Quality standards and litigation in prenatal diagnosis routine ultrasound:Pitfalls - What may be missed?

Background: As with all new diagnostic options in medicine, great hope was placed in the introduction of high-resolution prenatal sonography. Progress tends to carry with it a demanding attitude of higher expectations. Patien ts and doctors alike may initially overestimate the possibilities of medica l advances. Questions: The question at hand is whether objective criteria can validate a positive influence of prenatal ultrasound on fetal outcome, How should a sonographic routine screening be structured, and what legal aspects need to be taken into consideration? Material and methods: This is an attempt to survey the heterogeneous pool o f internationally published data with regard to these critical questions. O nly a rationally devised analysis of possibilities and restrictions of rout ine prenatal sonography can answer the question of "what - if anything - ma y be missed?" Results and conclusions: Screening ultrasound matches sonography on indicat ion. Despite controversial data a discussion of different studies leads to a positive conclusion on the benefits of ultrasound monitoring in pregnant women. Ultrasound-screening has an explicit effect on medical and economic issues as well as on litigation.