The practice patterns of second trimester fetal ultrasonography: A questionnaire survey and an analysis of checklists

Abstract

ObjectiveTo analyze practice patterns and checklists of second trimester ultrasonography, and to investigate management plans when soft markers are detected among Korean Society of Ultrasound in Obstetrics and Gynecology (KSUOG) members.MethodsAn internet-based self-administered questionnaire survey was designed. KSUOG members were invited to the survey. Checklists of the second trimester ultrasonography were also requested. In the questionnaire survey, general practice patterns of the second trimester ultrasonography and management schemes of soft markers were asked. In the checklists analysis, the number of items were counted and also compared with those recommended by other medical societies.ResultsA total of 101 members responded. Eighty-seven percent routinely recommended second trimester fetal anatomic surveillance. Most (91.1%) performed it between 20+0 and 23+6 weeks of gestation. Written informed consents were given by 15.8% of respondents. Nearly 60% recommended genetic counseling when multiple soft markers and/or advanced maternal age were found. Similar tendencies were found in the managements of individual soft markers. However, practice patterns were very diverse and sometimes conflicting. Forty-eight checklists were analyzed in context with the number and content of the items. The median item number was 46.5 (range, 17 to 109). Of 49 items of checklists recommended by International Society of Ultrasound in Obstetrics and Gynecology and/or American Congress of Obstetricians and Gynecologists, 14 items (28.6%) were found in less than 50% of the checklists analyzed in this study.ConclusionAlthough general practice patterns were similar among KSUOG members, some of which were conflicting, and there is a need for standardization of the practice patterns and checklists of second trimester ultrasonography, which also have very wide range of spectrum.

Ultrasound markers of chromosome aberrations on routine second trimester screening

“…Although not pathological per se, the incidence of ultrasound soft markers is higher in fetuses with chromosomal aberrations. (SUN et al, 2020;ALI et al, 2012;PARK et al, 2015) Major abnormalities are observed in 25% of fetuses with chromosomal abnormalities, whereas one or more soft markers may be observed in at least 50% of affected fetuses (RANIGA et al, 2006). The finding of one major structural malformation or two or more soft markers increases the risk for chromosomal aberrations in fetuses, and in these cases there is a necessity for genetic informing of patients, and invasive prenatal testing (BENN et al, 2015).…”