Completed Sonographic Anatomic Surveys: The Exception Rather Than the Rule.
OBJECTIVE
To determine how often fetal organ systems are imaged completely and whether this rate varies by hospital.


METHODS
All initial sonographic anatomic examinations between 16 and 24 weeks from 3 hospitals (perinatal designation levels I-III) from January 2012 through December 2013 were identified in their obstetric and gynecologic anatomic survey report databases, focusing on 36 anatomic fields. Structures were grouped into regions: brain, face, spine, heart, abdomen, and extremities. Rates of complete visualization of each structure, structure grouping, and the total were calculated and compared by χ2testing.


RESULTS
From 7211 examinations (2578 from level I, 986 from level II, and 3647 from level III), the completion rate was 16.8% (I, 20.6%; II, 20.0%; and III, 13.2%; P < .00001). Brain and extremity imaging was complete 85% of the time or more but spine only 62.4% (sacrum consistently lowest). Completeness rates varied significantly (P< .00001) for the face (28.1%-64.4%, due to low rates of clearing lips at level III, and level I not clearing profiles), heart (37.3%-56.1%, level I < II < III), and abdomen (65.2%-85.7%, due to lower rates of clearing kidneys at level I). Completion of both the heart and spine was 32.0% (I, 23.0%; II, 25.4%; and III, 40.2%; P < .00001).


CONCLUSIONS
With a comprehensive reporting system, completion rates for full anatomic sonograms are low. Facial, cardiac, and spinal structures are least complete, and follow-up examinations often remain incomplete. Completion benchmarks would be helpful because "incomplete" studies lead to repeated examinations that increase health care costs.
University of Rochester School of Medicine, Rochester, New York USA. chris_glantz@urmc.rochester.edu.
J Christopher
JC
Glantz
D000328:Adult; D005260:Female; D005333:Fetus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*
anatomic; completion; obstetric ultrasound; sonography