Towards detecting open spina bifida in the first trimester: the examination of the posterior brain.

Introduction: Our aim was to examine the value of indirect signs of open spina bifida in the mid-sagittal view of the posterior brain at the 11-13 weeks' ultrasound examination and to summarize the current evidence for the first-trimester diagnosis of spina bifida.

Methods: This was a prospective study in routine obstetric population. The presence of four almost parallel lines (four-line view) in the posterior brain was recorded.

First trimester cervical length is associated with mid-trimester loss.

Objective: To study the value of the cervical length (CL) measurement at 11-14 weeks in predicting second trimester miscarriage occurring at 16-24 weeks.

Methods: Prospective study in routine obstetric population using transvaginal ultrasound examination to measure the length of the endocervical canal at 11-14 weeks.

Results: The study group consisted of 2836 singleton pregnancies.

Assessment of the posterior brain at 11-14 weeks for the prediction of open neural tube defects.

Objective: To evaluate the routine midsagittal view of the posterior brain at the 11-13 weeks' ultrasound examination, for predicting open neural tube defects.

Methods: Posterior brain was examined midsagittally for normality of the four-line view (upper and lower border of the brain stem, the choroid plexus of the fourth ventricle and the occipital bone). Intracranial translucency and cisterna magna (CM) were measured.

Screening for major structural abnormalities at the 11- to 14-week ultrasound scan.

Objective: The purpose of this study was to examine the value of performing a detailed examination of the fetus as part of the routine 11 to 14 weeks' ultrasound scan in a 2-stage screening process for major structural defects in low-risk pregnancies.

Study Design: This was a prospective study in 1148 singleton pregnancies at 11 to 14 weeks of gestation using a combination of transabdominal and transvaginal sonography to estimate the sensitivity of the first and second trimester ultrasound scan in the detection of major anomalies.

Results: Seven of the 14 major anomalies were detected at the 11 to 14 weeks scan, and an additional 6 at the second trimester scan.