The performance of routine ultrasonographic screening of pregnancies in the Eurofetus Study

OBJECTIVES: The purpose of the Eurofetus Study was to evaluate the accuracy of the antenatal detection of malformations by routine ultrasonographic ex amination in unselected populations. STUDY DESIGN: All ultrasonographic diagnoses of malformations and the outco mes of the fetuses were prospectively recorded in 61 European obstetric uni ts over a 3-year period (1990-1993). Also recorded were ail cases of malfor mation diagnosed after abortion or birth for the mothers who underwent foll ow-up in these centers. RESULTS: Of 3685 malformed fetuses, 2262 had received diagnoses during preg nancy (sensitivity, 61.4%). Of a total number of 4615 malformations, 2593 w ere detected (sensitivity, 56.2%). The detection sensitivity was higher far the major than for the minor abnormalities (73.7% vs 45.7%), and the diagn osis was made earlier in the pregnancy (24.2 weeks vs 27.6, P < .01). Overa ll, 55% of the major abnormalities were detected within 24 gestational week s. Within each severity group the accuracy of detection depended on the sys tem. For the major abnormalities it was better for the central nervous syst em (88.3%) and urinary tract (84.8%) but lower for the heart and great vess els (38.8%), Detection of minor abnormalities was also effective for the ur inary tract (89.1%) but not for the heart and great vessels (20.8%) or the musculoskeletal system (18%). Detection of abnormalities had an influence o n the rate of termination of pregnancy. The rate of live births for the mot hers bearing fetuses with major abnormalities was lower than that for the m others in whom no abnormalities were detected, mainly because of the higher rate of elective terminations of pregnancy in the former group. CONCLUSION: Systematic ultrasonographic screening during pregnancy can now detect a large proportion of fetal malformations, although same still escap e detection.