Constantine G, McCormack J
Birmingham Maternity Hospital, Queen Elizabeth Medical Centre, Edgbaston, U.K.
Prenat Diagn. 1991 Dec;11(12):905-14. doi: 10.1002/pd.1970111205.
During 1988 and 1989, 3565 women booked under consultants who performed an ultrasound scan at booking, whilst 4984 booked under consultants who performed a formal mid-trimester scan between 16 and 18 weeks. All significant anomalies diagnosed prenatally and in the neonatal period were recorded, the incidence in each group being 12.9/1000 and 9.83/1000, respectively (NS). The sensitivity of diagnosis before 20 weeks was 45 percent in the 'mid-trimester' group (kappa 0.62) compared with 30 percent in the 'booking' group (kappa 0.46), overall sensitivity of prenatal diagnosis, however, being similar in both groups (63 vs. 65 percent, kappa 0.77 vs. 0.79). Cardiac anomalies were the single largest group which were not detected equally prenatally in both groups. This study shows that formal mid-trimester scanning leads to anomalies being detected significantly earlier in the antenatal period. Although not statistically significant, three lethal anomalies were missed prenatally in the 'booking' group which we would have expected to diagnose on a mid-trimester scan. These figures are discussed in the light of previous reports.
在1988年和1989年期间，3565名孕妇在预约时由进行超声扫描的顾问医生负责登记，而4984名孕妇则由在孕中期16至18周进行正式扫描的顾问医生负责登记。记录了所有产前和新生儿期诊断出的重大异常情况，每组的发病率分别为12.9/1000和9.83/1000（无显著性差异）。“孕中期”组在20周前的诊断敏感性为45%（卡帕值0.62），而“预约”组为30%（卡帕值0.46），不过两组产前诊断的总体敏感性相似（分别为63%和65%，卡帕值0.77和0.79）。心脏异常是两组中产前未被同等检出的最大单一类别。本研究表明，正式的孕中期扫描能显著更早地在孕期检测出异常情况。尽管无统计学显著性差异，但“预约”组有3例致命异常在产前漏诊，而我们原本预计在孕中期扫描时可诊断出这些异常。将根据先前的报告对这些数据进行讨论。
