Bernaschek G, Stuempflen I, Deutinger J
Department of Prenatal Diagnosis and Therapy, University of Vienna, Austria.
Prenat Diagn. 1996 Sep;16(9):807-11. doi: 10.1002/(SICI)1097-0223(199609)16:9<807::AID-PD949>3.0.CO;2-8.
The quality of prenatal ultrasound may be influenced by different factors. In this study, the influence of the experience of the investigator on the quality of routine ultrasound screening during pregnancy was evaluated. We related the detection rate of fetal malformations in routine ultrasound screening in the region of Vienna to the experience level of the examiner. All 323 cases of fetal malformations registered by the obstetrical departments of Vienna or registered by the Vienna perinatal mortality statistics of 1990 and 1991 were evaluated. For analysis we used the medical charts or the patient-held antenatal records ("Mutter-Kind-Pass'). Obstetricians in private offices (level I) detected 22 per cent, the examiner in the hospital (level I-II) 40 per cent, and the examiner in the centre for prenatal diagnosis and therapy (level III) 90 per cent of all fetal malformations. The detection rate before the 24th week of gestation was significantly different (25 per cent vs. 34 per cent vs. 58 per cent). Our results suggest that an important factor for the quality of prenatal ultrasound investigation is the education of the sonographers. Furthermore, each pregnant woman should undergo ultrasound screening once in a level II or III centre before 24 weeks or before fetal viability.
产前超声的质量可能受到不同因素的影响。在本研究中，评估了检查人员的经验对孕期常规超声筛查质量的影响。我们将维也纳地区常规超声筛查中胎儿畸形的检出率与检查人员的经验水平相关联。对维也纳产科部门登记的或1990年和1991年维也纳围产期死亡率统计中登记的所有323例胎儿畸形病例进行了评估。为了进行分析，我们使用了病历或患者持有的产前记录（“母婴手册”）。私人诊所的产科医生（I级）检出了所有胎儿畸形的22%，医院的检查人员（I-II级）检出了40%，产前诊断与治疗中心的检查人员（III级）检出了90%。妊娠24周前的检出率有显著差异（25%对34%对58%）。我们的结果表明，超声检查人员的培训是产前超声检查质量的一个重要因素。此外，每位孕妇应在妊娠24周前或胎儿具有存活性之前，在II级或III级中心接受一次超声筛查。
