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Routine ultrasound scanning for congenital abnormalities

N Wald1, A Kennard

  • 1Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, St. Bartholomew's, London, United Kingdom. n.j.wald@mds.qmw.ac.uk

Annals of the New York Academy of Sciences
|July 21, 1998
PubMed
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Ultrasound screening for fetal abnormalities needs better assessment. A proposed classification system categorizes abnormalities to evaluate the clinical usefulness of screening and its associated costs.

Area of Science:

  • Medical screening
  • Fetal medicine
  • Diagnostic imaging

Background:

  • Screening aims to detect disorders in asymptomatic individuals for early intervention.
  • The clinical utility of screening methods must be rigorously evaluated before widespread adoption.
  • Ultrasound is widely used for fetal abnormality screening but lacks adequate assessment.

Purpose of the Study:

  • To propose a classification system for fetal abnormalities detected via ultrasound.
  • To assess the clinical usefulness of ultrasound screening for fetal abnormalities.
  • To evaluate the medical and financial costs associated with fetal abnormality screening.

Main Methods:

  • Classifying detectable fetal abnormalities into four clinically relevant groups.
  • Estimating screening detection rates and false-positive results for each category.

Related Experiment Videos

  • Analyzing the medical and financial implications of screening, including costs of uncertain findings.

    • Main Results:

    • A four-category system for fetal abnormalities (death inevitable, long-term handicap, intrauterine treatment, postnatal investigation).
    • Highlights the need to estimate detection rates, false positives, and costs for each category.
    • Identifies potential for increased maternal anxiety and unnecessary interventions due to uncertain findings.

    Conclusions:

    • A systematic approach is needed to evaluate the value of ultrasound screening for fetal abnormalities.
    • Classification aids in assessing the clinical utility and cost-effectiveness of screening.
    • Careful consideration of uncertain findings is crucial to minimize unnecessary interventions and patient distress.