title: Screening for foetal malformations: performance of routine ultrasonography in the population of the Swiss Canton of Vaud.
abstract: OBJECTIVE
  To determine the sensitivity of ultrasonography in screening for foetal malformations in the pregnant women of the Swiss Canton of Vaud.
  
  
  METHODS
  Retrospective study over a period of five years.
  
  
  METHODS
  We focused our study on 512 major or minor clinically relevant malformations detectable by ultrasonography. We analysed the global sensitivity of the screening and compared the performance of the tertiary centre with that of practitioners working in private practice or regional hospitals.
  
  
  RESULTS
  Among the 512 malformations, 181 (35%) involved the renal and urinary tract system, 137 (27%) the heart, 71 (14%) the central nervous system, 50 (10%) the digestive system, 42 (8%) the face and 31 (6%) the limbs. Global sensitivity was 54.5%. The lowest detection rate was observed for cardiac anomalies, with only 23% correct diagnoses. The tertiary centre achieved a 75% detection rate in its outpatient clinic and 83% in referred patients. Outside the referral centre, the diagnostic rate attained 47%.
  
  
  CONCLUSIONS
  Routine foetal examination by ultrasonography in a low-risk population can detect foetal structural abnormalities. Apart from the diagnosis of cardiac abnormalities, the results in the Canton of Vaud are satisfactory and justify routine screening for malformations in a low-risk population. A prerequisite is continuing improvement in the skills of ultrasonographers through medical education.
authors.affiliation: Département de Gynécologie-Obstétrique, maternité du CHUV, Lausanne, Switzerland.
authors.forename: Y
authors.initials: Y
authors.lastname: Vial
authors.forename: C
authors.initials: C
authors.lastname: Tran
authors.forename: M C
authors.initials: MC
authors.lastname: Addor
authors.forename: P
authors.initials: P
authors.lastname: Hohlfeld
mesh_terms: D002490:Central Nervous System / Q000002:abnormalities / Q000000981:diagnostic imaging; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control; D004064:Digestive System / Q000000981:diagnostic imaging; D004065:Digestive System Abnormalities; D005260:Female; D005333:Fetus / Q000002:abnormalities*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging; D006801:Humans; D008403:Mass Screening; D009139:Musculoskeletal Abnormalities / Q000000981:diagnostic imaging; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013557:Switzerland / Q000453:epidemiology; D016216:Ultrasonography, Prenatal