THE INFLUENCE OF THE EXPERIENCE OF THE INVESTIGATOR ON THE RATE OF SONOGRAPHIC DIAGNOSIS OF FETAL MALFORMATIONS IN VIENNA

The quality of prenatal ultrasound may be influenced by different fact ors. In this study, the influence of the experience of the investigato r on the quality of routine ultrasound screening during pregnancy was evaluated. We related the detection rate of fetal malformations in rou tine ultrasound screening in the region of Vienna to the experience le vel of the examiner. All 323 cases of fetal malformations registered b y the obstetrical departments of Vienna or registered by the Vienna pe rinatal mortality statistics of 1990 and 1991 were evaluated. For anal ysis we used the medical charts or the patient-held antenatal records ('Mutter-Kind-Pass'). Obstetricians in private offices (level I) detec ted 22 per cent, the examiner in the hospital (level I-II) 40 per cent , and the examiner in the centre for prenatal diagnosis and therapy (l evel III) 90 per cent of all fetal malformations, The detection rate b efore the 24th week of gestation was significantly different (25 per c ent vs. 34 per cent vs. 58 per cent). Our results suggest that an impo rtant factor for the quality of prenatal ultrasound investigation is t he education of the sonographers. Furthermore, each pregnant woman sho uld undergo ultrasound screening once in a level II or III centre befo re 24 weeks or before fetal viability.