[Quality criteria and risks for malpractice in ultrasound prenatal diagnosis. What is allowed--what may be missed?].
BACKGROUND
As with all new diagnostic options in medicine, great hope was placed in the introduction of high-resolution prenatal sonography. Progress tends to carry with it a demanding attitude of higher expectations. Patients and doctors alike may initially overestimate the possibilities of medical advances.


OBJECTIVE
The question at hand is whether objective criteria can validate a positive influence of prenatal ultrasound on fetal outcome. How should a sonographic routine screening be structured, and what legal aspects need to be taken into consideration?


METHODS
This is an attempt to survey the heterogeneous pool of internationally published data with regard to these critical questions. Only a rationally devised analysis of possibilities and restrictions of routine prenatal sonography can answer the question of "what--if anything--may be missed?"


CONCLUSIONS
Screening ultrasound matches sonography on indication. Despite controversial data a discussion of different studies leads to a positive conclusion on the benefits of ultrasound monitoring in pregnant women. Ultrasound-screening has an explicit effect on medical and economic issues as well as on litigation.
Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Grosshadern, Klinikum der Universität München. Alexander.Strauss@gyn.med.uni-muenchen.de
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D000013:Congenital Abnormalities / Q000000981:diagnostic imaging* / Q000517:prevention & control; D003951:Diagnostic Errors; D005260:Female; D005858:Germany; D006801:Humans; D007231:Infant, Newborn; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008403:Mass Screening / Q000331:legislation & jurisprudence*; D011247:Pregnancy; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal