THE VALUE OF SONOGRAPHIC DIAGNOSIS OF FETAL MALFORMATIONS - DIFFERENTRESULTS BETWEEN INDICATION-BASED AND SCREENING-BASED INVESTIGATIONS

The advantages of a routine screening or indication-based ultrasound i nvestigation during pregnancy are still under debate. This is the firs t study where both methods are compared in two different time periods. More malformations were diagnosed before the 24th week of gestation b y means of screening-based than indication-based investigation (18 per cent vs. 5 per cent, P<0.005), and before 28 weeks in 26 per cent com pared with 15 per cent respectively (P<0.01). Twenty-six per cent of a ll malformations were detected by means of screening-based investigati ons as opposed to 15 per cent by means of indication-based scans. Prim ary fetal malformations were also diagnosed much earlier (25 weeks vs. 30 weeks). Except for the fetal head, the detection rate of malformat ions was higher in nearly all other body regions of the fetus in the s creening-based investigation. The most important advantage of a screen ing-based ultrasound investigation during pregnancy is to detect the m alformations early enough in pregnancy for possible intrauterine treat ment or to offer safe termination of pregnancy for the woman, at least for those anomalies that are lethal or significantly handicapping.