[Sensitive and specific screening for detection of spina bifida by echography in the second trimester; systematic review and meta-analysis].
OBJECTIVE
Evaluation of the diagnostic accuracy of ultrasound in the second trimester for the detection of spina bifida.


METHODS
Systematic review and meta-analysis.


METHODS
Medline and Embase were searched to identify prospective studies in a general pregnant population. Also, in the Cochrane Library, references of identified reports and recent reviews were checked for relevant studies. Retrieved abstracts were selected independently by 2 authors using predefined criteria. Assessment of quality and generalizability of the included studies and data extraction were performed by 3 authors independently. The data were tested for heterogeneity and pooled estimates of sensitivity and specificity were calculated for all studies.


RESULTS
13 studies were included. Specificity was approximately 100% in all cases. Sensitivity varied from 40% to 100%. The summary point estimate for sensitivity was 71% with a 95% confidence interval of 59%-81%.


CONCLUSIONS
Ultrasound in the second trimester is a specific investigation to detect spina bifida, which may detect seven out of ten defects. Used as a screening tool, it could contribute to a significant reduction in the number of children born with spina bifida.
Vos
J M
JM
Afd. Kindergeneeskunde, Academisch Medisch Centrum/Emma Kinderziekenhuis, DE Amsterdam. m.offringa@amc.uva.nl
Offringa
M
M
Bilardo
C M
CM
Lijmer
J G
JG
Barth
P G
PG
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening / Q000379:methods*; D009426:Netherlands; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016135:Spinal Dysraphism / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D016216:Ultrasonography, Prenatal