No. 352-Technical Update: The Role of Early Comprehensive Fetal Anatomy Ultrasound Examination

Obstetrical Ultrasound During Pregnancy

“…Ten evidence-based guidelines with recommendations regarding obstetrical ultrasound were identified. 2,[7][8][9][10][11][12][13][14][15] Six of the guidelines were developed by the Society of Obstetricians and Gynaecologists of Canada, 2,8,10-12,15 2 were developed by ISUOG -the International Society of Ultrasound in Obstetrics and Gynecology, 7,14 1 was developed by the U.S. Department of Veterans Affairs and the U.S. Department of Defense, 9 and 1 was developed by the American College of Obstetricians and Gynecologists. 13 Each of the 10 included guidelines…”

“…Ten evidence-based guidelines with recommendations regarding obstetrical ultrasound were identified. 2,[7][8][9][10][11][12][13][14][15] Additional details regarding the characteristics of included publications are provided in Appendix 2.…”

“…Health technology assessment and systematics reviews, randomized controlled trials, non-randomized studies, evidence-based guidelines collected evidence using a review of the literature and expert opinion, when needed. 2,[7][8][9][10][11][12][13][14][15] One of the guidelines also used patient focus groups to inform their recommendations. 9 Five of the included guidelines 2,8,10,11,15 used the criteria described by the Canadian Task Force on Preventive Health Care to determine the quality of evidence and classify the strength of recommendations.…”

Antenatal Fetal Assessment: 75 Years Later (1945-2019)

“…14 A technical update on comprehensive early fetal anatomy ultrasound reports that the majority of fetal organs are visible by the end of the first trimester, the majority of significant and ultrasound identified fetal anomalies are detectable, and this anomaly detection allows for an earlier counselling and diagnostic process for improved pregnancy management. 15 The complete "routine" second trimester obstetrical ultrasound examination and report should be offered between 18 and 22 weeks gestation, and the report should include the number of fetuses, gestational age by crown-rump length, location of the placenta, and assessment for normal or abnormal fetal anatomical development. The ultrasound report should include patient demographic information; number of fetuses and indications of life; fetal biometry; fetal anatomy; amniotic fluid assessment; placenta position related to cervix; and maternal uterus, ovary, cervix, and bladder anatomy.…”

Évaluation fœtale prénatale : 75 ans plus tard (1945-2019)

“…L' echographie syst ematique en d ebut de grossesse a am elior e la d etection pr ecoce de grossesses multiples, am elior e la datation gestationnelle et peut r eduire le taux de d eclenchement artificiel du travail pour les foetus postmatures. Les chercheurs ont soulign e que la litt erature disponible pour examen pr esentait une importante variabilit e, tant pour le nombre d' echographies qu'ont reçu les patientes que pour le moment o u elles les ont reçues14 .Une mise a jour technique sur l' echographie compl ete pr ecoce de l'anatomie foetale indique que la majorit e des organes foetaux sont visibles a la fin du premier trimestre; la majorit e des anomalies foetales significatives et d etermin ees par echographie sont d etectables, et ce d epistage des anomalies permet un processus de consultation et de diagnostic plus pr ecoce pour une meilleure prise en charge de la grossesse15 . L'examen et le rapport « syst ematiques » complets d' echographie obst etricale au deuxi eme trimestre doivent etre offerts entre 18 et 22 semaines de gestation, et le rapport doit inclure le nombre de foetus, l'âge gestationnel selon la distance vertex-coccyx, l'emplacement du placenta et l' evaluation du d eveloppement anatomique foetal normal ou anormal.…”