Targeted mid-trimester ultrasound examination: how does fetal anatomic visualization depend upon the duration of the scan?

Authors: Catanzarite, V.; Delaney, K.¹; Wolfe, S.¹; Dowling, D.; Daneshmand, S.; Cousins, L.; Poeltler, D.²

Source: Ultrasound in Obstetrics and Gynecology, Volume 26, Number 5, October 2005 , pp. 521-526(6)

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Abstract:

Objective

To determine the relationship between visualization of key fetal anatomic structures during mid-trimester ultrasound examination with gestational age and duration of examination.

Methods

One hundred ultrasound examinations at 16–22 weeks' gestation were reviewed to determine the times at which key fetal anatomic features were seen. Scans were terminated at 30 min or when a comprehensive anatomic survey was complete. Exclusion criteria included multiple gestation, maternal weight > 77 kg, abdominal wall scarring, and suspected fetal anomalies.

Results

Visualization of cranial anatomy including lips, face, midline, ventricles, choroid plexus, and cerebellum was achieved in 98% of patients within 30 min. The corresponding figures for spine, cardiac screening (four-chamber, aortic, and pulmonary outflow views) and for abdominal anatomy (stomach, kidneys, bladder, ventral wall, and three-vessel cord) were 91%, 91%, and 99%, respectively. A complete anatomic survey including each of the above elements was obtained by 10, 15, 20, 25, and 30 min in 8%, 31%, 53%, 72% and 81% of the subjects. Rates of complete anatomic surveys within 30 min improved by gestational age interval, from 20/30 (67%) at 16–18 weeks, to 36/44 (82%) at 18–20 weeks, and 25/26 (96%) at 20–22 weeks; this rise was primarily due to improvements in visualization of the spine and heart.

Conclusions

A comprehensive anatomical survey can be completed in 10 min or less in a minority of patients. For each 5-min time increment up to 30 min, the rate of complete surveys improves. Rates of completed anatomic surveys rise with gestational age. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.

Keywords: fetal anatomic visualization; prenatal diagnosis; routine ultrasound

Document Type: Research article

DOI: http://dx.doi.org/10.1002/uog.1953

Affiliations: 1: Division of Maternal Fetal Medicine and Sharp/Children's Prenatal Diagnostic Center, San Diego Perinatal Center, Sharp/Children's Prenatal Diagnostic Center, USA 2: Sharp Mary Birch Hospital for Women, San Diego, USA

Publication date: 2005-10-01

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Targeted mid-trimester ultrasound examination: how does fetal anatomic visualization depend upon the duration of the scan?

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