A. Saarikemppainen et al., FETAL ANOMALIES IN A CONTROLLED ONE-STAGE ULTRASOUND SCREENING TRIAL - A REPORT FROM THE HELSINKI ULTRASOUND TRIAL, Journal of perinatal medicine, 22(4), 1994, pp. 279-289
The aim of the study was to compare whether systematic strictly timed
screening of all pregnancies would improve the detection of major feta
l anomalies. All pregnant women (95%) from a certain area were randoml
y allocated for one ultrasound screening examination between the 16th
and 20th weeks of gestation. Otherwise the screening (N = 4691) and co
ntrol groups (N = 4619) received the same antenatal care. Screening in
cluded a systematic search for fetal anomalies. In the screening group
, 40% of major fetal anomalies were detected in the screening, and 11
abortions were induced because the malformation was either lethal or s
everely handicapping. In the control group, 77.0% of participants had
ultrasound examination any time during pregnancy. By ultrasound 13 (27
%) major fetal anomalies were detected, only two of these before the 2
1st week of gestation. Screening detected most of the anomalies of the
central nervous system and genitourinary system and cases with multip
le anomalies, but was less satisfactory in detecting the anomalies of
the heart and gastrointestinal tract. The perinatal mortality rate was
4.2 per 1000 in the screening group and 8.4 per 1000 in the control g
roup (p = 0.013). The detection of major fetal anomalies in ultrasound
screening can reduce perinatal mortality. A systematic search for fet
al anomalies should be included in the ultrasound screening of all pre
gnancies.