背景:重要的异常是那些致命的或那些需要长期随访和无法负担的治疗。这些异常的检测允许提前终止妊娠或这些诊断的怀孕所需的支持系统。与过度诊断相关的焦虑使这名妇女成为现代成像技术的受害者。然而,在需要满足大量需求的发展中国家繁忙的扫描室中准确检测重大异常尤其具有挑战性。
目的:目的是在繁忙的扫描室中审核诊断准确性。
方法:第三级中心的回顾性队列。
方法:在预产期后对20周扫描中发现的重大异常进行审核。注意到遗漏或过度诊断的异常。
方法:本研究中的所有分类变量均使用计数和百分比进行总结。
结果:2.8万名女性在研究期间接受了形态学超声检查。963名(3.4%)妇女在出生时被发现有异常。在285例(30%)中发现了多个异常,在678例(70%)中发现了孤立的异常。泌尿生殖系统异常是最常见的,其次是中枢神经系统异常。只有53(0.2%)的异常被错过。它们主要是心血管系统的综合征和异常。识别出的最重要的异常可以用基本的超声机器来诊断。
结论:910/963(95%)的重大异常可以识别,即使在繁忙的中心,如果确保系统的评估方法。
BACKGROUND: Significant anomalies are those that are lethal or those that require prolonged follow-up and unaffordable treatments. Detection of these anomalies allows early termination or the support systems necessary for pregnancies with these diagnoses. Anxiety associated with overdiagnosis makes the woman a victim of modern imaging technology. However, accurate detection of significant anomalies in a busy scan room of a developing country with the need to cater to large numbers is particularly challenging.
OBJECTIVE: The aim was to audit the diagnostic accuracy in a busy scan room.
METHODS: Retrospective cohort in a tertiary center.
METHODS: Audit of significant anomalies identified at the 20-week scan was performed after the expected date of confinement. Anomalies that were missed or overdiagnosed were noted.
METHODS: All the categorical variables in this research were summarized using counts and percentages.
RESULTS: Twenty-eight thousand women underwent morphology ultrasound during the study period. 963 (3.4%) women were detected to have anomalies at birth. Multiple anomalies were seen in 285 (30%) cases and isolated ones in 678 (70%) cases. Anomalies of the genitourinary system were the commonest followed by the anomalies of central nervous system. Only 53 (0.2%) anomalies were missed. They were mainly syndromes and anomalies of the cardiovascular system. The most significant anomalies that were identified could be diagnosed with a basic ultrasound machine.
CONCLUSIONS: 910/963 (95%) of significant anomalies can be identified even in busy centers if a systematic assessment approach is ensured.