescu Marius Cristian Marinaș Larisa Pătru Dragoș George Popa Elena Cristina Andrei Aura Iuliana Popa Gabriel Florin Răzvan Mogoș Nicolae Dragoș Mărgăritescu Ciprian Laurențiu Pătru First-Trimester Morphological Evaluation of Fetuses and Medical Law Implications Diagnostics fetal anomalies first trimester ultrasound |
| title | First-Trimester Morphological Evaluation of Fetuses and Medical Law Implications |
| title_full | First-Trimester Morphological Evaluation of Fetuses and Medical Law Implications |
| title_fullStr | First-Trimester Morphological Evaluation of Fetuses and Medical Law Implications |
| title_full_unstemmed | First-Trimester Morphological Evaluation of Fetuses and Medical Law Implications |
| title_short | First-Trimester Morphological Evaluation of Fetuses and Medical Law Implications |
| title_sort | first trimester morphological evaluation of fetuses and medical law implications |
| topic | fetal anomalies first trimester ultrasound |
| url | https://www.mdpi.com/2075-4418/15/10/1277 |
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