Biostatistical evaluation of the effectiveness of fetal ultrasound diagnostics with application of new uncertainty factor and difficulty factor in cases of craniofacial malformations-gray zone in biostatistics for imaging procedures.

BACKGROUND

The craniofacial malformations occur less frequently, with a prevalence rate of approximately 0.1%. Our aim is to investigate the effectiveness of prenatal ultrasound in the detection of the craniofacial abnormalities.

METHODS

In our study, we have processed the prenatal sonographic and postnatal clinical and fetopathological data of 242 anatomical deviations of 218 fetuses with craniofacial malformations over a 12-year period. The patients were divided into three groups: Group I, Totally Recognized; Group II, Partially Recognized; Group III, Not Recognized. To characterize the diagnostics of disorders we developed the Uncertainty Factor F (U) = P (Partially Recognized)/[P (Partially Recognized) + T (Totally Recognized)] and Difficulty factor F (D) = N (Not Recognized)/[P (Partially Recognized) + T (Totally Recognized)].

RESULTS

Prenatal ultrasound diagnosis of fetuses with facial and neck malformations completely coincided in 71/218 cases (32.6%) with postnatal/fetopathological findings. In 31/218 cases (14.2%) the detection was only partial, while in 116/218 cases no craniofacial malformations were diagnosed prenatally (53.2%). The Difficulty Factor was high or very high in almost each disorder group, with a cumulative score of 1.28. The Uncertainty Factor cumulative score was 0.32.

CONCLUSIONS

The effectiveness of the detection of the facial and neck malformations was low (29.75%). The Uncertainty Factor F (U) and Difficulty Factor F (D) parameters, which characterized the difficulties of the prenatal ultrasound examination well.