Routine radiographer screening for fetal abnormalities by ultrasound in an unselected low risk population.
A screening programme for fetal abnormalities began at The Hillingdon Hospital in July 1986. Second trimester ultrasound scans are performed by radiographers. A combined prospective and retrospective study of the ultrasound findings and outcome in all pregnancies delivered in 1989-1990 was undertaken. 6412 babies were born during this period, of whom 6183 (96%) were examined by ultrasound in the second trimester; 29 pregnancies were terminated for fetal abnormality. Of the 89 fetuses who were abnormal at birth or at induced termination of the pregnancy (1.4%), 84 were scanned in the second trimester. In 51 cases the abnormality was detected before 22 weeks gestation (sensitivity, 60.7%). 56 of these 84 abnormal fetuses scanned had potentially lethal or major handicapping abnormalities of which 41 were detected by ultrasound before 22 weeks gestation (sensitivity, 73%). There was one false positive diagnosis of abnormality which did not affect outcome. 6352 babies were normal at delivery or on discharge from hospital (specificity, 99.98%).
Shirley
I M
IM
Hillingdon Hospital, Uxbridge, Middlesex, UK.
Bottomley
F
F
Robinson
V P
VP
D000028:Abortion, Induced; D005260:Female; D005333:Fetus / Q000002:abnormalities*; D006801:Humans; D007621:Karyotyping; D008403:Mass Screening; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000235:genetics; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D016216:Ultrasonography, Prenatal