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Ultrasound detection rate of single umbilical artery in the first trimester of pregnancy
Author(s) -
Lamberty Clarissa O.,
de Carvalho Mário Henrique Burlacchini,
Miguelez Javier,
Liao Adolfo Wenjaw,
Zugaib Marcelo
Publication year - 2011
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2791
Subject(s) - concordance , medicine , obstetrics , prospective cohort study , pregnancy , umbilical cord , kappa , umbilical artery , predictive value of tests , population , first trimester , positive predicative value , single umbilical artery , preeclampsia , gynecology , ultrasound , gestation , predictive value , radiology , surgery , anatomy , linguistics , philosophy , genetics , environmental health , biology
Objective To determine accuracy of first trimester detection of single umbilical artery (SUA). Methods The number of vessels in the umbilical cord was examined in a prospective cohort of 779 singleton, low‐risk, unselected pregnancies, in the first (11–13 weeks) and second (17–24 weeks) trimesters, using both power and color Doppler and after delivery, by placental histopathologic exam. Concordance between first and second trimester findings to postnatal diagnoses was compared by calculating kappa coefficients. Results There was medium concordance between the findings in the first trimester and the postnatal diagnoses (kappa = 0.52) and high concordance (kappa = 0.89) for the second trimester scan. Sensitivity, specificity, positive and negative predictive values for the findings in the first trimester were 57.1, 98.9, 50.0 and 99.2% and for the second trimester were 86.6, 99.9, 92.9 and 99.7%. Conclusion Sensitivity and positive predictive value of first trimester scan to identify an isolated SUA in a prospective unselected population was poor. Diagnosis of isolated SUA as well as a definitive judgment about the presence of associated anomalies would still require a scan in the second trimester. Copyright © 2011 John Wiley & Sons, Ltd.