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. 2014 May 8:14:164.
doi: 10.1186/1471-2393-14-164.

The Welsh study of mothers and babies: protocol for a population-based cohort study to investigate the clinical significance of defined ultrasound findings of uncertain significance

Lisa Hurt  1 , Melissa Wright, Fiona Brook, Susan Thomas, Frank Dunstan, David Fone, Gareth John, Sue Morris, David Tucker, Marilyn Ann Wills, Lyn Chitty, Colin Davies, Shantini Paranjothy
Affiliations

The Welsh study of mothers and babies: protocol for a population-based cohort study to investigate the clinical significance of defined ultrasound findings of uncertain significance

Lisa Hurt et al. BMC Pregnancy Childbirth. .

Abstract

Background: Improvement in ultrasound imaging has led to the identification of subtle non-structural markers during the 18 - 20 week fetal anomaly scan, such as echogenic bowel, mild cerebral ventriculomegaly, renal pelvicalyceal dilatation, and nuchal thickening. These markers are estimated to occur in between 0.6% and 4.3% of pregnancies. Their clinical significance, for pregnancy outcomes or childhood morbidity, is largely unknown. The aim of this study is to estimate the prevalence of seven markers in the general obstetric population and establish a cohort of children for longer terms follow-up to assess the clinical significance of these markers.

Methods/design: All women receiving antenatal care within six of seven Welsh Health Boards who had an 18 to 20 week ultrasound scan in Welsh NHS Trusts between July 2008 and March 2011 were eligible for inclusion. Data were collected on seven markers (echogenic bowel, cerebral ventriculomegaly, renal pelvicalyceal dilatation, nuchal thickening, cardiac echogenic foci, choroid plexus cysts, and short femur) at the time of 18 - 20 week fetal anomaly scan. Ultrasound records were linked to routinely collected data on pregnancy outcomes (work completed during 2012 and 2013). Images were stored and reviewed by an expert panel.The prevalence of each marker (reported and validated) will be estimated. A projected sample size of 23,000 will allow the prevalence of each marker to be estimated with the following precision: a marker with 0.50% prevalence to within 0.10%; a marker with 1.00% prevalence to within 0.13%; and a marker with 4.50% prevalence to within 0.27%. The relative risk of major congenital abnormalities, stillbirths, pre-term birth and small for gestational age, given the presence of a validated marker, will be reported.

Discussion: This is a large, prospective study designed to estimate the prevalence of markers in a population-based cohort of pregnant women and to investigate associations with adverse pregnancy outcomes. The study will also establish a cohort of children that can be followed-up to explore associations between specific markers and longer-term health and social outcomes.

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Figures

Figure 1
Figure 1
Flow chart of recruitment, data collection and data linkage.
See this image and copyright information in PMC

References

    1. National Institute for Health and Clinical Excellence. Antenatal care. NICE Clinical Guideline 62. London: NICE; 2008.
    1. Royal College of Obstetricians and Gynaecologists. Amniocentesis and Chorionic Villus Sampling, Green-top Guideline No 8. London: RCOG; 2010. - PubMed
    1. Bricker L, Garcia J, Henderson J, Mugford M, Neilson J, Roberts T, Martin MA. Ultrasound screening in pregnancy: a systematic review of the clinical effectiveness, cost-effectiveness and women’s views. Health Technol Assess. 2000;4(16):29. - PubMed
    1. Sepulveda W, Romero D. Significance of echogenic foci in the fetal heart. Ultrasound Obstet Gynaecol. 1998;12:445–449. doi: 10.1046/j.1469-0705.1998.12060445.x. - DOI - PubMed
    1. Lamont RF, Havutcu E, Salgia S, Adinkara P, Nicholl R. The association between isolated fetal echogenic cardiac foci on second-trimester ultrasound scan and trisomy 21 in low-risk unselected women. Ultrasound Obstet Gynaecol. 2004;23:346–351. doi: 10.1002/uog.1018. - DOI - PubMed

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