Paoletti Debra, Smyth Lillian, Westerway Susan, Hyett Jon, Mogra Ritu, Haslett Stephen, Peek Michael
ANU Medical School College of Health and Medicine The Australian National University Canberra Australian Capital Territory Australia.
Centenary Hospital for Women and Children The Canberra Hospital Canberra Australian Capital Territory Australia.
Australas J Ultrasound Med. 2021 Aug 26;24(4):225-237. doi: 10.1002/ajum.12282. eCollection 2021 Nov.
Inconsistent reporting practices in third trimester ultrasound, the choice of reference charts in particular, have the potential to misdiagnose abnormal fetal growth. But this may lead to unnecessary anxiety and confusion amongst patients and clinicians and ultimately influence clinical management. Therefore, we sought to determine the extent of variability in choice of fetal biometry and Doppler reference charts and reporting practices in Australia and New Zealand.
Clinicians performing and/or reporting obstetric ultrasound were invited to answer questions about fetal biometry and Doppler charts in a web-based survey.
At least four population-based charts are in current use. The majority of respondents (78%) report the percentile for known gestational age (GA) alongside measurements and 63% using a cut-off of estimated fetal weight (EFW) < 10 percentile when reporting small for gestational age (SGA) and/or fetal growth restriction (FGR). The thresholds for the use of fetal and maternal Doppler in third trimester ultrasound varied in terms of the GA, EFW cut-off, and how measures were reported. The majority of respondents were not sure of which Doppler charts were used in their practice.
This survey revealed inconsistencies in choice of reference chart and reporting practices. The potential for misdiagnosis of abnormal fetal growth remains a significant issue.
孕晚期超声报告做法不一致,尤其是参考图表的选择,有可能误诊胎儿生长异常。但这可能会在患者和临床医生中引发不必要的焦虑和困惑,并最终影响临床管理。因此,我们试图确定澳大利亚和新西兰胎儿生物测量和多普勒参考图表选择以及报告做法的变异程度。
邀请进行和/或报告产科超声检查的临床医生通过网络调查回答有关胎儿生物测量和多普勒图表的问题。
目前至少使用四种基于人群的图表。大多数受访者(78%)在报告测量值时会报告已知孕周(GA)的百分位数,63%在报告小于孕周(SGA)和/或胎儿生长受限(FGR)时使用估计胎儿体重(EFW)<第10百分位数的临界值。孕晚期超声中使用胎儿和母体多普勒的阈值在孕周、EFW临界值以及测量报告方式方面各不相同。大多数受访者不确定他们在实践中使用的是哪种多普勒图表。
本次调查揭示了参考图表选择和报告做法的不一致。胎儿生长异常的误诊可能性仍然是一个重大问题。