Objective The aim of this article was to estimate the population prevalence of seven defined ultrasound findings of uncertain significance (?markers?) in the second trimester and the associated risk of adverse pregnancy outcomes. Method A prospective record-linked cohort study of 30 078 pregnant women who had second trimester anomaly scans between July 2008 and March 2011 in Wales was conducted. Results The prevalence of markers ranged from 43.7 per 1000 singleton pregnancies for cardiac echogenic foci [95% confidence interval (CI): 38.8, 51.1] to 0.6 for mild-to-moderate ventriculomegaly (95% CI: 0.3, 1.0). Isolated echogenic bowel was associated with an increased risk of congenital anomalies [risk ratio (RR) 4.54, 95% CI: 2.12, 9.73] and preterm birth (RR 2.30, 95% CI: 1.08, 4.90). Isolated pelvicalyceal dilatation was associated with an increased risk of congenital anomalies (RR 3.82, 95% CI: 2.16, 6.77). Multiple markers were associated with an increased risk of congenital anomalies (RR 5.00, 95% CI: 1.35, 18.40) and preterm birth (RR 3.38, 95% CI 1.20, 9.53). Conclusions These data are useful for counselling families and developing clinical guidance and care pathways following the detection of markers in clinical practice, particularly the need for follow-up scans to monitor placental function and growth in pregnancies with isolated echogenic bowel, and further investigation for multiple markers
Bibliographical noteArticle first published online: 20 NOV 2015 This is an open access article under the terms of the Creative Commons Attribution License
We gratefully acknowledge the contribution of Rosemary Johnson (Antenatal Screening Wales, Public Health Wales NHS Trust) for her input into the design, coordination and implementation of this study. We would also like to thank the individuals within the following organisations who contributed to the management or running of the study: Antenatal Screening Wales; the antenatal screening coordinators, midwives and superintendent sonographers at all participating Health Boards (Abertawe Bro Morgannwg University Health Board, Aneurin Bevan University Health Board, Betsi Cadwaladr University Health Board, Cardiff and Vale University Health Board, Cwm Taf University Health Board and Hywel Dda University Health Board); and the members of the quality assurance expert panel. We also acknowledge the substantial contribution of all women who participated in the study.