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Abstract

Sonographische Fehlbildungsdiagnostik im zweiten und dritten Trimenon

Obstetric ultrasound is nowadays a well accepted part of routine antenatal care in many countries. In this setting, ultrasound has been increasingly used for the prenatal diagnosis or exclusion of fetal malformations. The prenatal diag nosis of a fetal disorder permits the enhancement of antepartum and intrapartum care and therefore has been shown to decrease the perinatal morbidity and mortality in some conditions.

As most malformations occur sporadically and in low risk patients, the identification of those fetuses is only achieved by application of a general screening examination with a reasonably high sensitivity. The accuracy of prenatal malfor mation screening is mainly influenced by the experience and skill of the examiner, but also depends on the gestational age of screening, the equipment used and the visibility (amniotic fluid volume, maternal BMI, fetal position). The fetal anatomic examination is preferentially performed at 20-22 weeks gestation, but some anomalies may be identified only later in gestation.

The accuracy of prenatal ultrasound screening differs widely, with higher detection rates in centers with highly trained and skilled examiners. Other reasons why an abnor mality may be not detected include an early gestational age, technical difficulties and an unsystematic, incomplete examination. Continuous theoretical and practical training of health care professionals is necessary, to further improve the potential benefits of prenatal ultrasound screening.

Annegret Geipel

Reviewer: Matthias Baumann, Nürnberg
und Dirk Masson, Hamburg

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2007;3(2):38-51