The importance of quality management in fetal measurement

Abstract

AC quality criteria are less easily recognized and obtained than those for head measurements; training, adherence to protocols and audit are important. Differences between ellipse and traced AC may not justify the use of separate charts; the number of non-elliptical sections suggests that ellipse fitting is not appropriate. Comparison between EFW errors is not a suitable tool for audit. Failure to meet quality criteria results in clinically significant errors.

Ultrasound (in)accuracy: it's in the formulae not in the technique – assessment of accuracy of abdominal circumference measurement in term pregnancies

“…This indicates that with appropriate training the AC measurement can be relied upon when performed by clinicians in situations when a sonographer is not easily accessible, for example in the labour ward of the hospital. Quality regulation in assessing the fetal AC is important though, with the AC shown to be the measurement where sonographers were most likely to be missing the quality criteria 31 . Tracing measurement of the fetal AC has been shown to more accurately fit the abdominal outline than elliptical measurement, particularly in term pregnancies where the fetal limbs often indent the smooth contour of the AC 31 .…”

“…Quality regulation in assessing the fetal AC is important though, with the AC shown to be the measurement where sonographers were most likely to be missing the quality criteria 31 . Tracing measurement of the fetal AC has been shown to more accurately fit the abdominal outline than elliptical measurement, particularly in term pregnancies where the fetal limbs often indent the smooth contour of the AC 31 . Due to this, the tracing method was utilised in this study.…”

“…– 31 As such, the AC measurement is faster and easier to obtain than the EFW in a term pregnancy, where the engaged head can make the HC and BPD measurements technically difficult and less reliable. It is also one of the measurements which appears to be more achievable in the obese population, with equivalence of image quality compared with patients of average BMI 41 .…”

Knowledge, attitudes and practices of obstetrical ultrasound in Conakry, Guinea

“…20 These criteria are specific for each parameter and they are made on the basis of fetal biometrics references. [21][22][23] The identification and study of these anatomical structures also constitute the basis of the detailed morphological study of the fetus. The analysis of our results shows a deficiency in the practice of obstetrical ultrasound, since only one service provider over four (24.8%) knew the key anatomical structures to identify when measuring the biparietal (BIP) and head circumference (HC); and a service provider over three (36.2%) correctly indicated the key anatomical structures to identify when measuring abdominal circumference (AC).…”

Re: Feasibility and reproducibility of an image‐scoring method for quality control of fetal biometry in the second trimester

“…I would also like to draw their attention to the earlier work of myself and my colleagues 2 , where we demonstrated the value of using such scoring as a feedback mechanism for training and coaching. We showed improvement in measurement quality over four cycles of audit, in both second and third trimesters, and demonstrated the value of the process in a wider trial in six centers 3 . We also found that comparing gestational ages from biparietal diameter and femoral length is a useful quantitative adjunct to image review.…”