Document Detail


Ultrasound screening for fetal structural abnormalities performed by trained midwives in the second trimester in a low-risk population--an appraisal.
MedLine Citation:
PMID:  19412800     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the performance of trained midwives in second trimester ultrasound screening for fetal structural abnormalities in a low-risk population. DESIGN: Retrospective study. SETTING: University Department of Obstetrics and Gynecology. POPULATION: About 13,882 women with singleton pregnancies. METHODS: The findings of routine second trimester anomaly scan performed by midwives were reviewed. Reasons for referral to maternal fetal medicine (MFM) specialists for further assessment were analyzed. MAIN OUTCOME MEASURES: The detection, false positive and false alarm rates for fetal anomalies. RESULTS: One hundred and eighty-nine pregnancies with unknown outcome were excluded from the final analysis. Overall, 617 (4.51%) women were referred to MFM specialists for further assessment, of which 470 (70.2%) were for soft markers alone and 147 (23.8%) for suspected fetal structural abnormalities. In these 13,693 fetuses with known outcome, malformed fetuses were present in 185, a prevalence of 1.35%. Of these, 115 were detected during the second trimester scan and two were detected in the third trimester. The remaining 68 malformed fetuses, most of which had minor anomalies, were identified after birth. The detection rate for a malformed fetus in second trimester scan was 62.2% (115/185) (95% CI 55.2-69.2). There were four cases of false positives and 33 cases of false alarm. CONCLUSIONS: Experienced midwives with proper training can detect the majority of major structural abnormalities. Continuous audit and quality control plays a significant role in optimizing the fetal structural examination.
Authors:
Min Chen; Tak Yeung Leung; Daljit Singh Sahota; Tak Yuen Fung; Lin Wai Chan; Lai Wa Law; Mo Ching Chau; Tzu-Hsi Terence Lao; Tze Kin Lau
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  88     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2009  
Date Detail:
Created Date:  2009-05-21     Completed Date:  2009-06-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  713-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. chenm@cuhk.edu.hk
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MeSH Terms
Descriptor/Qualifier:
Congenital Abnormalities / ultrasonography*
Female
Fetus / abnormalities
Humans
Mass Screening
Midwifery*
Pregnancy
Pregnancy Complications / ultrasonography*
Pregnancy Trimester, Second
Retrospective Studies
Ultrasonography, Prenatal*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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