Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Additional registration fee required

Faculty have requested this content not be shared on social media

CME Credit Offered

Poster Icons

Foundation Awardee

No Social Media

Back

Q&A

Ultrasound/Imaging

Poster Session 4

(1124) Reproductive Outcomes with Universal Detailed First Trimester Ultrasound

Wednesday, February 14, 2024

1:00 PM – 2:30 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Lauren Roby, MD

Resident
Christiana Care Health Services
Newark, DE, United States

Coauthor(s)

Anne Reed-Weston, MD (she/her/hers)

Resident Physician
Christiana Care Health Systems
Newark, DE, United States
PS

Philip Shlossman, MD

Delaware Center for Maternal & Fetal Medicine of Christiana Care, Inc.
Newark, DE, United States
Anthony C. Sciscione, DO

Program Director
Delaware Center for Maternal & Fetal Medicine of Christiana Care, Inc.
Newark, DE, United States

Objective: In a political climate where reproductive autonomy is being challenged and earlier decisions are key to access in many states, we sought to determine the effect on termination rates of performing routine detailed first trimester ultrasounds (DFTUs).

Study Design: At our institution, we offer all pregnant patients DFTU’s and cell free DNA screening (cfDNA). We performed a retrospective cohort study of all pregnancies who received a DFTU between February 23, 2022 and March 31, 2023. All exams were performed by the Division of Maternal-Fetal Medicine at our large academic teaching hospital. The cohort was divided into two groups: those with fetal anomalies found on DFTU and those without. Our primary outcome was the rate of termination. Univariate analysis was performed.

Results: A total of 3715 patients had a DFTU, of which 41 (1.10%) of DFTUs had at least one fetal anomaly noted. There was no difference in maternal BMI between the groups. Maternal age was greater in the abnormal DFTU group (33.1 versus 30.7, p = 0.004), as was gravidity (3.54 versus 2.57, p = 0.0003). Gestational age at time of DFTU performance was lower in the abnormal DFTU group (12.7 weeks versus 13.0 weeks, p < 0.001). 18/41 (43.9%) chose elective termination versus 11/3674 (0.30%) without an anomaly (P< 0.001). Of the 18 who chose elective termination 14/18 (77.8%) did so based on the results of the DFTU, terminating prior to their routine second trimester ultrasound. Of the patients who shared the gestational age at which they terminated, the average gestational age at termination with abnormal DFTU was 15.6 weeks (SD 3.99) versus 19.8 weeks (SD 2.86) for those with normal DFTU. Of those 18, 13/18 (72.2%) also had a genetic anomaly identified on a genetic test (cfDNA, CVS, or amniocentesis).

Conclusion: Patients who have an abnormal DFTU are likely to pursue an elective termination, and the majority of those happen before a routine second trimester sonogram is performed.