[Quality of praenatal diagnostic ultrasound - comparison of sonographically detected foetal anomalies with diagnostic findings verified post-partum in Switzerland].
OBJECTIVE
Comparison of all praenatally detected cases of foetal anomalies to actual diagnostic findings post partum during a one year period in Switzerland.


METHODS
A retrospective questionnaire-based evaluation including the 5 university hospitals and 6 large hospitals in Switzerland as a population-based study. Analysis of all foetal anomalies detected praenatally by ultrasound in the year of 1995 in these centres.


RESULTS
347 cases have been included in the study. 89 % of cases were detected using screening methods. (2/3) were referred by obstetrical practitioners and GPs. 62 % of the pregnancies were completed and 33 % terminated, while the rest resulted in abortion or stillbirth. In terminated pregnancies there was a 82 % agreement between praenatal and postmortem findings. Sonographic results and clinical/post-mortem diagnosis were in agreement about the presence of major foetal anomalies in 18 % of cases. Additional minor anomalies unperceived by sonography, however, were seen post mortem. There was no false positive case.


CONCLUSIONS
Without ultrasound screening almost 90 % of anomalies would have been missed due to the absence of clinical symptoms. The Swiss two-step system for praenatal ultrasound screening, based on screening scans done by the obstetrician and GP in practice, or residents in the public outpatient clinics respectively, and the detailed scan done by a subspecialized perinatologist shows excellent results especially in the subgroup of terminated pregnancies.
Stiller
R
R
Departement für Frauenheilkunde, Klinik und Poliklinik für Geburtshilfe, Universitätsspital Zürich. ruth.stiller@fhk.usz.ch
Huch
R
R
Huch
A
A
Zimmermann
R
R
D000025:Abortion, Eugenic / Q000706:statistics & numerical data; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013557:Switzerland; D016216:Ultrasonography, Prenatal
Qualität der pränatalen sonographischen Diagnostik - Vergleich sonographisch erfasster Fehlbildungen mit dem tatsächlichen fetalen Outcome in der Schweiz.