P01.10: Effect of training on feasibility of early morphology evaluation at 11‐13 + 6 weeks of gestation

Abstract

To test the feasibility of ultrasound screening for fetal malformations at 11-13 + 6 weeks of gestation (wg) performed by unexperienced trainee after one month training. Trainee in obstetrics analyzed 255 consecutive fetuses at 11-13 + 6 wg contextually at NT measurement. Each operator tried to obtain in each fetus an ultrasound evaluation for: CRL, Nuchal Translucency (NT), nasal bone (NB), internal NT (iNT), cephalic circumference (CC), falx cerebri, thalamus, cerebellum, brain stem, lens, jaw, bone palate, abdominal circumference (AC), stomach, diaphragm, lungs, thymus, upper and lower limb bones, bladder, umbilical arteries, kidneys, renal arteries, cardiac four chambers (4Cw) and great vessels sections (3Vw), aortic arch, ductus venosus flow, tricuspid regurgitation (TR). Each operator evaluated the ultrasound features and recorded them as “visualized, not visualized” and “normal, abnormal, invaluable”. Subsequently the stored ultrasound images were blinded evaluated by an expert operator and results were compared. 254 women were performed. 265 fetuses were examined (10 twin pregnancies). Average wg was 12,4 ± 0,4. Visualization of CRL, NT, NB, CC, AC, Upper and Lower Bones, falx cerebri, thalamus, lens, jaw, bone palate, stomach, lungs, upper and lower limb bones, bladder, umbilical arteries, cardiac four chambers (4Cw) and great vessels sections (3Vw) was above 98%( confirmed by expert operators). Discordant % of visualization was found for iNT (95 vs 90), Cerebellum (88%vs72%) brain stem (97%vs88%) Lens (100%vs95%) Diaphragm (99%vs92%) Thymus (14%vs11%). Kidneys (99%vs95%) renal arteries (92%vs55%) TR (96%vs90%) aortic arch (96%vs79%) DV (97%vs88%). Complete concordance between normal and abnormal evaluation was assessed. Ultrasound screening for fetal malformations at 11-13 + 6 wg is feasible even if performed after a brief training. Pitfalls in the visualization of kidneys, ductus venosus flow ant tricuspid regurgitation are frequent.