Reassurance from second trimester sonographic placental scan for pregnancies complicated by abnormal first trimester biomarkers

Abstract

Objective

Enhanced first trimester aneuploidy screening (eFTS) combines serum biomarkers and ultrasound. Abnormal biomarkers are associated with placental complications, such as fetal growth restriction (FGR). We aimed to evaluate whether a Midtrimester placental scan can provide reassurance regarding FGR in women with abnormal eFTS biomarkers.

Methods

We conducted a retrospective cohort study of women who had eFTS and delivered at a single referral center. Women with abnormal biomarkers had a mid-trimester scan of the placenta (morphologic assessment, fetal biometry and uterine artery pulsatility index). We compared pregnancies with abnormal eFTS biomarkers and normal placental scans (study group) with those who had normal eFTS biomarkers (control group).

Results

A total of 6,514 women were included, of whom 343 (5.3%) comprised the study group. Women in the study group had an increased risk of hypertensive disorders of pregnancy [(aOR)1.96(95%CI 1.21–3.16)], and preterm birth <37 weeks [aOR1.98(95%CI 1.33–2.95)] compared to the control group. Yet, their neonates were not at higher risk for FGR <3^rd, 5^th, or 10^th percentile [aOR1.16(95%CI 0.83–1.63), 1.14(95%CI 0.70–1.87), and 0.47(95%CI 0.17–1.27), respectively].

Conclusion

A normal second trimester placental scan provided reassurance regarding the risk of FGR in women at high risk based on abnormal eFTS biomarkers.

Keywords:

• Placental scan
• fetal growth restriction
• first trimester screening
• risk prediction
• ultrasound

Ethics approval

Ethical approval was obtained from the local institutional review board – North York General Hospital, Toronto, ON (REB#17-0016).

Consent to participate and consent to publication

This was a retrospective study involving anonymized and deidentified chart reviews. Waiver of individual consent to participate and/or publish was waived by the local institutional review board.

Disclosure statement

All of the authors report no conflict of interest.

Presentation information

The abstract of this manuscript was presented as a poster presentation at the SMFM 40^th Annual Pregnancy Meeting, Grapevine, TX, USA (February 2020).

Data availability statement

Available per request.

Additional information

Funding

The second author received a grant for a summer research studentship. The funding source had no role in the study design, data analysis, or article preparation.