A Multicentric Analysis of a Pre-Ecographic Score in Pregnancy: Time for a Dedicated Classification System.

Area of Science:

• Obstetrics and Gynecology
• Medical Imaging
• Prenatal Care

Background:

• Maternal characteristics can affect ultrasound (US) image quality and operator experience.
• Standardized methods are needed to assess US examination difficulty, especially in early gestation.

Purpose of the Study:

• To evaluate how maternal factors influence ultrasound image quality and operator satisfaction.
• To preliminarily assess a rating scale for stratifying ultrasound examination difficulty in early pregnancy.

Main Methods:

• A multicentric observational study involving 445 pregnant women at 11-21 weeks gestation.
• Inclusion criteria: obesity, retroverted uterus, myomas, previous surgery, limited echo-absorption.
• Operator satisfaction (Likert scale) and a pre-echographic limiting score (0-9) were primary outcomes.

Main Results:

• Operator satisfaction was inversely related to the pre-echographic limiting score.
• This relationship held regardless of maternal age, operator, center, or examination duration.
• Maternal conditions significantly influence sonographic examination quality and operator experience.

Conclusions:

• Certain maternal conditions require monitoring for optimal ultrasound performance.
• A validated rating scale could aid in stratifying early gestation ultrasound difficulty.
• Further validation is needed for the proposed difficulty stratification scale.