O-28: Detection of Fetal Major Structural Abnormalities with US in ART Patients during One Year

Background: The aims were to determine the diagnostic accuracy of ultrasound sonography in detecting major structural anomalies on all patients who conceived during a year of infertility treatment [assisted reproductive technology (ART) or non-ART treatments] at the Royan Institute, and to study the outcome of cases with nuchal translucency (NT) ≥ 95th centile in the first trimester of pregnancy. Materials and Methods: This prospective study was conducted to detect congenital malformations among 703 infertile patients using ultrasound sonography during the first and second trimesters at the Royan institute between 2008 and 2009. All treated patients who had a viable pregnancy on 7th weeks of gestation were included in this study. Prenatal ultrasound determined a total of 932 fetuses, including 509 singletons and194 multiples. All cases with an increased NT (>95th percentile) were referred to amniocentesis and karyotyping, genetic counseling as well as fetal echocardiography. All infants were examined by a pediatrician at birth, and follow-up visits for any major anomalies were scheduled during one year after birth. The obtained result was taken as the gold standard .In the case of major congenital anomalies fetal autopsy finding was taken as the gold standard. Results: According to the results of this study, the finding of first trimester sonography revealed a sensitivity of 54.7%, a specificity of 99.6 %, a positive predictive value (PPV) of 55.1% and a negative predictive value (NPV) of 99.6 %. The result of second trimester sonography showed a sensitivity of 66.2%, specificity of 99.8 %, PPV of 74.3% and a NPV of 99.7%.This study also shows no elevated risk of major malformation between infants of infertile women conceived by ART. Conclusion: Major structural anomalies in the fetus can be reliably diagnosed by a prenatal ultrasound screening.