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Panniculus Retractor Use for Visualization of Fetal Anatomy: A Randomized Controlled Trial.

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|July 25, 2024
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A panniculus retractor device did not improve fetal anatomic examination completion rates in pregnant patients with obesity (BMI 40+). The device was well-tolerated but did not enhance the visualization of key fetal anatomical views.

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Area of Science:

  • Medical Imaging
  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • Obesity in pregnancy (BMI 40 or higher) presents challenges for fetal anatomic examination due to abdominal panniculus.
  • Standard ultrasound techniques may be limited in visualizing all necessary fetal structures in these patients.

Purpose of the Study:

  • To determine if a panniculus retractor device improves the completion rate of fetal anatomic examinations in pregnant patients with high BMI and a panniculus.
  • To assess the safety and tolerability of the device in this population.

Main Methods:

  • A randomized trial involving 150 pregnant patients with BMI 40+ and a panniculus.
  • Participants were randomized to undergo fetal anatomic examination with a panniculus retractor device or usual care.
  • The primary outcome was the completion rate of 16 prespecified fetal views.

Main Results:

  • The completion rate for 16 prespecified views was 25.7% with the retractor versus 31.6% with usual care (RR 0.81, 95% CI, 0.49-1.35).
  • No significant differences were found in secondary outcomes, including overall view completion, examination duration, or anomaly detection.
  • Patient and ultrasonographer satisfaction were similar between the groups.

Conclusions:

  • The use of a panniculus retractor device in pregnant patients with high BMI and a panniculus did not improve the completion rate of key fetal anatomic views.
  • The device was well-tolerated by both patients and ultrasonographers, indicating a favorable safety profile.