Risk Assessment at 11–14-Week Antenatal Visit

A Tertiary Referral Center Experience from South India

Anusha Vellamkondu, Akhila Vasudeva, Rajeshwari G. Bhat, Asha Kamath, Sapna V. Amin, Lavanya Rai, Pratap Kumar

Research output: Contribution to journalArticle

Abstract

Background: Present study carried out in a tertiary referral hospital in South India attempts to determine the predictive value of integrated screening at 11–14-week antenatal visit. Objectives: To determine the detection rate of fetal abnormalities at 11–14 weeks and also to predict the placental dysfunction disorders based on early integrated evaluation. Method: Integrated screening performed on 440 women between 11 and 14 weeks, including detailed maternal history [medical history, bad obstetric history (BOH)], body mass index (BMI), mean arterial pressure (MAP), detailed ultrasound and maternal serum biochemistry as part of combined first-trimester screening for aneuploidy. Results: There were two proven Down’s syndrome foetuses; both detected with combined screening test. There were 12 fetuses with major anomalies, out of whom 7 (58.3%) detected in 11–14-week scan. Among 440, 114 pregnancies (25.9%) developed complications in pregnancy, including 33 (7.5%) gestational hypertension, 8 (1.8%) pre-eclampsia, 41 (9.38%) SGA, 13 (2.9%) abortions, 22 (5%) indicated and 9 (2.04%) spontaneous preterm deliveries, 38 (8.63%) GDM and 3 (0.6%) stillbirth/IUD. Among the risk factors, age >35 years, BMI >23 kg/m2, BOH, MAP >105 mmHg and PAPP-A <0.5 MoM correlated well with adverse outcome. Using early integrated screening, 78.9% of obstetric complications could be predicted although 306 (69.5%) were labeled high risk, among whom 90 (29.4%) developed adverse pregnancy outcomes. Conclusions: Majority of fetal abnormalities can be detected, and majority adverse pregnancy outcomes can be predicted at 11–14-week antenatal visit, although this study shows high screen positivity and low specificity in a tertiary referral unit.

Original languageEnglish
Pages (from-to)421-427
Number of pages7
JournalJournal of Obstetrics and Gynecology of India
Volume67
Issue number6
DOIs
Publication statusPublished - 01-12-2017

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Tertiary Care Centers
Obstetrics
India
Pregnancy Outcome
Arterial Pressure
Body Mass Index
Fetus
History
Mothers
Pregnancy-Associated Plasma Protein-A
Pregnancy Induced Hypertension
Stillbirth
Pregnancy Complications
Aneuploidy
First Pregnancy Trimester
Down Syndrome
Pre-Eclampsia
Biochemistry
Referral and Consultation
Pregnancy

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynaecology

Cite this

@article{47415285f82942939e345942dfbd0352,
title = "Risk Assessment at 11–14-Week Antenatal Visit: A Tertiary Referral Center Experience from South India",
abstract = "Background: Present study carried out in a tertiary referral hospital in South India attempts to determine the predictive value of integrated screening at 11–14-week antenatal visit. Objectives: To determine the detection rate of fetal abnormalities at 11–14 weeks and also to predict the placental dysfunction disorders based on early integrated evaluation. Method: Integrated screening performed on 440 women between 11 and 14 weeks, including detailed maternal history [medical history, bad obstetric history (BOH)], body mass index (BMI), mean arterial pressure (MAP), detailed ultrasound and maternal serum biochemistry as part of combined first-trimester screening for aneuploidy. Results: There were two proven Down’s syndrome foetuses; both detected with combined screening test. There were 12 fetuses with major anomalies, out of whom 7 (58.3{\%}) detected in 11–14-week scan. Among 440, 114 pregnancies (25.9{\%}) developed complications in pregnancy, including 33 (7.5{\%}) gestational hypertension, 8 (1.8{\%}) pre-eclampsia, 41 (9.38{\%}) SGA, 13 (2.9{\%}) abortions, 22 (5{\%}) indicated and 9 (2.04{\%}) spontaneous preterm deliveries, 38 (8.63{\%}) GDM and 3 (0.6{\%}) stillbirth/IUD. Among the risk factors, age >35 years, BMI >23 kg/m2, BOH, MAP >105 mmHg and PAPP-A <0.5 MoM correlated well with adverse outcome. Using early integrated screening, 78.9{\%} of obstetric complications could be predicted although 306 (69.5{\%}) were labeled high risk, among whom 90 (29.4{\%}) developed adverse pregnancy outcomes. Conclusions: Majority of fetal abnormalities can be detected, and majority adverse pregnancy outcomes can be predicted at 11–14-week antenatal visit, although this study shows high screen positivity and low specificity in a tertiary referral unit.",
author = "Anusha Vellamkondu and Akhila Vasudeva and Bhat, {Rajeshwari G.} and Asha Kamath and Amin, {Sapna V.} and Lavanya Rai and Pratap Kumar",
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Risk Assessment at 11–14-Week Antenatal Visit : A Tertiary Referral Center Experience from South India. / Vellamkondu, Anusha; Vasudeva, Akhila; Bhat, Rajeshwari G.; Kamath, Asha; Amin, Sapna V.; Rai, Lavanya; Kumar, Pratap.

In: Journal of Obstetrics and Gynecology of India, Vol. 67, No. 6, 01.12.2017, p. 421-427.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk Assessment at 11–14-Week Antenatal Visit

T2 - A Tertiary Referral Center Experience from South India

AU - Vellamkondu, Anusha

AU - Vasudeva, Akhila

AU - Bhat, Rajeshwari G.

AU - Kamath, Asha

AU - Amin, Sapna V.

AU - Rai, Lavanya

AU - Kumar, Pratap

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background: Present study carried out in a tertiary referral hospital in South India attempts to determine the predictive value of integrated screening at 11–14-week antenatal visit. Objectives: To determine the detection rate of fetal abnormalities at 11–14 weeks and also to predict the placental dysfunction disorders based on early integrated evaluation. Method: Integrated screening performed on 440 women between 11 and 14 weeks, including detailed maternal history [medical history, bad obstetric history (BOH)], body mass index (BMI), mean arterial pressure (MAP), detailed ultrasound and maternal serum biochemistry as part of combined first-trimester screening for aneuploidy. Results: There were two proven Down’s syndrome foetuses; both detected with combined screening test. There were 12 fetuses with major anomalies, out of whom 7 (58.3%) detected in 11–14-week scan. Among 440, 114 pregnancies (25.9%) developed complications in pregnancy, including 33 (7.5%) gestational hypertension, 8 (1.8%) pre-eclampsia, 41 (9.38%) SGA, 13 (2.9%) abortions, 22 (5%) indicated and 9 (2.04%) spontaneous preterm deliveries, 38 (8.63%) GDM and 3 (0.6%) stillbirth/IUD. Among the risk factors, age >35 years, BMI >23 kg/m2, BOH, MAP >105 mmHg and PAPP-A <0.5 MoM correlated well with adverse outcome. Using early integrated screening, 78.9% of obstetric complications could be predicted although 306 (69.5%) were labeled high risk, among whom 90 (29.4%) developed adverse pregnancy outcomes. Conclusions: Majority of fetal abnormalities can be detected, and majority adverse pregnancy outcomes can be predicted at 11–14-week antenatal visit, although this study shows high screen positivity and low specificity in a tertiary referral unit.

AB - Background: Present study carried out in a tertiary referral hospital in South India attempts to determine the predictive value of integrated screening at 11–14-week antenatal visit. Objectives: To determine the detection rate of fetal abnormalities at 11–14 weeks and also to predict the placental dysfunction disorders based on early integrated evaluation. Method: Integrated screening performed on 440 women between 11 and 14 weeks, including detailed maternal history [medical history, bad obstetric history (BOH)], body mass index (BMI), mean arterial pressure (MAP), detailed ultrasound and maternal serum biochemistry as part of combined first-trimester screening for aneuploidy. Results: There were two proven Down’s syndrome foetuses; both detected with combined screening test. There were 12 fetuses with major anomalies, out of whom 7 (58.3%) detected in 11–14-week scan. Among 440, 114 pregnancies (25.9%) developed complications in pregnancy, including 33 (7.5%) gestational hypertension, 8 (1.8%) pre-eclampsia, 41 (9.38%) SGA, 13 (2.9%) abortions, 22 (5%) indicated and 9 (2.04%) spontaneous preterm deliveries, 38 (8.63%) GDM and 3 (0.6%) stillbirth/IUD. Among the risk factors, age >35 years, BMI >23 kg/m2, BOH, MAP >105 mmHg and PAPP-A <0.5 MoM correlated well with adverse outcome. Using early integrated screening, 78.9% of obstetric complications could be predicted although 306 (69.5%) were labeled high risk, among whom 90 (29.4%) developed adverse pregnancy outcomes. Conclusions: Majority of fetal abnormalities can be detected, and majority adverse pregnancy outcomes can be predicted at 11–14-week antenatal visit, although this study shows high screen positivity and low specificity in a tertiary referral unit.

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