Detection of malformations in chromosomally normal fetuses by routine ultrasound at 12 or 18 weeks of gestation - a randomised controlled trial in 39 572 pregnancies
Saltvedt, S ; Almstrom, H ; Kublickas, M ; Valentin, Lil LU
and Grunewald, C
(2006)
In BJOG: An International Journal of Obstetrics & Gynaecology
113(6).
p.664-674
- Abstract
- Objective To compare the antenatal detection rate of malformations in chromosomally normal fetuses between a strategy of offering one routine ultrasound examination at 12 gestational weeks (gws) and a strategy of offering one routine examination at 18 gws. Design Randomised controlled trial. Setting Multicentre trial including eight hospitals. Population A total of 39 572 unselected pregnant women. Methods Women were randomised either to one routine ultrasound scan at 12 (12-14) gws including nuchal translucency (NT) measurement or to one routine scan at 18 (15-22) gws. Anomaly screening was performed in both groups following a check-list. A repeat scan was offered in the 12-week scan group if the fetal anatomy could not be adequately seen... (More)
- Objective To compare the antenatal detection rate of malformations in chromosomally normal fetuses between a strategy of offering one routine ultrasound examination at 12 gestational weeks (gws) and a strategy of offering one routine examination at 18 gws. Design Randomised controlled trial. Setting Multicentre trial including eight hospitals. Population A total of 39 572 unselected pregnant women. Methods Women were randomised either to one routine ultrasound scan at 12 (12-14) gws including nuchal translucency (NT) measurement or to one routine scan at 18 (15-22) gws. Anomaly screening was performed in both groups following a check-list. A repeat scan was offered in the 12-week scan group if the fetal anatomy could not be adequately seen at 12-14 gws or if NT was >= 3.5 mm in a fetus with normal or unknown chromosomes. Main outcome measures Antenatal detection rate of malformed fetuses. Results The antenatal detection rate of fetuses with a major malformation was 38% (66/176) in the 12-week scan group and 47% (72/152) in the 18-week scan group (P = 0.06). The corresponding figures for detection at < 22 gws were 30% (53/176) and 40% (61/152) (P = 0.07). In the 12-week scan group, 69% of fetuses with a lethal anomaly were detected at a scan at 12-14 gws. Conclusions None of the two strategies for prenatal diagnosis is clearly superior to the other. The 12-week strategy has the advantage that most lethal malformations will be detected at < 15 gws, enabling earlier pregnancy termination. The 18-week strategy seems to be associated with a slightly higher detection rate of major malformations, although the difference was not statistically significant. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/406273
- author
- Saltvedt, S
; Almstrom, H
; Kublickas, M
; Valentin, Lil
LU
and Grunewald, C
- organization
- publishing date
- 2006
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- ultrasonography, screening, prenatal diagnosis, abnormalities, prenatal, ultrasound
- in
- BJOG: An International Journal of Obstetrics & Gynaecology
- volume
- 113
- issue
- 6
- pages
- 664 - 674
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000238357600006
- pmid:16709209
- scopus:33646889964
- ISSN
- 1471-0528
- DOI
- 10.1111/j.1471-0528.2006.00953.x
- language
- English
- LU publication?
- yes
- id
- caac6270-519d-4897-8dda-13da306e6028 (old id 406273)
- date added to LUP
- 2016-04-01 15:50:56
- date last changed
- 2022-01-28 07:33:14
@article{caac6270-519d-4897-8dda-13da306e6028,
abstract = {{Objective To compare the antenatal detection rate of malformations in chromosomally normal fetuses between a strategy of offering one routine ultrasound examination at 12 gestational weeks (gws) and a strategy of offering one routine examination at 18 gws. Design Randomised controlled trial. Setting Multicentre trial including eight hospitals. Population A total of 39 572 unselected pregnant women. Methods Women were randomised either to one routine ultrasound scan at 12 (12-14) gws including nuchal translucency (NT) measurement or to one routine scan at 18 (15-22) gws. Anomaly screening was performed in both groups following a check-list. A repeat scan was offered in the 12-week scan group if the fetal anatomy could not be adequately seen at 12-14 gws or if NT was >= 3.5 mm in a fetus with normal or unknown chromosomes. Main outcome measures Antenatal detection rate of malformed fetuses. Results The antenatal detection rate of fetuses with a major malformation was 38% (66/176) in the 12-week scan group and 47% (72/152) in the 18-week scan group (P = 0.06). The corresponding figures for detection at < 22 gws were 30% (53/176) and 40% (61/152) (P = 0.07). In the 12-week scan group, 69% of fetuses with a lethal anomaly were detected at a scan at 12-14 gws. Conclusions None of the two strategies for prenatal diagnosis is clearly superior to the other. The 12-week strategy has the advantage that most lethal malformations will be detected at < 15 gws, enabling earlier pregnancy termination. The 18-week strategy seems to be associated with a slightly higher detection rate of major malformations, although the difference was not statistically significant.}},
author = {{Saltvedt, S and Almstrom, H and Kublickas, M and Valentin, Lil and Grunewald, C}},
issn = {{1471-0528}},
keywords = {{ultrasonography; screening; prenatal diagnosis; abnormalities; prenatal; ultrasound}},
language = {{eng}},
number = {{6}},
pages = {{664--674}},
publisher = {{Wiley-Blackwell}},
series = {{BJOG: An International Journal of Obstetrics & Gynaecology}},
title = {{Detection of malformations in chromosomally normal fetuses by routine ultrasound at 12 or 18 weeks of gestation - a randomised controlled trial in 39 572 pregnancies}},
url = {{http://dx.doi.org/10.1111/j.1471-0528.2006.00953.x}},
doi = {{10.1111/j.1471-0528.2006.00953.x}},
volume = {{113}},
year = {{2006}},
}