Sensitivity and specificity of routine antenatal screening for congenital anomalies by ultrasound: The Belgian Multicentric Study

Levi, Salvator; Hyjazi, Yolande; Schaapst, J.‐.; Defoort, Paul; Coulon, R.; Buekens, Pierre

doi:10.1046/j.1469-0705.1991.01020102.x

Cited by 159 publications

(126 citation statements)

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“…Similarly, when the UEA was found in the setting of other non-upper extremity anomalies, pregnancy termination was more common. This aligns with previous studies showing that mothers are more likely to terminate a pregnancy in the setting of severe systemic anomalies [16][17][18][19].…”

Section: Itemsupporting

confidence: 92%

The Impact of Prenatal Diagnosis of an Upper Extremity Anomaly on Pregnancy Outcome

Sullivan¹,

Adkinson²

2017

Surgery Curr Res

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Objective: Upper extremity anomalies (UEA) occur when there is an interruption in the normal process of embryonic limb development. The prenatal diagnosis of an UEA may impact the decision to deliver or terminate the pregnancy. We sought to elucidate factors associated with pregnancy outcome in the setting of a known UEA. Methods:We reviewed electronic medical records at three affiliated hospitals to identify mothers with an UEA diagnosed by prenatal ultrasound. Maternal demographics, anomaly type, and clinical management variables were collected. Patients were stratified by primary outcome of either delivery or elective termination. Multivariate analysis was performed to identify factors associated with pregnancy termination.Results: Thirty mother/child dyads were confirmed to have an UEA by prenatal ultrasound. Fourteen pregnancies resulted in live birth of the fetus (47%) and 16 pregnancies were terminated (53%). Pregnancies with multiple anomalies (P<0.05) and/or bilateral UEAs (P<0.05) were more likely to undergo termination. Consultation with an upper extremity surgeon was associated with delivery (P<0.05). Maternal demographics were not associated with pregnancy outcome. Conclusions:Fetal anomaly characteristics are associated with pregnancy outcome. Although prenatal consultation with an upper extremity surgeon was associated with delivery, this subset of patients were more likely to have isolated, unilateral anomalies.

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Section: Itemsupporting

confidence: 92%

The Impact of Prenatal Diagnosis of an Upper Extremity Anomaly on Pregnancy Outcome

Sullivan¹,

Adkinson²

2017

Surgery Curr Res

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“…Many reports on the eVectiveness of antenatal ultrasound diagnosis are from tertiary referral centres where high risk populations are screened. Few studies have reported on the eVectiveness of screening populations by routine (rather than targeted) ultrasound scans, [3][4][5][6] and the role of routine ultrasonography and its validity as a screening test for fetal malformation in a low risk population is still open to debate. 7 Of all congenital anomalies, neural tube defects (NTDs) are the easiest to identify prenatally.…”

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confidence: 99%

Evaluation of the prenatal diagnosis of neural tube defects by fetal ultrasonographic examination in different centres across Europe

et al. 2000

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Objective-Evaluation of prenatal diagnosis of neural tube defects by ultrasound examination in unselected populations across Europe. Setting-Prenatal ultrasound units in areas that report to contributing congenital malformation registers. Methods-All cases with a suspected or confirmed neural tube defect and delivered within the 30 month study period were identified from 18 Congenital Malformation Registers from 11 European countries. Data on the pregnancy, prenatal scans, outcome of pregnancy, and information on diVerent screening policies for each country were analysed. Results-670 766 deliveries occurred in the area covered by the registers during the study period. A neural tube defect was diagnosed at delivery in 542 cases. In 84% of these, the lesion was isolated (166 anencephaly, 252 spina bifida, 35 encephalocele). Of the 166 isolated cases with anencephaly, 96% were correctly identified prenatally; one was missed on scan, two were wrongly diagnosed, and four were not scanned (sensitivity 98%). 84% of the prenatal diagnoses were made before 24 weeks' gestation; 86% of isolated anencephalic pregnancies were terminated. Of the 252 cases of isolated spina bifida, 171 (68%) were correctly identified prenatally; 66% of these before 24 weeks' gestation. The diagnosis was missed on scan in 60 cases and 21 were not scanned (sensitivity 75%). The mean reduction in birth prevalence because of termination of pregnancy for spina bifida was 49% (range 6-100%). There was a wide variation between centres in prenatal detection rate (33-100%), termination of pregnancy of prenatally diagnosed cases (17-100%), and gestation both at diagnosis and termination of pregnancy. Conclusion-A high prenatal detection rate for anencephaly was reported by all registers. There is a large variation in prenatal detection and termination rates for spina bifida between centres, reflecting diVerences both in policy and culture. (J Med Screen 2000;7:169-174)

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“…Furthermore, only 17% of fetal structural anomalies were detected before 24 weeks, as compared with an average of 52% (range, 21 to 84%) in European screening studies. [9][10][11][12][13][14] Due to late diagnosis any interventions for malformed fetuses, which could alter the perinatal outcome, were no possible. Another limitation in interpretation of these results is that the study population was at a very low-risk for perinatal problems.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Screening in Low-risk Obstetrical Population: Effect on Perinatal Outcome

Theodora¹,

Antsaklis²

2008

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Abstract:The issue of routine sonography for low-risk pregnant women continues to be controversial since randomized trials have not been able to demonstrate a clear benefit especially in prenatal outcome in the past. Ultrasonography early in pregnancy can be definitely used for accurate gestational age determination and detection of multiple gestations. Additionally ultrasound scan is the best method for detecting fetal malformation as well as fetuses in high-risk for growth restriction. Since fetal chromosomal and structural anomalies, prematurity and poor placentation account for 90% of poor perinatal outcome, ultrasound could theoretically help in decreasing perinatal mortality and severe perinatal morbidity.

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Sensitivity and specificity of routine antenatal screening for congenital anomalies by ultrasound: The Belgian Multicentric Study

Cited by 159 publications

References 0 publications

The Impact of Prenatal Diagnosis of an Upper Extremity Anomaly on Pregnancy Outcome

The Impact of Prenatal Diagnosis of an Upper Extremity Anomaly on Pregnancy Outcome

Evaluation of the prenatal diagnosis of neural tube defects by fetal ultrasonographic examination in different centres across Europe

Ultrasound Screening in Low-risk Obstetrical Population: Effect on Perinatal Outcome

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