title: [The advantages of early midtrimester targeted fetal systematic organ screening for the detection of fetal anomalies--will a global change start in Israel?].
abstract: BACKGROUND
  Despite more than three decades of universal popularity of fetal sonography as an integral part of pregnancy evaluation, there is still no unequivocal agreement regarding the optimal dating of fetal sonographic screening and the type of ultrasound (transvaginal vs abdominal).
  
  
  METHODS
  TransvaginaL systematic sonography at 14-17 weeks for fetal organ screening.
  
  
  RESULTS
  The evaluation of over 72.000 early (14-17 weeks) and late (18-24 weeks) fetal ultrasonographic systematic organ screenings revealed that 96% of the malformations are detectable in the early screening with an incidence of 1:50 gestations. Only 4% of the fetal anomalies are diagnosed later in pregnancy. Over 99% of the fetal cardiac anomalies are detectable in the early screening and most of them appear in low risk gestations.
  
  
  CONCLUSIONS
  Therefore, we suggest a new platform of fetal sonographic evaluation and follow-up: The extensive systematic fetal organ screening should be performed by an expert sonographer who has been trained in the detection of fetal malformations, at 14-17 weeks gestation. This examination should also include fetal cardiac echography Three additional ultrasound examinations are suggested during pregnancy: the first, performed by the patient's obstetrician at 6-7 weeks for the exclusion of ectopic pregnancy, confirmation of fetal viability, dating, assessment of chorionicity in multiple gestations, and visualization of maternal adnexae. The other two, at 22-26 and 32-34 weeks, require less training and should be performed by an obstetrician who has been qualified in the sonographic detection of fetal anomalies.
  
  
  CONCLUSIONS
  The advantages of early midtrimester targeted fetal systematic organ screening for the detection of fetal anomalies may dictate a global change.
authors.forename: Moshe
authors.initials: M
authors.lastname: Bronshtein
authors.forename: Ido
authors.initials: I
authors.lastname: Solt
authors.forename: Zeev
authors.initials: Z
authors.lastname: Blumenfeld
mesh_terms: D000013:Congenital Abnormalities / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D004452:Echocardiography / Q000379:methods; D005260:Female; D047109:Fetal Development / Q000502:physiology; D005318:Fetal Heart / Q000002:abnormalities / Q000000981:diagnostic imaging; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D018743:Perinatal Care / Q000458:organization & administration; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods / Q000706:statistics & numerical data