First trimester placental ultrasound to predict fetal growth restriction: The OxPLUS Study

Background:

Fetal growth restriction (FGR) is the single greatest cause of stillbirth. An effective first-trimester screening test would identify pregnancies at 'high-risk' thereby targeting NHS resources towards those at-risk enabling delivery before stillbirth occurs. FGR can be predicted at 11-13 weeks' using placental volume and vascularity, but no method is currently available to estimate these which can be used for population-screening.

Aims:

To use an observational cohort study to examine the utility of the OxNNet Toolkit for the prediction of FGR in an unselected population presenting for routine first-trimester scanning.

Objectives:

• To assess the ability of the OxNNet Toolkit placental metrics to predict FGR and other adverse pregnancy outcomes in an unselected cohort presenting for first-trimester screening by NHS sonographers.

• To facilitate full healthcare economic analysis based on the predictive ability of the screening result.

Work Packages:

WP1: Train NHS sonographers to perform the 3D ultrasound scan and develop training-protocols and manuals.

WP2: Undertake the OxPLUS study to examine prediction of FGR using the OxNNet Toolkit placental metrics.

WP3: Perform a health economic evaluation that assesses the cost-effectiveness of the routine employment of the test

Anticipated Impact

This should produce two major value propositions: better pregnancy outcomes and economic benefits from preventing unnecessary imaging.