What Is the Rate of Incomplete Fetal Anatomic Surveys During a Second-Trimester Scan? Retrospective Observational Study of 4000 Nonobese Pregnant Women.
OBJECTIVE
The purpose of this study was to estimate the rate of incomplete fetal anatomic surveys during a second-trimester scan due to an unfavorable fetal position in a nonobese population.


METHODS
All pregnant women who came to the Altamedica Fetal-Maternal Medical Center, a specialized center for prenatal diagnosis, for a routine second-trimester scan between January 2012 and April 2013 were retrospectively included in the analysis. Patients with a body mass index higher than 30.0 kg/m(2) or anterior fibroids larger than 5 cm were not included in the study.


RESULTS
Of 4000 pregnant women admitted for a second-trimester scan, 169 (4.2%) came back within 2 weeks to complete the examination because of an unfavorable fetal position. In particular, 104 (2.6%) needed visualization of only 1 view, and 65 (1.6%) needed more than 1 view. The most difficult organ to visualize was the corpus callosum, in 73 cases (1.8%); the face was not visualized in 69 cases (1.7%); the cerebellar vermis was not seen in 47 fetuses (1.1%); and the heart could not be completely examined in 40 fetuses (1.0%). Of the 4000 women, 169 (4.2%) had a nonexhaustive scan; 149 (3.7%) needed a second scan to complete the second-trimester survey; 14 (0.35%) needed a third scan; and 2 (0.05%) remained with a not completely exhaustive scan.


CONCLUSIONS
There is always a small percentage of incomplete fetal anatomic surveys during a second-trimester scan, which cannot be modified by the sonographer's skill or by technical sonographic innovations.
Department of Prenatal Diagnosis, Altamedica, Fetal-Maternal Medical Center, Rome, Italy (F.P., M.G., P.C., M.L.M., L.D., C.G.); Division of Obstetrics and Gynecology, University of Catania, Santo Bambino Hospital, Catania, Italy (F.A.G.); and Department of Obstetrics and Gynecology, Campus Bio Medico, University of Rome, Rome, Italy (S.C.). frpadula@gmail.com.
Francesco
F
Padula
Department of Prenatal Diagnosis, Altamedica, Fetal-Maternal Medical Center, Rome, Italy (F.P., M.G., P.C., M.L.M., L.D., C.G.); Division of Obstetrics and Gynecology, University of Catania, Santo Bambino Hospital, Catania, Italy (F.A.G.); and Department of Obstetrics and Gynecology, Campus Bio Medico, University of Rome, Rome, Italy (S.C.).
Ferdinando Antonio
FA
Gulino
Department of Prenatal Diagnosis, Altamedica, Fetal-Maternal Medical Center, Rome, Italy (F.P., M.G., P.C., M.L.M., L.D., C.G.); Division of Obstetrics and Gynecology, University of Catania, Santo Bambino Hospital, Catania, Italy (F.A.G.); and Department of Obstetrics and Gynecology, Campus Bio Medico, University of Rome, Rome, Italy (S.C.).
Stella
S
Capriglione
Department of Prenatal Diagnosis, Altamedica, Fetal-Maternal Medical Center, Rome, Italy (F.P., M.G., P.C., M.L.M., L.D., C.G.); Division of Obstetrics and Gynecology, University of Catania, Santo Bambino Hospital, Catania, Italy (F.A.G.); and Department of Obstetrics and Gynecology, Campus Bio Medico, University of Rome, Rome, Italy (S.C.).
Maurizio
M
Giorlandino
Department of Prenatal Diagnosis, Altamedica, Fetal-Maternal Medical Center, Rome, Italy (F.P., M.G., P.C., M.L.M., L.D., C.G.); Division of Obstetrics and Gynecology, University of Catania, Santo Bambino Hospital, Catania, Italy (F.A.G.); and Department of Obstetrics and Gynecology, Campus Bio Medico, University of Rome, Rome, Italy (S.C.).
Pietro
P
Cignini
Department of Prenatal Diagnosis, Altamedica, Fetal-Maternal Medical Center, Rome, Italy (F.P., M.G., P.C., M.L.M., L.D., C.G.); Division of Obstetrics and Gynecology, University of Catania, Santo Bambino Hospital, Catania, Italy (F.A.G.); and Department of Obstetrics and Gynecology, Campus Bio Medico, University of Rome, Rome, Italy (S.C.).
Maria Luisa
ML
Mastrandrea
Department of Prenatal Diagnosis, Altamedica, Fetal-Maternal Medical Center, Rome, Italy (F.P., M.G., P.C., M.L.M., L.D., C.G.); Division of Obstetrics and Gynecology, University of Catania, Santo Bambino Hospital, Catania, Italy (F.A.G.); and Department of Obstetrics and Gynecology, Campus Bio Medico, University of Rome, Rome, Italy (S.C.).
Laura
L
D'Emidio
Department of Prenatal Diagnosis, Altamedica, Fetal-Maternal Medical Center, Rome, Italy (F.P., M.G., P.C., M.L.M., L.D., C.G.); Division of Obstetrics and Gynecology, University of Catania, Santo Bambino Hospital, Catania, Italy (F.A.G.); and Department of Obstetrics and Gynecology, Campus Bio Medico, University of Rome, Rome, Italy (S.C.).
Claudio
C
Giorlandino
D000293:Adolescent; D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003951:Diagnostic Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000000981:diagnostic imaging / Q000453:epidemiology; D056888:Patient Positioning / Q000379:methods / Q000706:statistics & numerical data*; D011247:Pregnancy / Q000706:statistics & numerical data*; D011262:Pregnancy Trimester, Second; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*; D055815:Young Adult
fetal anatomy; fetal position; fetal sonography; obstetric ultrasound; second-trimester scan; sonographic skill