(1155) Prenatal evaluation of fetal abdominal calcifications in the age of advanced sonographic and genetic screening.

The advent of maternal cell free DNA (cfDNA) screening has led to early detection of fetuses with chromosomal abnormalities. Similarly, prenatal ultrasound technique and equipment have advanced leading to increased detection of soft markers of aneuploidy such as abdominal calcifications (AC). The purpose of our study was to assess neonatal outcomes after detection of fetal ACs.

Study Design:

This is a retrospective case series of patients diagnosed with fetal abdominal calcifications at a single center between 2016 and 2023. A query was created within our ultrasound software (Viewpoint 2.0). Presence, location, number and size of ACs, presence of other soft markers and abnormalities were collected. Chart review was used to determine gestational age (GA) of diagnosis, maternal demographics, viral serologies, genetic/ carrier screening and pregnancy outcomes.

Results:

130 patients had fetal ACs. Prenatal detection of ACs increased steadily within the study period. 73.5% of patients had low risk cfDNA screening, 6.1% had abnormal cfDNA with increased risk of Trisomy 21 and 20.9% of patients opted out of screening. All genetic screening results were known at the time of identification of ACs. Table 1 shows evaluation and outcomes of ACs based on genetic testing. 120 patients (92%) had extrahepatic ACs in the left upper quadrant adjacent to the stomach with other locations including intrahepatic and gastric foci. Patients who had low risk cfDNA underwent the same evaluation (maternal fetal medicine consultation, viral serologies, cystic fibrosis testing and further ultrasounds) as those that did not have testing completed. 95.7% of all patients underwent follow up ultrasound which showed either stable or resolved ACs. The mean GA of delivery was 38 6/7 weeks with mean birthweight and 1 and 5 minute APGAR scores of 2973 gm and 8/8.86 respectively. No neonates in our series had follow up imaging of prenatally diagnosed ACs by 1 month or 1 year of life.   

Conclusion:

Ultrasound identification of fetal ACs resulted in increased testing and follow-up without clinically relevant abnormalities in any infants.