Antenatal ultrasound and postnatal autopsy findings in terminations after 12 weeks' gestation due to fetal abnormality: population-based study in Western Norway, 1988-2002.
BACKGROUND
Ultrasound screening has been part of antenatal care for several decades, and warrants high expertise to meet the criteria for a worthwhile screening program. In particular, the rate of false positives should be low.


OBJECTIVE
To examine time trends of pregnancy terminations for fetal abnormality after 12 weeks' gestation, and to assess the agreement between antenatal ultrasound and post-termination autopsy findings for the main pathologies leading to termination.


METHODS
During the period 1988 to 2002, 198 pregnancies were terminated for fetal abnormality after 12 weeks' gestation. We reviewed the case notes for those 151 who were autopsied (male/female/undetermined ;= ;91/56/4). Annual rates of live births and stillbirths were retrieved from the Medical Birth Registry of Norway.


RESULTS
Antenatal ultrasound provided a correct diagnosis of the major abnormality in 149/151 cases (99%), based on post-termination autopsy findings. The annual rate of terminations after 12 weeks' gestation varied between 0.6 and 3.4 (mean 1.8) per 1000 live births, with a trend toward higher rates over the study period (P=0.001, chi-square test for linear-by-linear association).


CONCLUSIONS
The specificity of antenatal ultrasound for major abnormalities was high, as compared to postnatal autopsy findings. The mean annual rates of termination after 12 weeks' gestation tended to increase over the 14-year study period.
Parkar
A P
AP
Department of Radiology, Haukeland University Hospital, Bergen, Norway.
Olsen
Ø E
ØE
Maartmann-Moe
H
H
Daltveit
A K
AK
Gjelland
K
K
Rosendahl
K
K
D000028:Abortion, Induced; D001344:Autopsy; D016009:Chi-Square Distribution; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009664:Norway / Q000453:epidemiology; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012042:Registries; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D050497:Stillbirth / Q000453:epidemiology; D016216:Ultrasonography, Prenatal