Performance of first trimester fetal anomaly scan: Single center results of six years Erol Arslan, Selim Buyukkurt, Mete Sucu, Selahattin Misirlioglu, Mehmet Ozsurmeli, Suleyman Cansun Demir, Ismail Cuneyt Evruke

Aim/Background First trimester ultrasound……Aneuploidy Screening Second trimester ultrasound……Fetal Anatomy Screening

Aim/Background Question 1: Can first trimester ultrasound be used for early anomaly detection????? If so, which kind of anomalies can be detected in early ultrasound examination?

Material and Method Retrospective Terminated single pregnancies due to fetal anomalies detected at and before 15+6 weeks From 2011 to 2016 Two groups: 2011-2013 and 2014-2016 Statistical Method: Fisher’s Exact Test

Material and Method Excluded ultrasonographic findings: Thickened nuchal translucency Tricuspid regurgitation A wave on ductus venosus doppler

Results In total 244 pregnancies were terminated 109 terminated during 2011-2013 (group 1) 135 terminated during 2014-2016 (group 2) 24% increase in diagnosed patients in group 2 comparing group 1

Results In total 287 anomalies were detected 121 were in group 1 37% increase in detected anomalies in group 2 comparing group 1

2011-2013 2014-2016 Cranial NTD 45 44 Spina bifida 5 4 Sacrococcygeal teratoma 1 Holoprosencephaly 3 6 Ventriculomegaly Cerebellar hypoplasia 2 AVSD Hypoplastic left ventricle Cystic hygroma 24 38 Hydrops fetalis 13 7 Micrognathia Nasal hypoplasia 9 Multicystic dysplastic kidney Renal agenesis Megacystitis Abdominal wall defects 10 17 Skeletal dysplasia Intestinal obstruction

Results The percentage of acrania/anencephaly and hydrops/non-hydrops fetalis in all anomalies were significantly higher in group 1. The percentage of AVSD and nasal bone hypoplasia in all anomalies were significantly higher in group 2.

Discussion A data of eight centers from 36,237 pregnancies showed a 29% detection rate of fetal anomalies during first trimester screening. A. Borrell et. All Clinical value of the 11 to 13+6 weeks sonogram for detection of congenital malformations: a review Am J Perinatol, 28 (2011), 117-124

Discussion In another review the highest rate was found for thorax/ abdomen group excluding cardiac defect and it was followed by central nervous system group. The detection rate of cardiac defect was 20% Harm-Gerd Karl Blaas, Detection of structural abnormalities in the first trimester using ultrasound

Discussion Whereas first trimester screening getting popular in developed countries, it is mostly using for aneuploidy screening in our country. Still most of the detected anomalies in first trimester were acrania/anencephaly and cystic hygroma in our study. Against it our diagnostic performance for specific anomalies like AVSD was improved

Conclusion During fetal aneuploidy screening in first trimester a meticulous examination can reveal major fetal abnormalities Early detection may make easier the termination for family.