Y. Vial et al., Screening for foetal malformations: performance of routine ultrasonographyin the population of the Swiss Canton of Vaud, SWISS MED W, 131(33-34), 2001, pp. 490-494
Objective: To determine the sensitivity of ultrasonography in screening for
foetal malformations in the pregnant women of the Swiss Canton of Vaud.
Study design: Retrospective study over a period of five years.
Method: We focused our study on 512 major or minor clinically relevant malf
ormations detectable by ultrasonography. We analysed the global sensitivity
of the screening and compared the performance of the tertiary centre with
that of practitioners working in private practice or regional hospitals.
Results: Among the 512 malformations, 181 (35%) involved the renal and urin
ary tract system, 137 (27%) the heart, 71 (14%) the central nervous system,
50 (10%) the digestive system, 42 (8%) the face and 31 (6%) the limbs. Glo
bal sensitivity was 54.5%. The lowest detection rate was observed for cardi
ac anomalies, with only 23% correct diagnoses. The tertiary centre achieved
a 75% detection rate in its outpatient clinic and 83% in referred patients
. Outside the referral centre, the diagnostic rate attained 47%.
Conclusions: Routine foetal examination by ultrasonography in a low-risk po
pulation can detect foetal structural abnormalities. Apart from the diagnos
is of cardiac abnormalities, the results in the Canton of Vaud are satisfac
tory and justify routine screening for malformations in a low-risk populati
on. A prerequisite is continuing improvement in the skills of ultrasonograp
hers through medical education.