Introduction of a nationwide first-trimester anomaly scan in the Dutch national screening program

A significant proportion of major fetal structural anomalies can be detected in the first trimester by ultrasound examination. However, the test performance of the first-trimester anomaly scan performed in a low-risk population as part of a nationwide prenatal screening program is unknown. Potential...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2024-07
Main Authors: Lust, Eline E.R., Bronsgeest, Kim, Henneman, Lidewij, Crombag, Neeltje, Bilardo, Caterina M., Galjaard, Robert-Jan H., Sikkel, Esther, van der Hout, Sanne, Coumans, Audrey, Elvan-Taşpınar, Ayten, Go, Attie T.J.I., Galjaard, Sander, Manten, Gwendolyn T.R., Pajkrt, Eva, van Leeuwen, Liesbeth, Haak, Monique C., Bekker, Mireille N.
Format: Article
Language:English
Subjects:
congenital abnormalities
fetal anomalies
first-trimester
first-trimester anomaly scan
FTAS
genetics
implementation
prenatal diagnosis
prenatal screening
prenatal ultrasonography
sensitivity and specificity
test characteristics
test performance
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Summary:A significant proportion of major fetal structural anomalies can be detected in the first trimester by ultrasound examination. However, the test performance of the first-trimester anomaly scan performed in a low-risk population as part of a nationwide prenatal screening program is unknown. Potential benefits of the first-trimester anomaly scan include early detection of fetal anomalies, providing parents with more time for reproductive decision-making. To investigate the uptake, test performance, and time to a final prenatal diagnosis after referral. A nationwide implementation study was conducted in the Netherlands (November 2021−November 2022). The FTAS was performed between 12+3 and 14+3 weeks of gestation by certified sonographers using a standard protocol. Women were referred to a tertiary care center if anomalies were suspected. Uptake, test performance, and time to a final prenatal diagnosis (days between referral and date of final diagnosis/prognosis for reproductive decision-making) were determined. Test performance was calculated for first-trimester major congenital anomalies, such as anencephaly and holoprosencephaly and all diagnosed anomalies
ISSN:0002-9378
1097-6868
1097-6868
DOI:10.1016/j.ajog.2024.07.026