Francis Hacker

Role of Genetic Ultrasonogram After Choroid Plexus Cyst Detection: A Cost-Effectiveness Analysis [371]

OBJECTIVE: In May 2014, the Fetal Imaging Workshop endorsed ultrasonographic follow-up in fetuses with isolated choroid plexus cysts that lacked a complete targeted scan for additional findings associated with trisomy 18 or had an elevated a priori risk. Our goal was to estimate outcomes and costs associated with this recommendation in women with prior aneuploidy screening. METHODS: A decision-analytic model was constructed using TreeAge software and probabilities derived from the literature. The model compared using a targeted ultrasonography with no follow-up in women with a negative quad screen and fetal choroid plexus cysts identified on screening ultrasonography. We stratified by maternal age younger than or older than 35 years of age. Ultrasonographic sensitivity for trisomy 18 was 97%. Outcomes of interest included diagnosis of trisomy 18, pregnancy termination, and trisomy 18 live births. Strategies were compared to generate a cost-effectiveness ratio with a threshold of

Maternal and fetal outcomes of pancreatitis in pregnancy

100,000 per quality-adjusted life-year. RESULTS: The targeted ultrasonographic strategy in women younger than 35 years resulted in 20 fewer trisomy 18 births and 7.6 additional quality-adjusted life-years per 10,000 pregnancies but was not cost-effective when compared with no further screening. In women 35 years and older, the targeted ultrasonographic strategy resulted in 39 fewer trisomy 18 births and 21.3 additional quality-adjusted life-years per 10,000 pregnancies, yielding a cost-effective strategy of

Isolated Echogenic Intracardiac Foci: A Comparison of Aneuploidy Screening Tests [28P]

36,438 per quality-adjusted life-year. CONCLUSION: Our results indicate in a population with prior negative aneuploidy screening, there is increased effectiveness by offering a targeted ultrasonography when a choroid plexus cyst is visualized and it is unknown if it is isolated. However, such ultrasonograms are only cost-effective in a high-risk population.