[Accuracy of prenatal diagnoses in terminated pregnancies--a retrospective analysis of results and influences].
OBJECTIVE
The aim of the study was to analyse the accuracy of prenatal sonography in terminated pregnancies and the influence of factors like personnel and standard of technique and organisation on the quality of prenatal sonography for the detection of fetal anomalies.


METHODS
The retrospective study includes 64 cases with termination of pregnancy from 1989 to 1997. We analyse prenatal sonographic and postnatal pathological findings of fetus, placenta and umbilical cord. Furthermore we compare two time periods (1989-93 and 1994-97) with different ultrasound conditions.


RESULTS
In 36 cases (56%) the prenatal diagnosis was exact. In 7 cases (11%) autopsy could not confirm all findings (false positive), whereas autopsy detected additional anomalies in 18 cases (28%) (false negative). The diagnosis was not correct in 3 cases (5%), whereby 2 pregnancies were terminated without proved somatic and chromosomal anomalies. Compared to 1989-93 the rate of false-positive (12 vs. 5) as well as false-negative (9 vs. 3) diagnoses decreased significantly (p < 0.002) in cases with major anomalies (heart, central nervous system).


CONCLUSIONS
We conclude that the improvement of the level of organisation, personnel and technical equipment has relevant impact on the accuracy of prenatal sonography. Autopsy as a method of quality control is absolutely necessary.
Faber
R
R
Universitätsfrauenklinik, Universität Leipzig. fabr@medizin.uni-leipzig.de
Stepan
H
H
Schilde
M
M
Froster
U G
UG
Horn
L C
LC
D000025:Abortion, Eugenic / Q000706:statistics & numerical data*; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005333:Fetus / Q000473:pathology; D005858:Germany; D006801:Humans; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*