scholarly journals P07.17: The use of first trimester biochemical markers for crown-rump length quality control

2012 ◽  
Vol 40 (S1) ◽  
pp. 197-197 ◽  
Author(s):  
J. Sabria ◽  
E. Sabrià ◽  
A. Borrell ◽  
R. Navarro ◽  
M. Gómez Roig ◽  
...  
Keyword(s):  
Quality Control ◽  
Biochemical Markers ◽  
First Trimester ◽  
Crown Rump Length

Quality control of ultrasonography markers for Down’s syndrome screening: a retrospective study by the laboratory

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Blanca Badal ◽  
Antonieta Ballesteros ◽  
Miriam Crespo ◽  
Daniel Morell-Garcia ◽  
Josep Miquel Bauçà ◽  
...  
Keyword(s):  
Quality Control ◽  
Protein A ◽  
Quality Criteria ◽  
First Trimester ◽  
Control Group ◽  
Aneuploidy Screening ◽  
Crown Rump Length ◽  
First Trimester Of Pregnancy ◽  
Cumulative Sum Control

Abstract Objectives Quality control of ultrasonography markers is necessary to ensure greater efficacy of prenatal aneuploidy screening. The aim of this study was to assess the quality of the crown-rump length (CRL) and nuchal translucence (NT) measurement accuracy by the laboratory according to quality indicators. Methods Retrospective observational study on 4,908 single-foetus pregnant women who underwent prenatal aneuploidy screening in the first trimester of pregnancy. Euploid foetuses with CRL between 45 and 84 mm were included, while those with NT≥3.5 mm were excluded. CRL measurement was considered to be accurate if the median multiples of the median (MoM) for pregnancy-associated plasma protein A (PAPP-A) was between 0.90 and 1.10. Fifteen sonographers participated in the study, six of whom comprised the control group. Systematic error for a sonographer was considered when CRL measurement was greater than ±2 mm with respect to the control group. Quality for NT was assured by means of the WHIRI method and each sonographer cumulative sum control chart (CUSUM). Results For CRL accuracy, five sonographers underestimated the measurements, while another four overestimated them, with no statistical differences. For smaller sized foetuses, all sonographers met the established specifications. Regarding NT control, three sonographers did not meet the quality criteria for the median MoM. All sonographers met the specifications for the logarithmic standard deviation of the NT MoM levels. Thirteen sonographers met the CUSUM specifications. Conclusions Evaluation of a quality control of ultrasonography parameters by laboratory professionals is necessary to avoid under- or overestimation tendencies for CRL and NT measurements. CUSUM is a useful tool for the immediate correction of errors in NT measurements.

scholarly journals Maternal serum biochemical markers combined with ultrasound diagnosis at the end of the first trimester

2021 ◽  
Vol 26 (4) ◽  
pp. 2879-2884
Author(s):  
MARIUS CRISTIAN MARINAȘ ◽  
LUCIAN GEORGE ZORILĂ ◽  
CIPRIAN LAURENȚIU PĂTRU ◽  
TIBERIU ȘTEFĂNIȚĂ ȚENEA COJAN ◽  
VLAD DUMITRU BALEANU ◽  
...  
Keyword(s):  
Biochemical Markers ◽  
Protein A ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Maternal Serum ◽  
Early Screening ◽  
Crown Rump Length ◽  
Chamber View ◽  
Great Vessel Anomalies ◽  
Serum Biochemical

Objectives. Evaluating the benefits of an early screening of combined maternal markers and ultrasound of the fetuses. Methods. Prospective study (1 January and 31 December 2018) enrolled 187 patients, evaluated at the end of the first trimester of pregnancy (nuchal scan). Biochemical markers: detection of free β human chorionic gonadotropin and serum pregnancy associated plasma protein A. The first trimester ultrasound examination included the assessment of the nuchal translucency, fetal crown rump length and fetal heart. Results. 9 cases with abnormal biomarkers, increased nuchal translucency and cardiac anomalies, including abnormal 4-chamber view (6 cases) and great vessel anomalies (3 cases). 1 case considered initially negative in the first trimester was diagnosed by morphological scan with tetralogy of Fallot in the second trimester. Conclusions. A first trimester combined ultrasound protocol and maternal serum biochemical markers is important in the early prenatal care screening.

Is there a Need for Own Median Calculation in the Second Trimester Biochemical Markers Screening?

2017 ◽  
Vol 68 (5) ◽  
pp. 1070-1072
Author(s):  
Dan Navolan ◽  
Mirela Nicolov ◽  
Simona Vladareanu ◽  
Ioana Ciohat ◽  
Marius Craina ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Biochemical Markers ◽  
Biochemical Marker ◽  
Second Trimester ◽  
Established Method ◽  
Crown Rump Length ◽  
The Difference ◽  
Fetal Aneuploidies ◽  
Singleton Pregnancies

Screening of fetal aneuploidies in early pregnancy is a well-established method in the materno-fetal medicine. The aim of our study was to analyze if the medians recommended by the manufacturers are adequate to perform an accurate screening or if there is a need for own laboratory medians calculation in second trimester biochemical marker screening.Sera were collected between 14 wp and 22 wp from 3374 singleton pregnancies. We analyzed three second trimester biochemical markers (AFP, hCG and free Estriol) concentration in all pregnant women and in a subgroup of pregnant women in which gestational age was determined based on crown-rump length. Our results showed that for all biochemical markers the difference between the manufacturer and the own calculated median was lower than 10% excepting the hCG value in the group of pregnant women in which the gestational age was determined on basis of crown-rump-length. Our results show it is recommended to replace the values of the median for hCG measurement with the own laboratory calculated medians. This does not seem to be necessary in the case of AFP and free Estriol measurement.

Crown–rump length measurement: a new age for first‐trimester ultrasound?

2021 ◽  
Author(s):  
J. Stirnemann ◽  
M. Massoud ◽  
N. Fries ◽  
C. Dumont ◽  
G. Haddad ◽  
...  
Keyword(s):  
First Trimester ◽  
New Age ◽  
Length Measurement ◽  
Crown Rump Length ◽  
First Trimester Ultrasound

scholarly journals Frontomaxillary Facial Angle Measurement in Screening for Trisomy 18 at 11 + 0 to 13 + 6 Weeks of Pregnancy: A Double-Centre Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Bartosz Czuba ◽  
Wojciech Cnota ◽  
Agata Wloch ◽  
Piotr Wegrzyn ◽  
Krzysztof Sodowski ◽  
...  
Keyword(s):  
Final Analysis ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Angle Measurement ◽  
Trisomy 18 ◽  
Crown Rump Length ◽  
Beta Hcg ◽  
Large Populations ◽  
Trimester Screening ◽  
Independent Marker

Objective. The aim of this study was to evaluate the effectiveness of prenatal screening for trisomy 18 with the use of the frontomaxillary facial angle (FMF angle) measurement.Material and Methods. The study involved 1751 singleton pregnancies at 11–13 + 6 weeks, examined between 2007 and 2011. Serum PAPP-A and free beta-hCG levels were assessed, and crown-rump length, nuchal translucency, and FMF angle were measured in all patients. 1350 fetuses with known follow-up were included in the final analysis.Results. Highly significant (P<0.01) negative correlation between the CRL and the FMF angle was found. There were 30 fetuses with trisomy 18. FMF angle was highly significantly larger (P<0.0001) in fetuses with trisomy 18 as compared to chromosomally normal fetuses. Two models of first trimester screening were compared: Model 1 based on maternal age, NT, and first trimester biochemistry test (DR 80–85% and FPR 0.3–0.6%), and Model 2 = Model 1 + FMF angle measurement (DR 87.3–93.3% and FPR 0.8–1.3%).Conclusions. The use of FMF angle measurement increases the effectiveness of the screening for trisomy 18. Introduction of the FMF angle as an independent marker for fetal trisomy 18 risk requires further prospective research in large populations.

First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies

2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Tanya Maric ◽  
Natasha Singh ◽  
Keith Duncan ◽  
Guy J. Thorpe-Beeston ◽  
Makrina D. Savvidou
Keyword(s):  
Fetal Growth ◽  
Case Control Study ◽  
Subsequent Development ◽  
First Trimester ◽  
Case Control ◽  
Retrospective Case ◽  
Crown Rump Length ◽  
Significant Difference ◽  
Twin Pregnancies ◽  
Control Study

AbstractTo investigate the relation between first-trimester fetal growth discrepancy, as assessed by crown-rump length (CRL) at 11+0 to 13+6 weeks of gestation, and subsequent development of preeclampsia (PE) in dichorionic diamniotic (DCDA) twin pregnancies. The association between inter-twin CRL and birth weight (BW) discrepancy was also investigated.This was a retrospective, case-control study of DCDA twin pregnancies. Inter-twin CRL discrepancy was calculated as 100×(larger CRL–smaller CRL)/larger CRL. BW discordance was calculated as 100×(larger BW–smaller BW)/larger BW.The study included 299 DCDA pregnancies that remained normotensive and 35 that subsequently developed PE. There was no significant difference in the inter-twin CRL discrepancy between pregnancies complicated by PE and those that were not [3.2%, interquartile range (IQR): 0.5–4.5% vs. 3.3%, IQR: 1.4–5.5%; P=0.17]. There was a positive correlation between inter-twin CRL and BW discrepancy but only in pregnancies that remained normotensive (P<0.001). In women that subsequently developed PE, there was no association between inter-twin CRL and BW discordance (P=0.54).In unselected DCDA twins, first-trimester CRL discrepancy is not different between pregnancies that subsequently develop PE and those that remain normotensive. Furthermore, in pregnancies that are complicated by PE, the association between inter-twin CRL and BW discrepancy appears to be lost.

Three-dimensional ultrasound first trimester fetal volume measurement and its relation to pregnancy outcome

2017 ◽  
Vol 45 (9) ◽  
Author(s):  
Haitham A. Torky ◽  
Asem A. Moussa ◽  
Ali M. Ahmad ◽  
Osama Dief ◽  
Manar A. Eldesoouky ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Preterm Labor ◽  
Three Dimensional ◽  
First Trimester ◽  
3D Ultrasound ◽  
Secondary Outcome ◽  
Crown Rump Length

AbstractAim of work:To determine whether fetal volume (FV) measured by three-dimensional (3D) ultrasound was able to detect fetuses at risk of low birth weight (primary outcome) and/or preterm labor (secondary outcome).Methods:One hundred pregnant women carrying a singleton living pregnancy who were sure of dates, and had a dating scan, with gestational age between 11 weeks and 13 weeks+6 days coming for routine first trimester nuchal translucency (NT) were examined by both two-dimensional (2D) and 3D ultrasound (Vocal System) for crown-rump length (CRL) and FV then followed up regularly every 4 weeks until 28 weeks then biweekly until 36 weeks then weekly until delivery both clinically and by ultrasound biometry.Findings:Eighty-seven cases had a normal outcome, while the remaining 13 cases had either preterm labor (four cases) or low-birth weight (nine cases). FV positively correlated with CRL (P=0.026), gestational age in weeks (P=0.002), neonatal body weight in grams (P=0.018) and neonatal body length at birth (P=0.04). A mean FV of 8.3 mmConclusion:3D assessment of FV in the first trimester provides an accurate method for predicting pregnancy outcome namely low birth weight and neonatal complications, however, it is a better positive predictor than a negative one.

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