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• W2019970594 abstract "ObjectiveAs ultrasound (US) has advanced the ability to visualize fetal anatomy at earlier gestational ages, it has engenderend attempts to perform fetal anatomy scans in the first trimester. First trimester US may improve anomaly detection but may also increase overall US utilization. We sought to assess the utility of first trimester US in a decision analysis.Study DesignA decision analytic model was created to compare first + second trimester anatomy scan to second trimester anatomy scan alone in 4 populations: overall, normal weight women, obese women, and diabetics. We assumed that: 1) all women undergoing first trimester anatomy scan would undergo second trimester anatomy scan, 2) when anatomy could not be completely visualized in the second trimester, a repeat US would be performed, to a maximum of 4 attempts. Probability estimates were obtained from the literature. Outcomes considered were number of: major structural anomalies detected, US performed, false positive US, and anomalies undetected. Multivariable sensitivity analyses were performed to evaluate the consistency of the model with varying assumptions.ResultsIn 4 theoretical cohorts of 10,000 pregnancies, a strategy of first trimester US detected the highest number of anomalies but required more US per anomaly detected (Table). First + second trimester anatomy scan was associated with a small increase in false positive US (<10/10,000). In populations with higher anomaly prevalence and lower second trimester US sensitivity (i.e. diabetes, obese), the number of additional US performed per anomaly detected with the first trimester US was <60/10,000 women.ConclusionIn populations at high risk for major structural anomalies, a first trimester anatomy scan in addition a second trimester scan may be a beneficial approach to detecting anomalies with fewer than 60 additional US per 10,000 women to detect 1 anomaly. The utility of first trimester anatomy scans should be evaluated prospectively in these high risk groups. ObjectiveAs ultrasound (US) has advanced the ability to visualize fetal anatomy at earlier gestational ages, it has engenderend attempts to perform fetal anatomy scans in the first trimester. First trimester US may improve anomaly detection but may also increase overall US utilization. We sought to assess the utility of first trimester US in a decision analysis. As ultrasound (US) has advanced the ability to visualize fetal anatomy at earlier gestational ages, it has engenderend attempts to perform fetal anatomy scans in the first trimester. First trimester US may improve anomaly detection but may also increase overall US utilization. We sought to assess the utility of first trimester US in a decision analysis. Study DesignA decision analytic model was created to compare first + second trimester anatomy scan to second trimester anatomy scan alone in 4 populations: overall, normal weight women, obese women, and diabetics. We assumed that: 1) all women undergoing first trimester anatomy scan would undergo second trimester anatomy scan, 2) when anatomy could not be completely visualized in the second trimester, a repeat US would be performed, to a maximum of 4 attempts. Probability estimates were obtained from the literature. Outcomes considered were number of: major structural anomalies detected, US performed, false positive US, and anomalies undetected. Multivariable sensitivity analyses were performed to evaluate the consistency of the model with varying assumptions. A decision analytic model was created to compare first + second trimester anatomy scan to second trimester anatomy scan alone in 4 populations: overall, normal weight women, obese women, and diabetics. We assumed that: 1) all women undergoing first trimester anatomy scan would undergo second trimester anatomy scan, 2) when anatomy could not be completely visualized in the second trimester, a repeat US would be performed, to a maximum of 4 attempts. Probability estimates were obtained from the literature. Outcomes considered were number of: major structural anomalies detected, US performed, false positive US, and anomalies undetected. Multivariable sensitivity analyses were performed to evaluate the consistency of the model with varying assumptions. ResultsIn 4 theoretical cohorts of 10,000 pregnancies, a strategy of first trimester US detected the highest number of anomalies but required more US per anomaly detected (Table). First + second trimester anatomy scan was associated with a small increase in false positive US (<10/10,000). In populations with higher anomaly prevalence and lower second trimester US sensitivity (i.e. diabetes, obese), the number of additional US performed per anomaly detected with the first trimester US was <60/10,000 women. In 4 theoretical cohorts of 10,000 pregnancies, a strategy of first trimester US detected the highest number of anomalies but required more US per anomaly detected (Table). First + second trimester anatomy scan was associated with a small increase in false positive US (<10/10,000). In populations with higher anomaly prevalence and lower second trimester US sensitivity (i.e. diabetes, obese), the number of additional US performed per anomaly detected with the first trimester US was <60/10,000 women. ConclusionIn populations at high risk for major structural anomalies, a first trimester anatomy scan in addition a second trimester scan may be a beneficial approach to detecting anomalies with fewer than 60 additional US per 10,000 women to detect 1 anomaly. The utility of first trimester anatomy scans should be evaluated prospectively in these high risk groups. In populations at high risk for major structural anomalies, a first trimester anatomy scan in addition a second trimester scan may be a beneficial approach to detecting anomalies with fewer than 60 additional US per 10,000 women to detect 1 anomaly. The utility of first trimester anatomy scans should be evaluated prospectively in these high risk groups." @default.
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• W2019970594 date "2015-01-01" @default.
• W2019970594 modified "2023-09-26" @default.
• W2019970594 title "405: Utility of first trimester anatomy scan for detecting anomalies: a decision analysis" @default.
• W2019970594 doi "https://doi.org/10.1016/j.ajog.2014.10.451" @default.
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