Detailed Second Trimester Ultrasound Examination in Low Risk Pregnancies: A Tertiary Center Experience

Abstract

Aim: Congenital anomalies are abnormal deviations from the standard type during morphogenesis that include fetal structural and functional abnormalities. A major congenital anomaly affects 2-3% of newborn babies. Major congenital anomalies are second major causes of prenatal mortality and morbidity after preterm birth. The aim of this study is to evaluate the anomaly type, incidence and prognosis of pregnancies which were found to have congenital anomaly during prenatal period.Material and Methods: The detailed ultrasound results of 2640 pregnant women who were followed at our hospital and as well as pregnant women referred to high-risk pregnancy clinic for various indications such as minor marker presence, family history and advanced maternal age were evaluated retrospectively.Results: A total of 107 major congenital anomalies were detected in 93 3.5% patients. The most common abnormality was detected in central nervous system 34.6% and the most common abnormalities in this group were ventriculomegaly and hydrocephalus 15/37 . The second most common malformations were detected in cardiovascular system. In this group septal defects were the most frequent malformations 9/21 . 79.4% 85 of fetuses with major fetal anomalies’ were diagnosed in 18 to 23 weeks detailed ultrasound scan.Conclusion: A large proportion of major fetal structural anomalies can be identified with 18-23 week detailed ultrasound evaluation; however, in cases whom, adequate visualization cannot be provided at second trimester, with the re-evaluation in the 3rd trimester, more than 90% of patients can be diagnosed in prenatal period.

Keywords

• 18-23 week ultrasound,major fetal anomalies,prenatal diagnosis

Düşük Riskli Gebelerde İkinci Trimester Ultrason Taraması: Tersiyer Merkez Sonuçları

Abstract

Amaç: Konjenital anomaliler, morfogenez sırasında, anormal gelişim sonucu meydana gelen fetal yapısal ve işlevsel anomalileri içerir. Yeni doğanların %2-3’ünde majör konjenital anomali bulunmaktadır. Majör anomaliler, preterm doğumlardan sonra fetal mortalite ve morbiditenin en önemli ikinci sıklıktaki sebebidir. Çalışmamızın amacı, kliniğimizde prenatal dönemde saptanan fetal anomalilerin tiplerini, insidans ve prognozlarını değerlendirmektirMateryal ve Metod: Hastanemiz gebe polikliniğinde takipleri yapılan ve riskli gebelik polikliniğine minör marker varlığı, aile hikâyesi, ileri anne yaşı gibi çeşitli endikasyonlar ile refere edilmiş olan 2640 hastanın detaylı ultrason sonuçları retrospektif olarak değerlendirildi.Sonuçlar: 2640 Hastanın 93’ünde %3.5 toplam 107 major konjenital anomali tespit edildi. En sık anomali tespit edilen sistem merkezi sinir sistemi olup %34.6 , bu grupta en sık ventrikülomegali ve hidrosefali 15/37 saptandı. İkinci sıklıkta kardiyak anomaliler saptanır iken, bu grupta en sık karşılaşılan malformasyon ise septal defektler idi 9/21 . Majör fetal anomalisi bulunan fetusların %79.4’üne 85 18-23 hafta detaylı ultrason taramasında tanı konuldu.Tartışma: Majör fetal yapısal anomalilerin büyük bir bölümü 18-23 haftalar arasında yapılacak detaylı ultrason değerlendirmesi ile tanımlanabilmekte ise de, yeterli görüntülemenin sağlanamadığı olgularda 3. trimesterde yapılacak tekrar değerlendirmeler ile prenatal dönemde olguların %90’dan fazlasına tanı konulabilir.

Keywords

• 18-23 hafta ultrasonografisi,majör fetal anomali,prenatal tanı

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