Fetal Soft Markers in Obstetric Ultrasound

Abstract Background: The use of ultrasound in pregnancy has significant health and economic outcomes for families and the health care system. With high resolution ultrasound, it is possible to examine fetal anatomy in great detail. The quality of images obtained today is such that minor deviations from normal can be clearly identified. Aim of Study: The purpose of this prospective study is the observation after detection of ultrasound soft markers, and to evaluate the usefulness of each ultrasound soft marker, and assess whether a specific soft marker should be looked for routinely on screening ultrasound. Patients and Methods: This was a prospective studyin 270 pregnant women at 16-24 weeks of gestation. All women were examined twice with ultrasonography for detection of any tissue abnormalities. First at 16-24 weeks of pregnancy and repeated for follow-up of the soft marker once detected at 32-36 weeks of pregnancy. Results: This study has demonstrated that when a soft marker is identified, there must be a careful search for other markers. The study showed a total of 27 (10%) of the studied women had tissue anomalies; 25 (9.3%) women had isolated soft tissue anomalies while 2 (0.7%) women had mixed anomalies. Three markers were not found in any woman, namely, increased nuchal fold thickness, absent nasal bone and ventriculomegaly. While the most frequent tissue anomalies were pyelectasis (3.7%) and choroid plexus cyst (2.2%). Another finiding in our study was echogenic bowel (EB) by 1.5%, EIF and shortened long bone by 1.10% and 0.75%, respectively; and the outcome of the new born are normal. There are some ultrasound findings commonly seen on second trimester routine scan that are associated with possible pro-gression (e.g. renal pelvis dilatation). These findings should be reported as anatomical variants and appropriate follow-up arranged. For renal pelvis dilatation, then it is common practice to re-scan in the third trimester to see if there is progression. Conclusion: Soft markers in second-trimester ultrasonog-raphy have limited use in screening for fetal aneuploidy. However, these markers can be used as a screening tool for adverse outcomes other than chromosomal abnormality.