{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:47:45Z","timestamp":1785836865230,"version":"3.56.0"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To report the implementation across Fetal Medicine units and the agreement between first and second trimester referral scans in the identification of fetal anomalies in cases referred for the expert assessment of the fetal anatomy in the first trimester following the publication of the national guidelines in Italy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This multicenter, retrospective study aimed to evaluate the implementation and diagnostic performance of first\u2010trimester referral ultrasound (US) in identifying fetal anomalies, following the introduction of national guidelines in Italy. The analysis included singleton pregnancies referred to nine specialized Fetal Medicine centers between 11\n                      <jats:sup>+0<\/jats:sup>\n                      and 13\n                      <jats:sup>+6<\/jats:sup>\n                      \u2009weeks' gestation due to increased risk for structural anomalies. Risk was defined as either a nuchal translucency (NT) measurement \u2265\u20093.5\u2009mm or suspicion of a structural anomaly at initial screening. Only cases undergoing referral US within the specified gestational window were included. Diagnostic accuracy was assessed by comparing findings from first\u2010trimester referral US with those from follow\u2010up referral US performed either at 14\u201316\u2009weeks or at 19\u201321\u2009weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 344 referred cases, 322 (93.6%) underwent first\u2010trimester referral US within the appropriate timeframe. After excluding miscarriages and terminations, 136 cases were evaluated again at 19\u201321\u2009weeks and 207 at 14\u201316\u2009weeks. The agreement between the 11\n                      <jats:sup>+0<\/jats:sup>\n                      \u201313\n                      <jats:sup>+6<\/jats:sup>\n                      \u2009week and 19\u201321\u2009week scans was 85.3%, with a sensitivity of 82.0%, specificity of 88.0%, positive predictive value (PPV) of 84.7%, and negative predictive value (NPV) of 85.7%. Agreement between the early and 14\u201316\u2009week scans was 91.3%, with sensitivity, specificity, PPV, and NPV of 90.7%, 92.1%, 93.9%, and 88.2%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study demonstrates successful implementation of national first\u2010trimester referral US guidelines in Italy. When performed by experienced operators using a standardized protocol, first\u2010trimester anatomy assessment is feasible and provides high diagnostic accuracy, enabling early detection of structural fetal anomalies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcu.70181","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T10:20:13Z","timestamp":1770286813000},"page":"1335-1348","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Implementation and Performance of First\u2010Trimester Referral Ultrasound Scan Following the Introduction of National Guidelines"],"prefix":"10.1002","volume":"54","author":[{"given":"Grazia","family":"Volpe","sequence":"first","affiliation":[{"name":"Prenatal Diagnosis and Fetal Surgery Unit Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Sarno","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine University of Naples Federico II  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Azienda Ospedaliera Universitaria Integrata Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-3393","authenticated-orcid":false,"given":"Daniele","family":"Di Mascio","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health and Urological Sciences, Umberto I Hospital Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"D'Ambrosio","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health and Urological Sciences, Umberto I Hospital Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7630-6514","authenticated-orcid":false,"given":"Tiziana","family":"Fanelli","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Di Venere and Sarcone Hospitals  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4340-7225","authenticated-orcid":false,"given":"Ilaria","family":"Fantasia","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Di Venere and Sarcone Hospitals  Bari Italy"},{"name":"Obstetrics and Gynecology Unit San Salvatore Hospital  L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Piero","family":"Minnella","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5081-5430","authenticated-orcid":false,"given":"Paola","family":"Quaresima","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Magna Graecia University of Catanzaro  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Corno","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Obstetrics and Gynecology Unit University of Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7201-0206","authenticated-orcid":false,"given":"Andrea","family":"Dall'Asta","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Obstetrics and Gynecology Unit University of Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the SIEOGiovani Committee of the Italian Society of Ultrasound in Obstetrics and Gynecology (SIEOG)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15477"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21895"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000490723"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26106"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23691"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26094"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD014715.pub2"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26224"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7552"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmu.2017.02.001"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24950"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26271"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogoh.2017.12.001"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.958405"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.05.031"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17422"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11071"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340701644843"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469\u20100705.2002.00735.x"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2022.10.016"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18905"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5331"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27649"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23740"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17246"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17487"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12552"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27538"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.10.037"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884\u2010016\u20101114\u20106"},{"issue":"4","key":"e_1_2_9_32_1","first-page":"396","article-title":"Introduction of a Nationwide First\u2010Trimester","volume":"232","author":"Lust E. E. R.","year":"2024","journal-title":"American Journal of Obstetrics and Gynecology"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6115"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.128"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.304.6831.867"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13287"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26129"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18816"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24888"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27488"},{"key":"e_1_2_9_42_1","volume-title":"Manuale Metodologico Per Ecografia Ostetrica E Ginecologica","author":"Societ\u00e0 Italiana di Ecografia Ostetrica e Ginecologia e Metodologie Biofisiche","year":"2024"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2021.02.017"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2642"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20844"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2710"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20358"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm\u20102022\u20100125"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23651"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"}],"container-title":["Journal of Clinical Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70181","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcu.70181","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T10:45:38Z","timestamp":1783161938000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcu.70181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,5]]},"references-count":49,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/jcu.70181"],"URL":"https:\/\/doi.org\/10.1002\/jcu.70181","archive":["Portico"],"relation":{},"ISSN":["0091-2751","1097-0096"],"issn-type":[{"value":"0091-2751","type":"print"},{"value":"1097-0096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,5]]},"assertion":[{"value":"2025-09-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}