The Ever Evolving 11-14 Week Scan

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Cathy Ridsdale

Abstract

Advancements in ultrasound equipment have led to improved resolution of smaller structures. In turn, this has allowed for the evolution of the 11–14-week scan. At its inception, the first-trimester scan was used primarily to indicate the risk for aneuploidy in a fetus. However, as time passed, the ability to detect structural abnormalities complemented the risk for chromosomal abnormalities. This literature review will discuss the evolution of the 11–14-week scan up to current-day recommendations for population screening.

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References

1 Snijders RJ, Sundberg K, Holzgreve W, Henry G, Nicolaides KH. Maternal age- and gestation-specific risk for trisomy 21. Ultrasound Obstet Gynecol. 1999 Mar;13(3):167-70. doi: 10.1046/j.1469-0705.1999.13030167.x. PMID: 10204206.
2 Nicolaides KH, Heath V, Liao AW. The 11-14 week scan. Bailliere's Best Pract Res Clin Obstet Gynaecol. 2000 Aug;14(4):581-94. doi: 10.1053/beog.2000.0098. PMID: 10985932.
3 Cicero S, Longo D, Rembouskos G, Sacchini C, Nicolaides KH. Absent nasal bone at 11-14 weeks of gestation and chromosomal defects. Ultrasound Obstet Gynecol. 2003 Jul;22(1):31-5. doi: 10.1002/uog.170. PMID: 12858299.
4 Zoppi MA, Ibba RM, Axiana C, Floris M, Manca F, Monni G. Absence of fetal nasal bone and aneuploidies at first-trimester nuchal translucency screening in unselected pregnancies. Prenat Diagn. 2003 Jun;23(6):496-500. doi: 10.1002/pd.628. PMID: 12813765.
5 Souka AP, Pilalis A, Kavalakis I, Antsaklis P, Papantoniou N, Mesogitis S, Antsaklis A. Screening for major structural abnormalities at the 11- to 14-week ultrasound scan. Am J Obstet Gynecol. 2006 Feb;194(2):393-6. doi: 10.1016/j.ajog.2005.08.032. PMID: 16458635.
6 Karim JN, Roberts NW, Salomon LJ, Papageorghiou AT. Systematic review of first-trimester ultrasound screening for detection of fetal structural anomalies and factors that affect screening performance. Ultrasound Obstet Gynecol. 2017 Oct;50(4):429-441. doi: 10.1002/uog.17246. Epub 2017 Sep 7. PMID: 27546497.
7 Syngelaki A , Hammami A, Bower S, Zidere V , Akolekar R and Nicolaides KH. Diagnosis of fetal non-chromosomal abnormalities on routine ultrasound examination at 11–13 weeks’ gestation. Ultrasound Obstet Gynecol 2019; 54: 468–476.
8 ISUOG Practice Guidelines: First Trimester Anatomy Scan. Ultrasound Obstet Gynecol 2013; 41: 102-113.
9 SOGC 2017: The role of Early Comprehensive Fetal Anatomy Ultrasound Examination. J Obstet Gynechol Can 2017; 39(12): 1203-1211.
10 SOGC 2019: Guideline on the use of the First Trimester Ultrasound. J Obstet Gynechol Can 2019; 41(3): 388-395.
11 SOGC 2021: Prevention, Screening, Diagnosis, and Pregnancy Management for Fetal Neural Tube Defects. J Obstet Gynechol Can 2021; 43(1); 124-139
12 OC18.08 J. Karin, S. Gordijn, A.T. Papageorghiou. Ultrasound in Obstetrics & Gynechology 2021; 58(Suppl. 1): 1-57
13 Johnson, J Lifting the quality of the first trimester anatomy scan – what is achievable on a population-wide basis? Sonography Canada SONOCON 2022 conference presentation, October 1, 2022.
14 Hoopmann M, Kagan O. The Fetal Profil. Ultraschall in Med 2017; 38: 611–618
15 International Society of Ultrasound in Obstetrics and Gynecology, Bilardo CM, Chaoui R, Hyett JA, Kagan KO, Karim JN, Papageorghiou AT, Poon LC, Salomon LJ, Syngelaki A, Nicolaides KH. ISUOG Practice Guidelines (updated): performance of 11–14-week ultrasound scan. Ultrasound Obstet Gynecol 2023; 61: 127–143.