An Audit of Second-Trimester Fetal Anomaly Scans Based on a Novel Image-Scoring Method in the Southwest Region of the Netherlands

Ursem, Nicolette; Peters, Ingrid; Est, Mieke N. Kraan–van der; Reijerink‐Verheij, Jacqueline C.I.Y.; Knapen, Maarten F. C. M.; Cohen–Overbeek, Titia E.

doi:10.7863/ultra.16.06055

Cited by 7 publications

(12 citation statements)

References 26 publications

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“…Additionally, although the 20-week anomaly scan was officially introduced in 2007 and required the storage of images, ultrasound images could only be retrieved for 82 out of the 204 participating patients. We note that the number of retrievable ultrasound studies was less prior to 2009, as also reported by our audit of the prenatal screening program in our region [30]. The same protocol was followed in both patient groups, therefore we do not have a logical explanation for the difference in number of retrievable ultrasounds between scaphocephaly (41/130) and trigonocephaly (41/74).…”

Section: Discussionsupporting

confidence: 56%

Prenatal ultrasound parameters in single-suture craniosynostosis

Cornelissen

Apon

Meulen

et al. 2017

The Journal of Maternal-Fetal & Neonatal Medicine

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Section: Discussionsupporting

confidence: 56%

Prenatal ultrasound parameters in single-suture craniosynostosis

Cornelissen

Apon

Meulen

et al. 2017

The Journal of Maternal-Fetal & Neonatal Medicine

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“…This programme included the combined test (CT) for trisomies 21, 13 and 18 and the 20‐week anomaly scan for structural anomalies. The 20‐week scan is performed following a systematic protocol for foetal anatomical assessment by qualified sonographers who meet the required quality standards 5 . In 2014, non‐invasive prenatal testing (NIPT) using cell‐free foetal DNA became available to women showing increased risk on the CT or with a previous child with a trisomy.…”

Section: Introductionmentioning

confidence: 99%

Effect of prenatal screening on trends in perinatal mortality associated with congenital anomalies before and after the introduction of prenatal screening: A population‐based study in the Northern Netherlands

Bardi

Bergman

Bouman

et al. 2021

Paediatric Perinatal Epid

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Background Perinatal mortality in foetuses/children with congenital anomalies remains high. Prenatal diagnosis, essential for risk assessment and organisation of perinatal/postnatal care, offers parents the opportunity to consider the termination of pregnancy. In times of quick changes in prenatal screening programmes, it is relevant to evaluate the effect of prenatal screening on perinatal mortality rates. Objectives The objective of this study was to study trends in early foetal and perinatal mortality associated with congenital anomalies before/after the introduction of the Dutch prenatal screening programme. Methods This population‐based cohort study included 8535 foetuses/neonates with congenital anomalies born in the Northern Netherlands between 2001 and 2017. Total deaths were defined as sum of early foetal (before 24 weeks’ gestation) and perinatal deaths (from 24 weeks’ gestation till day 7 post‐partum). Foetal deaths were categorised into spontaneous or elective termination of pregnancy for foetal anomalies (TOPFA). Trends in total mortality as well as early foetal and perinatal mortality were studied. Joinpoint regression was used to calculate the average annual percentage chance (AAPC) and identify linear trends in mortality within subperiods. Results Total and perinatal mortality were 17% and 4%. Total mortality was higher in abnormal karyotype and central nervous system anomalies. We observed an increase in total mortality over time: 11.9% in 2001 versus 21.9% in 2017 (AAPC 2.6, 95% confidence interval [CI] 1.5, 3.7), caused by an increase in early foetal mortality from 5.5% to 19.2% (AAPC 8.7, 95% CI 4.7, 12.9) and a decrease in perinatal mortality from 6.4% to 2.7% (AAPC −5.6, 95% CI −10.0, −1.0). The increase in early foetal mortality reflects an increase in TOPFA from 3.6% to 16.9% (AAPC 8.3, 95% CI 4.2, 12.7), mostly occurring at 13–14 and 20–23 weeks’ gestation. Conclusions The introduction of the prenatal screening programme led to a decrease in perinatal mortality among foetuses and neonates with congenital anomalies and a marked increase in early foetal mortality before 24 weeks’ gestation due to higher rates of TOPFA.

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“…Participants in the survey also cited certification similar to that required for nuchal translucency and cervical length assessments as a high priority to improve screening. Indeed, regular audits for maintenance of certification or quality control have been successful and could be implemented on a wider scale by either a governing body such as the American College of Obstetricians and Gynecologists or the American Institute of Ultrasound Medicine.…”

Section: Discussionmentioning

confidence: 99%

Physician Barriers and Facilitators for Screening for Congenital Heart Disease With Routine Obstetric Ultrasound

Pinto

Henry

Grobman

et al. 2019

J of Ultrasound Medicine

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Objectives-Prenatal detection of congenital heart disease with obstetric screening remains at less than 50% in most population studies, far from what is thought to be achievable. We sought to identify barriers/facilitators for screening from the perspective of interpreting physicians and to understand how these barriers/facilitators may be associated with interpretation of screening images.Methods-Our mixed-methods studies included 4 focus groups in centers across the United States with obstetric, maternal-fetal medicine, and radiology providers who interpreted obstetric ultrasound studies. Themes around barriers/facilitators for fetal heart screening were coded from transcripts. A national Web-based survey was then conducted, which quantitatively measured reported barriers/facilitators and measured physicians' ability to interpret fetal heart-screening images. Multivariable generalized linear random-effect models assessed the association between barriers/facilitators and the accuracy of image interpretation at the image level.Results-Three main themes were identified in the focus groups: intrinsic barriers (ie, comfort with screening), external barriers (ie, lack of feedback), and organizational barriers (ie, study volumes). Among 190 physician respondents, 104 interpreted ultrasound studies. Perceptions of barriers varied by practice setting, with nontertiary providers having lower self-efficacy and perceived usefulness of cardiac screening. Facilitators associated with the odds of accurate interpretation of screening images were knowledge (odds ratio, 2.54; P = .002) and the volume of scans per week (odds ratio, 1.01 for every additional scan; P = .04).Conclusions-Some of the main barriers to cardiac screening identified and prioritized by physicians across the United States were knowledge of screening and minimal volumes of scans. Targeting these barriers will aid in improving prenatal detection of congenital heart disease.

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An Audit of Second-Trimester Fetal Anomaly Scans Based on a Novel Image-Scoring Method in the Southwest Region of the Netherlands

Abstract: Quality assessment using the image-scoring method demonstrated that most of the sonographers met the expectations of the audit process, but those who had subpar performance met the expectations after retraining.

Cited by 7 publications

References 26 publications

Prenatal ultrasound parameters in single-suture craniosynostosis

Prenatal ultrasound parameters in single-suture craniosynostosis

Effect of prenatal screening on trends in perinatal mortality associated with congenital anomalies before and after the introduction of prenatal screening: A population‐based study in the Northern Netherlands

Physician Barriers and Facilitators for Screening for Congenital Heart Disease With Routine Obstetric Ultrasound

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