Detailed Fetal Anatomic Ultrasound Examination Duration and Association With Body Mass Index

Gupta, Vivek Kumar; Adams, Jacquelyn H.; Heiser, Timothy; Iruretagoyena, J. Igor; Hoppe, Kara K.; Antony, Kathleen M.

doi:10.1097/aog.0000000000003489

Cited by 10 publications

(8 citation statements)

References 35 publications

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“…A prior analysis of these data showed that there is a positive relationship between the detailed fetal anatomic examination duration and a rising maternal BMI. 17 This finding is similar to prior studies suggesting that obesity was associated with increased time needed to complete a first-trimester screen 14,15 and contrasts with the findings of Romary et al, 35 which did not show these differences in the examination duration between gravidae of various BMIs for either a firstor second-trimester ultrasound examination.…”

Section: Discussionsupporting

confidence: 85%

“…The frequency of suboptimal examinations was shown to increase with higher maternal prepregnancy BMI classes, consistent with prior studies. [8][9][10][15][16][17][18][25][26][27][28][29][30][31][32][33] Although not explored in Values in parentheses are 95% confidence intervals. this study, prior approaches to combat this issue have suggested that an earlier scan in addition to the standard 20-week anomaly scan has higher completion rates in obese women at the cost of increased resource use.…”

Section: Discussionmentioning

confidence: 99%

“…This study was a secondary analysis of data obtained at the Center for Perinatal Care at the University of Wisconsin-Madison as part of the previously published study by Gupta et al 17 in 2019. The parent study and this secondary analysis were both approved by the Institutional Review Board at the UnityPoint Health-Meriter Hospital (Meriter Institutional Review Board number 2017-012).…”

Section: Methodsmentioning

confidence: 99%

“…13 Obesity has also been shown to increase the time required to complete ultrasound examinations for fetal anomaly screens and first-trimester aneuploidy risk assessment. [14][15][16][17] Obese women are also more likely to require repeated examinations to complete the fetal anatomic survey. 18 It has been suggested that delaying the ultrasound examination in obese gravidae to 20 to 22 weeks may improve visualization of anatomy.…”

mentioning

confidence: 99%

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A Matter of Time

Poehlmann

Timmel

Adams

et al. 2020

J of Ultrasound Medicine

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Objective-To assess the average duration of detailed fetal anatomic surveys in pregnancy in relation to gestational age (GA) and the maternal body mass index (BMI) to determine optimal timing of the examination.Methods-This was a retrospective cohort study of gravidae presenting for detailed fetal anatomic examinations between January 1, 2010, and June 30, 2017. After excluding examinations expected to have longer duration (ie, multifetal, major fetal anomalies), there were a total of 6522 examinations performed between GAs of 18 weeks 0 days and 22 weeks 0 days. Women were grouped by BMI, and results were analyzed by logistic regression.Results-Gravidae of normal weight (BMI, 18.5-24.9 kg/m 2 ) had a decrease of 47.47 seconds of the examination time with each increasing week of gestation (P = .036). Overweight (BMI, 25-29.9 kg/m 2 ) gravidae similarly had a decrease of 66.31 seconds of the examination time with each additional week of gestation (P = .017). Underweight (BMI, 8.5 kg/m 2 ) and obese (BMI, ≥30 kg/m 2 ) gravidae did not have differences in the examination time with increasing GA. Increases in suboptimal examinations were noted with an increasing BMI (P < .001). There was a decreased frequency of suboptimal examinations in obese gravidae with a BMI of 40 kg/m 2 or higher with increasing GA (P = .037).Conclusions-The duration of detailed fetal anatomic examinations decreased with increasing GA in normal-weight and overweight gravidae but not in obese gravidae. Performing the anatomy scan earlier in class I and II obese gravidae (BMI, 30-40 kg/m 2 ) may enable improved pregnancy management options without increasing the examination duration or likelihood of a suboptimal evaluation.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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A Matter of Time

Poehlmann

Timmel

Adams

et al. 2020

J of Ultrasound Medicine

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“…Sonography in the super obese population can be difficult, as the amplitude diminishes as sound propagates through the body, making images hard to obtain and interpret. In a recent retrospective study, the anatomic survey in patients with super obesity took 13.5 minutes longer than patients with normal BMI 7 . Multiple prior studies have found that as BMI increases, the completion rate of the anatomic survey decreases and the number of studies required to complete the evaluation increases 8‐10 .…”

Section: Introductionmentioning

confidence: 99%

Accuracy and Completion Rate of the Fetal Anatomic Survey in the Super Obese Parturient

Simmons

Wendel

Whittington

et al. 2020

J of Ultrasound Medicine

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Objective To determine the completion rate of ultrasound in with a body mass index (BMI) ≥ 50 to women with BMI 18.5 to 29.9. Study Design This study was a retrospective cohort study. Women with a singleton pregnancy, age 18 to 45 with a BMI ≥50 that delivered between 2013–2016 were compared to women with a BMI 18.5 to 29.9 during that same time period to assess the accuracy and, as a second aim, the completion rate of the fetal anatomic survey. Data were analyzed using two‐sample t test, chi‐square test, or logistic regression as appropriate. Results Eighty‐one cases with a BMI ≥50 were compared with 81 patients with a BMI 18.5 to 29.9. Maternal demographics and timing (gestational age) at the time of the ultrasound were similar between groups. In women with a BMI 18.5 to 29.9, completion of anatomy was 58% of the time with the first ultrasound, 81% with second ultrasound, and 84% with the third ultrasound. In women with BMI ≥50, completion of anatomy was 10% of the time with the first ultrasound, 33% with the second ultrasound, and 42% with the third ultrasound. Each time frame was statistically significant. Agreement level on the accuracy to detect fetal anomalies between groups were not statistically significant between the groups. Conclusion In women with a BMI ≥50 compared to women with BMI of 18.8 to 29.9, more ultrasounds are needed to complete the anatomic survey although overall accuracy in fetal anomaly detection is similar.

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Obstetric ultrasound and women with obesity: Do we need industry guidance?

Russo,

Quinton

2024

Sonography

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Australia, like many developed countries is experiencing an obesity crisis, with maternal obesity associated with increased risks of fetal and maternal complications. For obstetric sonographers, there are technical challenges to exclude a fetal anomaly or pregnancy complication in a woman with obesity. Furthermore, scan times are often longer, greater probe pressure is needed and follow up scans are often undertaken to complete examinations. There are numerous studies reporting high rates of work‐related musculoskeletal disorders (WRMSDs) amongst sonographers and papers that provide tips and tricks to improve imaging and ergonomics. However, there is no specific industry guidance by way of a guideline, consensus statement or position paper from our leading professional associations, on how we can address this complex issue obstetric sonographers encounter when scanning women with obesity, or our communication with women about the difficulties faced. Given the high and increasing rates of obesity, the high risk of pain and WRMSDs for sonographers and limitations associated with these examinations, this raises the question—is it time for our industry to discuss guidance and communication in obstetric ultrasound for women with obesity to mitigate sonographer risk of WRMSDs, while ensuring safe, high quality care for these women?

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Detailed Fetal Anatomic Ultrasound Examination Duration and Association With Body Mass Index

Cited by 10 publications

References 35 publications

A Matter of Time

A Matter of Time

Accuracy and Completion Rate of the Fetal Anatomic Survey in the Super Obese Parturient

Obstetric ultrasound and women with obesity: Do we need industry guidance?

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