The Health Council has issued an advisory report on the first-trimester anomaly scan.
Since autumn 2021, pregnant women in the Netherlands have been offered an ultrasound examination at around 13 weeks of pregnancy. This first-trimester anomaly scan can detect major foetal structural anomalies. Prior to 2021, the first screening ultrasound was offered at around 20 weeks. The first-trimester anomaly scan is currently offered temporarily as part of scientific research. The Ministry of Health, Welfare and Sport asked the Health Council to advise on whether the first-trimester anomaly scan should be permanently offered, based on the research findings.
Compared to the second-trimester anomaly scan, the first-trimester anomaly scan provides more time to establish a diagnosis. It also gives parents more time to make reproductive decisions. In this way, the first-trimester anomaly scan promotes so-called reproductive autonomy, which is its intended purpose. However, the results were often inaccurate. A relatively high number of anomalies were missed (false-negative results). Additionally, it frequently occurred that pregnant women were referred for further diagnostics, but no anomaly was found (false-positive results). The Health Council concludes that the benefits do not outweigh the harms, which is a necessary condition for the permanent introduction of the first-trimester anomaly scan. The council notes that only research data from the first year are available, which may not accurately reflect the current situation.
The Health Council acknowledges the importance of reproductive autonomy and, in its advisory report, identifies opportunities to improve the benefit-risk ratio. The council recommends exploring these opportunities using recent research data.