Completed Sonographic Anatomic Surveys: The Exception Rather Than the Rule

Area of Science:

• Medical imaging
• Obstetrics and Gynecology
• Fetal medicine

Background:

• Routine prenatal sonographic examinations are crucial for assessing fetal development.
• Standardized reporting of fetal anatomic surveys aims to ensure comprehensive evaluation.

Purpose of the Study:

• To evaluate the completeness rates of fetal organ system imaging during routine sonographic examinations.
• To determine if imaging completeness varies across hospitals with different perinatal designations.

Main Methods:

• Retrospective review of 7211 initial sonographic anatomic examinations (16-24 weeks gestation) from three hospitals (perinatal levels I-III).
• Assessment of visualization rates for 36 anatomic fields, grouped into brain, face, spine, heart, abdomen, and extremities.
• Statistical comparison of completion rates using chi-squared testing.

Main Results:

• Overall completion rate for full anatomic sonograms was low at 16.8%, varying significantly by hospital level (Level I: 20.6%, Level II: 20.0%, Level III: 13.2%).
• Spine (62.4%), face (28.1%-64.4%), and heart (37.3%-56.1%) imaging completeness was notably low, with significant inter-hospital variation.
• Combined heart and spine imaging completion was only 32.0%, with lower rates in Level I and II hospitals.

Conclusions:

• Comprehensive fetal anatomic sonograms have low completion rates, particularly for facial, cardiac, and spinal structures.
• Incomplete studies are common and often require follow-up examinations, increasing healthcare costs.
• Establishing completion benchmarks is essential to improve diagnostic accuracy and reduce healthcare expenditures.