Updated DEGUM Quality Requirements for the Basic Prenatal Screening Ultrasound Examination (DEGUM Level I) between 18 + 0 and 21 + 6 weeks of gestation

Abstract

A precondition for the early detection of fetal abnormalities is the high quality of prenatal basic ultrasound (screening examination). The objective of ultrasound screening is the recognition of abnormal fetal growth and fetal anatomical anomalies. The prenatal detection of fetal abnormalities enables detailed prenatal counselling of parents, improved care at birth and potentially a reduction in morbidity and mortality. In the guidelines for maternity care in Germany (“Mutterschaftsrichtlinien”), the performance of basic ultrasound in pregnancy is not clearly defined. The required image documentation includes a few biometric measurements only. Therefore, adherence to a standard technique and the possibility of audit are limited, thus not necessarily resulting in high screening quality. In this update of the DEGUM quality requirements for level I screening ultrasound examination between 18 + 0 and 21 + 6 weeks of gestation, the required parameters, standard planes and required documentation are described in detail. The greater experience of gynecologists in the field of sonographic screening examinations and the use of a modern ultrasound technique allow improvement of the screening quality. This will improve the standard of basic ultrasound screening. Due to the enhanced standard of the DEGUM I examination, more pregnant women may benefit from a detailed ultrasound examination and specialized therapy in DEGUM level II and III centers. The required fetal structures are described in detail. This update of the requirements for level I DEGUM basic ultrasound examination between 18 + 0 and 21 + 6 weeks of gestation goes far beyond the guidelines for maternity care in Germany (the “Mutterschaftsrichtlinien”) thereby elevating standards.

Development and implementation of a comprehensive postgraduate ultrasound curriculum for residents in obstetrics and gynecology: a feasibility study

“…To determine what best to include into an ultrasound curriculum for postgraduate gynecological and obstetrical residents, we consulted several main resources: The German ultrasound society (Deutsche Gesellschaft für Ultraschall in der Medizin, DEGUM) which has an own ultrasound section for Gynecology and Obstetrics. In this several quality levels are described (level I-III) with the required standard sections and fetal measurements [ 12 – 14 ]. The European Board and College of Obstetrics Gynecology (EBCOG) which sets the European standard for every resident [ 15 ].…”

“…The German ultrasound society (Deutsche Gesellschaft für Ultraschall in der Medizin, DEGUM) which has an own ultrasound section for Gynecology and Obstetrics. In this several quality levels are described (level I-III) with the required standard sections and fetal measurements [ 12 – 14 ].…”

Point-of-care ultrasound in obstetrics and gynecology

“…Such a curriculum was introduced by the European Board and College of Obstetrics and Gynaecology (EBCOG) within the last years [ 31 ]. Nevertheless, appropriate ultrasound and interpretation skills are needed by the examiner and, thus, carefully selected evaluation and teaching tools have to be assessed for these trainings [ 32 ]. A curriculum also has to be developed with local needs in mind, e.g., there are data suggesting that only one fifth of OBGYN residents are actually planning to perform or interpret obstetric ultrasound studies in their postgraduate training in the USA [ 29 ].…”

“…It enables qualified DEGUM Level I investigators to perform a ultrasound screening exam. These recommendations also define the requirements for advising pregnant women in the scope of ultrasound examinations, as well as the prerequisites for obtaining the DEGUM Level I qualification [ 32 ].…”

Aorto-Left Ventricular Tunnel – Prenatal Diagnosis and Outcome

“…The majority of these cases were detected by fetal echocardiography prompted by hydrops fetalis, but the precise diagnosis of ALVT could only be achieved based on postnatal echocardiography or autopsy. As standards of the second-trimester scan have been established in the past decades, prenatal detection rates of structural heart defects, such as ALVT, may have improved [17][18][19]. In order to shed some light on the prenatal clinical spectrum of ALVT, we retrospectively reviewed all cases diagnosed prenatally in five large tertiary referral centers for congenital heart defects for the findings of prenatal ultrasound, the intrauterine course, and the postnatal outcome.…”