title: Advances in ultrasound imaging for congenital malformations during early gestation.
abstract: BACKGROUND
  With refinement in ultrasound technology, detection of fetal structural abnormalities has improved and there have been detailed reports of the natural history and expected outcomes for many anomalies. The ability to either reassure a high-risk woman with normal intrauterine images or offer comprehensive counseling and offer options in cases of strongly suspected lethal or major malformations has shifted prenatal diagnoses to the earliest possible gestational age.
  
  
  METHODS
  When indicated, scans in early gestation are valuable in accurate gestational dating. Stricter sonographic criteria for early nonviability guard against unnecessary intervention. Most birth defects are without known risk factors, and detection of certain malformations is possible in the late first trimester.
  
  
  RESULTS
  The best time for a standard complete fetal and placental scan is 18 to 20 weeks. In addition, certain soft anatomic markers provide clues to chromosomal aneuploidy risk. Maternal obesity and multifetal pregnancies are now more common and further limit early gestation visibility.
  
  
  CONCLUSIONS
  Other advanced imaging techniques during early gestation in select cases of suspected malformations include fetal echocardiography and magnetic resonance imaging.
authors.affiliation: Divisions of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico.
authors.forename: William F
authors.initials: WF
authors.lastname: Rayburn
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Jolley
authors.forename: Lynn L
authors.initials: LL
authors.lastname: Simpson
mesh_terms: D000367:Age Factors; D000013:Congenital Abnormalities / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods; D005260:Female; D005328:Fetal Viability / Q000235:genetics / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D011247:Pregnancy; D014463:Ultrasonography / Q000379:methods* / Q000639:trends*
keywords: aneuploidy; early ultrasonography; malformations; nonviability; prenatal diagnosis
references.citation: Prenat Diagn. 2011 Nov;31(11):1054-61
references.pmid: 21800333
references.citation: NCHS Data Brief. 2012 Jan;(80):1-8
references.pmid: 22617378
references.citation: AJR Am J Roentgenol. 2012 Aug;199(2):W222-31
references.pmid: 22826425
references.citation: Am J Obstet Gynecol. 2012 Oct;207(4):306.e1-5
references.pmid: 22683101
references.citation: Curr Opin Otolaryngol Head Neck Surg. 2012 Dec;20(6):482-90
references.pmid: 22913933
references.citation: J Am Soc Echocardiogr. 2012 Dec;25(12):1342-52
references.pmid: 23084470
references.citation: Am J Obstet Gynecol. 2013 Jan;208(1):3-18
references.pmid: 23200164
references.citation: J Ultrasound Med. 2013 Jun;32(6):1067-82
references.pmid: 23716531
references.citation: Lancet. 2013 Jul 20;382(9888):223-33
references.pmid: 23683720
references.citation: Semin Fetal Neonatal Med. 2013 Oct;18(5):251-60
references.pmid: 23751926
references.citation: J Ultrasound Med. 2013 Oct;32(10):1713-9
references.pmid: 24065251
references.citation: N Engl J Med. 2013 Oct 10;369(15):1443-51
references.pmid: 24106937
references.citation: Obstet Gynecol. 2013 Dec;122(6):1160-7
references.pmid: 24201688
references.citation: Am J Obstet Gynecol. 2014 May;210(5):387-97
references.pmid: 24793721
references.citation: J Pediatr Surg. 2014 Jun;49(6):853-8; discussion 858
references.pmid: 24888822
references.citation: Ultrasound Obstet Gynecol. 2014 Jun;43(6):670-4
references.pmid: 24307080
references.citation: Ultrasound Obstet Gynecol. 2014 Oct;44(4):388-93
references.pmid: 24890732
references.citation: Am J Obstet Gynecol. 1994 Jan;170(1 Pt 1):32-3
references.pmid: 8296840
references.citation: Ultrasound Obstet Gynecol. 1997 Oct;10(4):242-6
references.pmid: 9383874
references.citation: Ultrasound Obstet Gynecol. 1998 Apr;11(4):258-61
references.pmid: 9618848
references.citation: Ultrasound Obstet Gynecol. 1999 Feb;13(2):81-3
references.pmid: 10079483
references.citation: Ultrasound Obstet Gynecol. 2004 Dec;24(7):730-4
references.pmid: 15586371
references.citation: Prenat Diagn. 2005 Apr;25(4):322-6
references.pmid: 15849792
references.citation: J Matern Fetal Neonatal Med. 2005 Jul;18(1):65-6
references.pmid: 16105794
references.citation: Am J Obstet Gynecol. 2005 Sep;193(3 Pt 2):1260-5
references.pmid: 16157148
references.citation: Am J Obstet Gynecol. 2006 Nov;195(5):1219-30
references.pmid: 16615922
references.citation: Obstet Gynecol. 2007 Feb;109(2 Pt 1):376-83
references.pmid: 17267839
references.citation: Am J Perinatol. 2007 Sep;24(8):449-56
references.pmid: 17992711
references.citation: Obstet Gynecol. 2009 Feb;113(2 Pt 1):451-61
references.pmid: 19155920
references.citation: Obstet Gynecol. 2009 May;113(5):1001-7
references.pmid: 19384114
references.citation: J Obstet Gynaecol Can. 2009 Mar;31(3):272-5, 276-80
references.pmid: 19416575
references.citation: Ultrasound Obstet Gynecol. 2009 Sep;34(3):249-52
references.pmid: 19705402
references.citation: Ultrasound Obstet Gynecol. 2010 Mar;35(3):267-72
references.pmid: 20052662
references.citation: Cochrane Database Syst Rev. 2010;(4):CD007058
references.pmid: 20393955
references.citation: J Matern Fetal Neonatal Med. 2010 Aug;23(8):781-4
references.pmid: 19921962
references.citation: Prenat Diagn. 2010 Sep;30(9):821-6
references.pmid: 20575150
references.citation: Prenat Diagn. 2011 Jan;31(1):90-102
references.pmid: 21210483
references.citation: Ultrasound Obstet Gynecol. 2011 Mar;37(3):296-301
references.pmid: 21229572
references.citation: Int J Gynaecol Obstet. 2000 Jan;68(1):71-2
references.pmid: 10687844
references.citation: Ultrasound Obstet Gynecol. 2000 Nov;16(6):510-4
references.pmid: 11169342
references.citation: Magn Reson Imaging Clin N Am. 2001 Feb;9(1):19-56, vii
references.pmid: 11278182
references.citation: Ultrasound Obstet Gynecol. 2001 Jul;18(1):9-17
references.pmid: 11489218
references.citation: J Ultrasound Med. 2001 Oct;20(10):1053-63
references.pmid: 11587012
references.citation: Ultrasound Obstet Gynecol. 2001 Dec;18(6):610-4
references.pmid: 11844199
references.citation: Prenat Diagn. 2002 Apr;22(4):316-20
references.pmid: 11981912
references.citation: Ultrasound Obstet Gynecol. 2002 Jun;19(6):570-4
references.pmid: 12047536
references.citation: Ultrasound Obstet Gynecol. 2002 Jul;20(1):22-9
references.pmid: 12100413
references.citation: J Ultrasound Med. 2002 Oct;21(10):1087-96; quiz 1097-8
references.pmid: 12369663
references.citation: J Ultrasound Med. 2002 Dec;21(12):1387-94
references.pmid: 12494981
references.citation: Ultrasound Obstet Gynecol. 2003 Jan;21(1):15-8
references.pmid: 12528155
references.citation: J Ultrasound Med. 2003 Mar;22(3):271-80
references.pmid: 12636327
references.citation: Magn Reson Imaging. 2004 Jul;22(6):851-4
references.pmid: 15234454
references.citation: Am J Obstet Gynecol. 2004 Oct;191(4):1247-52
references.pmid: 15507948
references.citation: AJR Am J Roentgenol. 1989 Jul;153(1):75-9
references.pmid: 2660539
references.citation: Obstet Gynecol. 1991 Jun;77(6):885-8
references.pmid: 2030862
references.citation: J Ultrasound Med. 2011 May;30(5):695-700
references.pmid: 21527618
references.citation: Am J Med Genet C Semin Med Genet. 2011 Aug 15;157C(3):215-26
references.pmid: 21766441