The practice patterns of second trimester fetal ultrasonography: A questionnaire survey and an analysis of checklists
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Objective To analyze practice patterns and checklists of second trimester ultrasonography, and to investigate management plans when soft markers are detected among Korean Society of Ultrasound in Obstetrics and Gynecology (KSUOG) members. Methods An internet-based self-administered questionnaire survey was designed. KSUOG members were invited to the survey. Checklists of the second trimester ultrasonography were also requested. In the questionnaire survey, general practice patterns of the second trimester ultrasonography and management schemes of soft markers were asked. In the checklists analysis, the number of items were counted and also compared with those recommended by other medical societies. Results A total of 101 members responded. Eighty-seven percent routinely recommended second trimester fetal anatomic surveillance. Most (91.1%) performed it between 20+0 and 23+6 weeks of gestation. Written informed consents were given by 15.8% of respondents. Nearly 60% recommended genetic counseling when multiple soft markers and/or advanced maternal age were found. Similar tendencies were found in the managements of individual soft markers. However, practice patterns were very diverse and sometimes conflicting. Forty-eight checklists were analyzed in context with the number and content of the items. The median item number was 46.5 (range, 17 to 109). Of 49 items of checklists recommended by International Society of Ultrasound in Obstetrics and Gynecology and/or American Congress of Obstetricians and Gynecologists, 14 items (28.6%) were found in less than 50% of the checklists analyzed in this study. Conclusion Although general practice patterns were similar among KSUOG members, some of which were conflicting, and there is a need for standardization of the practice patterns and checklists of second trimester ultrasonography, which also have very wide range of spectrum.
Abstract
Objective To analyze practice patterns and checklists of second trimester ultrasonography, and to investigate management plans when soft markers are detected among Korean Society of Ultrasound in Obstetrics and Gynecology (KSUOG) members. Methods An internet-based self-administered questionnaire survey was designed. KSUOG members were invited to the survey. Checklists of the second trimester ultrasonography were also requested. In the questionnaire survey, general practice patterns of the second trimester ultrasonography and management schemes of soft markers were asked. In the checklists analysis, the number of items were counted and also compared with those recommended by other medical societies. Results A total of 101 members responded. Eighty-seven percent routinely recommended second trimester fetal anatomic surveillance. Most (91.1%) performed it between 20+0 and 23+6 weeks of gestation. Written informed consents were given by 15.8% of respondents. Nearly 60% recommended genetic counseling when multiple soft markers and/or advanced maternal age were found. Similar tendencies were found in the managements of individual soft markers. However, practice patterns were very diverse and sometimes conflicting. Forty-eight checklists were analyzed in context with the number and content of the items. The median item number was 46.5 (range, 17 to 109). Of 49 items of checklists recommended by International Society of Ultrasound in Obstetrics and Gynecology and/or American Congress of Obstetricians and Gynecologists, 14 items (28.6%) were found in less than 50% of the checklists analyzed in this study. Conclusion Although general practice patterns were similar among KSUOG members, some of which were conflicting, and there is a need for standardization of the practice patterns and checklists of second trimester ultrasonography, which also have very wide range of spectrum.
참고문헌 (12)
- "ACR-ACOG-AIUM-SRU practice guideline for the performance of obstetrical ultrasound: amended 2014 (resolution 39)" (2014)[URL]
- Salomon LJ., "Practice guidelines for performance of the routine mid-trimester fetal ultrasound scan", Ultrasound Obstet Gynecol, 37, pp.116~126 (2011)
- Bethune M., "Literature review and suggested protocol for managing ultrasound soft markers for Down syndrome : thickened nuchal fold, echogenic bowel, shortened femur, shortened humerus, pyelectasis and absent or hypoplastic nasal bone", Australas Radiol, 51, pp.218~225 (2007)
- Breathnach FM., "The second trimester genetic sonogram", Am J Med Genet C Semin Med Genet, 145C, pp.62~72 (2007)
- Agathokleous M., "Meta-analysis of second-trimester markers for trisomy 21", Ultrasound Obstet Gynecol, 41, pp.247~261 (2013)
- Raniga S., "Ultrasonographic soft markers of aneuploidy in second trimester : are we lost?", MedGenMed, 8, pp.9~ (2006)
- Rebarber A., "An ethnic predilection for fetal echogenic intracardiac focus identified during targeted midtrimester ultrasound examination : a retrospective review", BMC Pregnancy Childbirth, 4, pp.12~ (2004)
- Shipp TD., "The frequency of the detection of fetal echogenic intracardiac foci with respect to maternal race", Ultrasound Obstet Gynecol, 15, pp.460~462 (2000)
- Bronsteen R., "Second-trimester sonography and trisomy 18 : the significance of isolated choroid plexus cysts after an examination that includes the fetal hands", J Ultrasound Med, 23, pp.241~245 (2004)
- Coco C., "Karyotyping of fetuses with isolated choroid plexus cysts is not justified in an unselected population", J Ultrasound Med, 23, pp.899~906 (2004)
- Demasio K., "Isolated choroid plexus cyst in low-risk women less than 35 years old", Am J Obstet Gynecol, 187, pp.1246~1249 (2002)
- 김건우, "The clinical practice patterns of fetal ultrasonography in the first-trimester: A questionnaire survey of members of the Korean Society of Ultrasound in Obstetrics and Gynecology", Obstetrics & Gynecology Science, 57(06), pp.448~456 (2014), 대한산부인과학회[DOI]