A nationwide first-trimester anomaly scan significantly improved early detection of fetal conditions, including those that may overlap with or resemble complications seen in fetal and neonatal alloimmune thrombocytopenia (FNAIT), according to a study published recently in BJOG: An International Journal of Obstetrics and Gynecology.
Early diagnosis could give families more time to make informed decisions while slightly extending the diagnostic process in some cases.
In this prospective cohort study from the Netherlands, researchers compared outcomes before and after implementation of first-trimester anomaly screening. Among corrected annual estimates, abnormal diagnostic scans rose from 750 to 1261, with definitive diagnoses increasing from 609 to 940. The largest gains were seen in “often detectable” anomalies and “other anomalies,” while first-trimester major anomalies increased modestly from 308 to 342.
“The increased number of severe anomalies provides a significant added value for parents with regard to earlier diagnostic certainty and more time for decision-making,” explained the authors of this study.
For patients, including those at risk for conditions such as FNAIT where early detection of fetal complications can be critical, this shift means more abnormalities are identified earlier in pregnancy. Earlier awareness can support closer monitoring, targeted testing, and timely referrals to specialists, particularly when fetal health may be affected by maternal–fetal interactions.
Read more about the testing and diagnosis for FNAIT
The median time to diagnosis increased slightly from 11 days to 13 days after implementation. Similarly, gestational age at termination of pregnancy rose marginally from 14 + 6 weeks to 15 + 1 weeks. Despite this, the earlier screening approach identified more cases overall, and total terminations increased from 411 to 554 annually, largely driven by additional findings in less obvious anomaly groups.
Importantly, the earlier scan also detected more subtle or complex findings, such as facial differences or limb abnormalities, which often required additional imaging and longer evaluation. This led to longer diagnostic timelines for some families. While earlier detection can be beneficial, it may also introduce periods of uncertainty, especially when findings are unclear or less severe.
Overall, the introduction of first-trimester screening enhanced early identification of fetal conditions, including those relevant to FNAIT-related concerns, and expanded opportunities for counseling and care planning. For patients, this means earlier answers and more options, balanced against the possibility of longer diagnostic pathways and increased anxiety while awaiting confirmation.
Sign up here to get the latest news, perspectives, and information about FNAIT sent directly to your inbox. Registration is free and only takes a minute.
