Comparative analysis of quality scores images between second- and third-trimester ultrasound scan.

OBJECTIVES: To evaluate whether the quality scores validated for second-trimester ultrasound scan can be used for third-trimester ultrasound scan. METHODS: Prospective multicenter ancillary study using data from the RECRET study. Nulliparous women, with no reported history, with second- and third-trimester ultrasound examinations performed by the same ultrasonographer and using the same ultrasound machine were recruited. The global score and the individual score of each ultrasound image were compared between second- and third-trimester ultrasound scan. The sample size was calculated for a non-inferiority (one-sided) paired Student t test. RESULTS: 103 women with 1606 anonymized ultrasound images were included. The median term at second- and third-trimester ultrasound scan was 22.2 weeks gestation (22.0-22.7) and 31.6 weeks gestation (30.7-34.7), respectively. The mean global score of ultrasound images was comparable between the second- and the third-trimester ultrasound examination (32.37 ± 2.62 versus 31.80 ± 3.27, p = 0.13). Means scores for each biometric parameters i.e. head circumference, abdominal circumference, and femur diaphysis length were comparable. The scores for the four-chamber view (5.11 ± 0.91 versus 5.36 ± 0.75, p = 0.02) and the spine (4.18 ± 1.17 versus 5.22 ± 1.02, p < 0.001) were significantly lower in the third trimester compared to the second trimester. The score for the kidney image was significantly higher for third trimester images compared to second trimester images (4.73 ± 0.51 versus 4.32 ± 0.67, p < 0.001. CONCLUSIONS: Biometrics parameters quality scores images previously validated for the second trimester ultrasound scan can be also used for the third trimester scan. However, anatomical quality scores images performances may vary between the second and the third trimester scan.

[Feasibility of chorionic villous sampling outside a prenatal diagnosis center]. / Faisabilité de la biopsie de trophoblaste en maternité de niveau 2 hors centre de référence de diagnostic prénatal.

OBJECTIVES: According to new recommendations, a high combined risk for Down syndrome in the first trimester of pregnancy must indicate the need for a prenatal diagnosis. This is possible thanks to chorionic villous sampling. The objective of our study was to show that chorionic villous sampling is achievable in everyday practice, even outside research centers for pre-natal diagnosis. PATIENTS AND METHODS: It was a descriptive, retrospective study. All the patients who underwent a chorionic villous sampling in our level II maternity center from November 2005 to September 2009 were included. Success and complications rates linked with the procedure were calculated. RESULTS: One hundred and fourteen pregnancies were included. A definitive diagnosis was given in 98.25% of cases. A secondary amniocentesis was necessary in 1.75% of cases. A medical termination of the pregnancy was done in 18.42% of cases. Without accounting for underlying pathology, fetal loss rate was up to 5.75%. Only one case of unexpected fetal loss was noted (1.15% of the ongoing pregnancies). CONCLUSION: Our study shows that the presence of trained professional allows for onsite performance chorionic villous sampling.