Feasibility of a Standardised Mid-Trimester Ultrasound Protocol: A National Multicenter Study

Area of Science:

• Medical Imaging
• Obstetrics and Gynecology
• Quality Assurance

Background:

• Mid-trimester ultrasound scans are crucial for fetal assessment.
• Standardization of ultrasound protocols can improve diagnostic accuracy and consistency.
• A consensus-based quality assessment (QA) system was developed to evaluate a national protocol.

Purpose of the Study:

• To assess the feasibility of implementing a standardized mid-trimester ultrasound protocol in routine practice.
• To evaluate the quality of ultrasound images obtained using the standardized protocol.
• To analyze the reliability of image assessment between self-evaluation and peer-evaluation.

Main Methods:

• A multicenter prospective observational study ('FLASH' study) involving 440 mid-trimester scans.
• Development of a 73-criterion consensus-based QA scoring system using a 3-round Delphi method with 28 experts.
• Sonographers performed 5 consecutive scans, assessed by themselves and a qualified expert.

Main Results:

• Feasibility of 21 recommended standardized views ranged from 88.5% to 100%.
• 88% of conformity criteria were met in over 90% of cases.
• High reliability (Gwet's AC1 > 0.80) was observed between self- and peer-assessment for 96% of criteria.

Conclusions:

• The national standardized mid-trimester ultrasound protocol is feasible in routine practice.
• The protocol ensures high quality of ultrasound imaging.
• The consensus-based QA scoring system is reliable for evaluating ultrasound image quality.