Benjamin Ross, Hilda Yenuberi, Swati Rathore, Annie Prasanthi, Manisha Beck, Jiji E Mathews
Department of Neonatology, Christian Medical College, Vellore, Tamil Nadu, South India.
Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamil Nadu, South India.
J Family Med Prim Care. 2020 Jul 30;9(7):3242-3245. doi: 10.4103/jfmpc.jfmpc_88_20. eCollection 2020 Jul.
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.
The aim was to audit the diagnostic accuracy in a busy scan room.
Retrospective cohort in a tertiary center.
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.
All the categorical variables in this research were summarized using counts and percentages.
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.
910/963 (95%) of significant anomalies can be identified even in busy centers if a systematic assessment approach is ensured.
重大异常是指那些致命的异常，或者那些需要长期随访且治疗费用高昂的异常。检测到这些异常可使对患有这些诊断的妊娠提前终止或提供必要的支持系统。与过度诊断相关的焦虑使女性成为现代成像技术的受害者。然而，在一个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。
目的是审核繁忙扫描室中的诊断准确性。
在一家三级中心进行回顾性队列研究。
在预计分娩日期之后，对在孕20周扫描时发现的重大异常进行审核。记录漏诊或过度诊断的异常情况。
本研究中的所有分类变量均使用计数和百分比进行汇总。
在研究期间，28000名女性接受了形态学超声检查。963名（3.4%）女性在出生时被检测出有异常。285例（30%）为多发异常，678例（70%）为单发异常。泌尿生殖系统异常最为常见，其次是中枢神经系统异常。仅53例（0.2%）异常被漏诊。它们主要是综合征和心血管系统异常。所发现的最重大异常可以用基本的超声机器诊断出来。
如果确保采用系统的评估方法，即使在繁忙的中心，963例重大异常中的910例（95%）也能被识别出来。
