155: Assessment of the number of umbilical cord vessels at the time of nuchal translucency screening

Abstract

Objective: To investigate feasibility of identifying the number of vessels in umbilical cord during nuchal translucency screening. Methods: We performed a prospective study in patients undergoing nuchal translucency screening at 11.0-13.9 weeks’ from 2011-2012. An oblique transverse view of fetal abdomen utilizing Doppler flow and a cross section view of free loop of umbilical cord were obtained. Maternal characteristics, technical aspects of first trimester ultrasound, and number of umbilical cord vessels identified in the second trimester were collected. McNemar’s test and kappa analysis were used to compare quantification of umbilical cord vessels in the first vs. second trimesters. Results: Total of 123 women were included. The number of umbilical cord vessels was successfully visualized in 95.9% of patients utilizing the bladder view, and 65.0% of patients on cross sectional cord views. Three-vessel cord was correctly identified in 99.2% of patients; one case was incorrectly diagnosed with a two two-vessel cord. McNemar’s test indicated that overall, first and second trimester ultrasounds have the same propensity to detect umbilical cord vessels (p=0.414), with moderate agreement (kappa=0.226). Conclusions: Identification of umbilical cord vasculature is possible in the first trimester and can be used as an adjunct to early fetal anatomy evaluation.