Learning curve for fetal postmortem ultrasound

Area of Science:

• Medical Imaging
• Fetal Medicine
• Pathology

Background:

• Postmortem ultrasound (PMUS) is an emerging technique for evaluating fetal demise.
• Understanding the learning curve and diagnostic evolution of PMUS is crucial for its clinical integration.

Purpose of the Study:

• To determine the learning curve of fetal postmortem ultrasound (PMUS).
• To evaluate the evolution of PMUS diagnostic performance over an 8-year period.

Main Methods:

• Prospective, double-blind study involving 100 fetuses (12-38 weeks gestation).
• Two fetal medicine specialists and two experts performed PMUS, analyzing 21 structures.
• Learning curves were computed using cumulative summation analysis; diagnostic accuracy was compared to autopsy data and previous studies.

Main Results:

• Trainees achieved expert level in PMUS within 28-36 cases.
• The non-diagnostic rate for PMUS structures was 6.5%.
• Over 8 years, expert PMUS showed improved diagnostic accuracy, with reduced non-diagnostic rates and higher sensitivity for cardiac and abdominal structures.

Conclusions:

• Fetal postmortem ultrasound (PMUS) demonstrates a rapid learning curve for fetal medicine specialists.
• Continuous improvement in diagnostic accuracy is observed over time with PMUS.
• PMUS is a valuable tool for postmortem fetal evaluation.