Quality assurance in obstetric ultrasound

Abstract

Ultrasound examination is a routine element of antenatal care, and an accurate and reliable ultrasound service is essential for confident patient management. Qualitative findings, e.g. fetal normality and placental site, may be confirmed at delivery, but this form of audit is not suitable for fetal measurements owing to the variation in gestation at delivery and the complexity of neonatal assessment. Our aim was to develop a simple audit method applied a short time after the ultrasound scan. The method was based on assessment of measured images against measurement criteria which are clearly defined in the literature, results for each criterion being recorded in a spreadsheet. Two main forms of report were generated, the first showing overall achievement of satisfactory measurements for each sonographer, the second providing graphical information to show which criteria required greater attention by individual sonographers. Over several phases of audit problems of quality recognition and technical skill were isolated, graphical reports were used to guide tuition and the levels of performance were improved. The method itself and the results satisfy managers at all levels that standards are in place and are being maintained.

Volumetric (3D) imaging reduces inter‐ and intraobserver variation of fetal biometry measurements

“…Accurate measurements are critically important to various aspects of obstetric management, including determination of gestational age, follow‐up of intrauterine growth restriction and estimation of fetal weight. Therefore, the importance of quality control for these measurements has been emphasized1, 2.…”

Bi̇r Grup Lokanta Ve Yemekhane Çalişaninda Brusella Anti̇korlarinin Vvright Aglüti̇nasyonu İle Araştirilmasi

“…Çolak ve ark (17). 1988-1989 yılları arasında kırsal alanlarda yaşayan 1332 kişide brusella antikorlarını araştırmışlar, seropozitifliğin erkek cinsiyette ve 45-54 yaş diliminde yoğunlaştığını tespit etmişlerdir.…”

“…Hekimler bu incelemeye diğer tetkiklerden de fazla baş-vurmaktadır. İleri ülkelerde de örneğin İngiltere'de USG incelemesi antenatal bakımın rutin elementi olarak görülmektedir (17). Ancak özellikle birinci basamakta çok ucuz, gerekli ve basit tetkik ve muayenelerin öncelikle ele alınması şimdilik daha anlamlı olacaktır.…”

‘Ceci n’est pas une échographie': a plea for quality assessment in prenatal ultrasound

“…The concept of scoring is suggestive of an external audit12. However, an operator's self‐assessment of image acceptability is probably an efficient component of training as well as being a good basis for a constructive comparison with an external audit13. The way external audit impacts on the quality of practice is not fully understood, but awareness of an ongoing audit itself has been shown to improve image quality at follow‐up14.…”