title: Prevalence of defined ultrasound findings of unknown significance at the second trimester fetal anomaly scan and their association with adverse pregnancy outcomes: the Welsh study of mothers and babies population-based cohort.
abstract: 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.
  
  
  METHODS
  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. © 2015 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.
authors.affiliation: Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hurt
authors.affiliation: Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK.
authors.forename: Melissa
authors.initials: M
authors.lastname: Wright
authors.affiliation: Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK.
authors.forename: Frank
authors.initials: F
authors.lastname: Dunstan
authors.affiliation: Public Health Wales NHS Trust, Cardiff, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Aneurin Bevan University Health Board, Caerleon, Newport, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Brook
authors.affiliation: Cardiff and Vale University Health Board, University Hospital of Wales, Cardigan House, Heath Park, Cardiff, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Morris
authors.affiliation: Public Health Wales NHS Trust, Cardiff, UK.
authors.forename: David
authors.initials: D
authors.lastname: Tucker
authors.affiliation: National Childbirth Trust, Alexandra House, Oldham Terrace, London, UK.
authors.forename: Marilyn Ann
authors.initials: MA
authors.lastname: Wills
authors.affiliation: Cwm Taf University Health Board, Ynysmeurig House, Navigation Park, Abercynon, Rhondda Cynon Taff, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Davies
authors.affiliation: NHS Wales Informatics Service, Tŷ Glan-yr-Afon, Cardiff, UK.
authors.forename: Gareth
authors.initials: G
authors.lastname: John
authors.affiliation: Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK.|Public Health Wales NHS Trust, Cardiff, UK.
authors.forename: David
authors.initials: D
authors.lastname: Fone
authors.affiliation: Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK.|Public Health Wales NHS Trust, Cardiff, UK.
authors.forename: Shantini
authors.initials: S
authors.lastname: Paranjothy
mesh_terms: D000328:Adult; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D050497:Stillbirth / Q000453:epidemiology; D016216:Ultrasonography, Prenatal; D014852:Wales / Q000453:epidemiology