Basic versus detailed sonography: what do we miss?
OBJECTIVE
The purpose of this study was to evaluate the impact of restrictive versus routine use of "detailed" second-trimester sonography.


METHODS
Records of singleton pregnancies undergoing evaluation from 2004 to 2008 were reviewed. A detailed examination (Current Procedural Terminology [CPT] code 76811) was routinely performed on all patients. Major structural abnormalities were categorized on the basis of whether the structure would be included in a "basic" examination (CPT code 76805). Risk factors for anomalies were identified. The Fisher exact test and Student t test were used for statistical comparison.


RESULTS
Major anomalies were identified in 218 patients, 75 of whom elected to undergo abortion. In 88 patients (40.4%), the abnormal structure would not be included in a basic examination. Risk factors were not more prevalent in those with anomalies requiring a detailed examination for diagnosis or in those patients who chose to undergo abortion.


CONCLUSIONS
Restricting detailed evaluation to those with risk factors would have prevented detection of a substantial proportion of anomalies.
Chasen
Stephen T
ST
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Weill Medical College of Cornell University, 525 E 68th St, Room J130, New York, NY 10021 USA. stchasen@med.cornell.edu
Kalish
Robin B
RB
Chervenak
Frank A
FA
D000013:Congenital Abnormalities / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003951:Diagnostic Errors; D005188:False Negative Reactions; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015994:Incidence; D009518:New York; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*