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The practice patterns of second trimester fetal ultrasonography: A questionnaire survey and an analysis of checklists.

Park HS, Seong WJ, Hong JS, Seol HJ, Hwang HS, Kim K, Ko HS, Kwak DW, Oh SY, Kim MY, Kim SJ, Korean Society of Ultrasound in Obstetrics and Gynecology Research Gro - Obstet Gynecol Sci (2015)

Bottom Line: In the checklists analysis, the number of items were counted and also compared with those recommended by other medical societies.The median item number was 46.5 (range, 17 to 109).Of 49 items of checklists recommended by International Society of Ultrasound in Obstetrics and Gynecology and/or American Congress of Obstetricians and Gynecologists, 14 items (28.6%) were found in less than 50% of the checklists analyzed in this study.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Graduate School of Medicine, Dongguk University, Seoul, Korea.

ABSTRACT

Objective: To analyze practice patterns and checklists of second trimester ultrasonography, and to investigate management plans when soft markers are detected among Korean Society of Ultrasound in Obstetrics and Gynecology (KSUOG) members.

Methods: An internet-based self-administered questionnaire survey was designed. KSUOG members were invited to the survey. Checklists of the second trimester ultrasonography were also requested. In the questionnaire survey, general practice patterns of the second trimester ultrasonography and management schemes of soft markers were asked. In the checklists analysis, the number of items were counted and also compared with those recommended by other medical societies.

Results: A total of 101 members responded. Eighty-seven percent routinely recommended second trimester fetal anatomic surveillance. Most (91.1%) performed it between 20+0 and 23+6 weeks of gestation. Written informed consents were given by 15.8% of respondents. Nearly 60% recommended genetic counseling when multiple soft markers and/or advanced maternal age were found. Similar tendencies were found in the managements of individual soft markers. However, practice patterns were very diverse and sometimes conflicting. Forty-eight checklists were analyzed in context with the number and content of the items. The median item number was 46.5 (range, 17 to 109). Of 49 items of checklists recommended by International Society of Ultrasound in Obstetrics and Gynecology and/or American Congress of Obstetricians and Gynecologists, 14 items (28.6%) were found in less than 50% of the checklists analyzed in this study.

Conclusion: Although general practice patterns were similar among KSUOG members, some of which were conflicting, and there is a need for standardization of the practice patterns and checklists of second trimester ultrasonography, which also have very wide range of spectrum.

No MeSH data available.


Related in: MedlinePlus

The most important soft markers that lead the clinicians to offer invasive test for karyotyping. Each respondent chose three in the list.
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Figure 1: The most important soft markers that lead the clinicians to offer invasive test for karyotyping. Each respondent chose three in the list.

Mentions: Table 1 shows general practice patterns of respondents when soft markers are found during second trimester ultrasonography. Nearly 60% offered invasive test when multiple soft markers were found and/or advanced maternal age was combined. Similar practice patterns were found in the analysis of the individual soft markers (Table 2). However, when such isolated soft markers as increased nuchal skinfold thickness, and mild ventriculomegaly were found, more than 20% of respondents recommended invasive test for chromosomal analysis. We found a wide, even, conflicting variations in counseling pattern among clinicians over same soft markers. For example, when intracardiac echogenic focus was found, amniocentesis was offered in about 51.5% (to offer invasive test with isolated finding + to offer invasive test if advanced maternal age present + to offer invasive test if accompanied by other soft markers) (Table 2). At the same time, however, in about 37.6% (not documented + none irrespective of any other soft marker accompanied), amniocentesis was not offered, or the finding was ignored. In cases of pyelectasia, megacisterna magna, short femur, and choroid plexus cyst, both conflicting recommendations accounted more than 20% each. As for the definition of the short femur, discrepancy of more than three weeks of gestational references was most frequently accepted. The preferences varied depending on the clinical settings (Table 3). Finally, participants were asked to select three most important things that lead to genetic counseling. These were increased nuchal skinfold thickness, advanced maternal age and mild ventriculomegaly (Fig. 1).


The practice patterns of second trimester fetal ultrasonography: A questionnaire survey and an analysis of checklists.

Park HS, Seong WJ, Hong JS, Seol HJ, Hwang HS, Kim K, Ko HS, Kwak DW, Oh SY, Kim MY, Kim SJ, Korean Society of Ultrasound in Obstetrics and Gynecology Research Gro - Obstet Gynecol Sci (2015)

The most important soft markers that lead the clinicians to offer invasive test for karyotyping. Each respondent chose three in the list.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663221&req=5

Figure 1: The most important soft markers that lead the clinicians to offer invasive test for karyotyping. Each respondent chose three in the list.
Mentions: Table 1 shows general practice patterns of respondents when soft markers are found during second trimester ultrasonography. Nearly 60% offered invasive test when multiple soft markers were found and/or advanced maternal age was combined. Similar practice patterns were found in the analysis of the individual soft markers (Table 2). However, when such isolated soft markers as increased nuchal skinfold thickness, and mild ventriculomegaly were found, more than 20% of respondents recommended invasive test for chromosomal analysis. We found a wide, even, conflicting variations in counseling pattern among clinicians over same soft markers. For example, when intracardiac echogenic focus was found, amniocentesis was offered in about 51.5% (to offer invasive test with isolated finding + to offer invasive test if advanced maternal age present + to offer invasive test if accompanied by other soft markers) (Table 2). At the same time, however, in about 37.6% (not documented + none irrespective of any other soft marker accompanied), amniocentesis was not offered, or the finding was ignored. In cases of pyelectasia, megacisterna magna, short femur, and choroid plexus cyst, both conflicting recommendations accounted more than 20% each. As for the definition of the short femur, discrepancy of more than three weeks of gestational references was most frequently accepted. The preferences varied depending on the clinical settings (Table 3). Finally, participants were asked to select three most important things that lead to genetic counseling. These were increased nuchal skinfold thickness, advanced maternal age and mild ventriculomegaly (Fig. 1).

Bottom Line: In the checklists analysis, the number of items were counted and also compared with those recommended by other medical societies.The median item number was 46.5 (range, 17 to 109).Of 49 items of checklists recommended by International Society of Ultrasound in Obstetrics and Gynecology and/or American Congress of Obstetricians and Gynecologists, 14 items (28.6%) were found in less than 50% of the checklists analyzed in this study.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Graduate School of Medicine, Dongguk University, Seoul, Korea.

ABSTRACT

Objective: To analyze practice patterns and checklists of second trimester ultrasonography, and to investigate management plans when soft markers are detected among Korean Society of Ultrasound in Obstetrics and Gynecology (KSUOG) members.

Methods: An internet-based self-administered questionnaire survey was designed. KSUOG members were invited to the survey. Checklists of the second trimester ultrasonography were also requested. In the questionnaire survey, general practice patterns of the second trimester ultrasonography and management schemes of soft markers were asked. In the checklists analysis, the number of items were counted and also compared with those recommended by other medical societies.

Results: A total of 101 members responded. Eighty-seven percent routinely recommended second trimester fetal anatomic surveillance. Most (91.1%) performed it between 20+0 and 23+6 weeks of gestation. Written informed consents were given by 15.8% of respondents. Nearly 60% recommended genetic counseling when multiple soft markers and/or advanced maternal age were found. Similar tendencies were found in the managements of individual soft markers. However, practice patterns were very diverse and sometimes conflicting. Forty-eight checklists were analyzed in context with the number and content of the items. The median item number was 46.5 (range, 17 to 109). Of 49 items of checklists recommended by International Society of Ultrasound in Obstetrics and Gynecology and/or American Congress of Obstetricians and Gynecologists, 14 items (28.6%) were found in less than 50% of the checklists analyzed in this study.

Conclusion: Although general practice patterns were similar among KSUOG members, some of which were conflicting, and there is a need for standardization of the practice patterns and checklists of second trimester ultrasonography, which also have very wide range of spectrum.

No MeSH data available.


Related in: MedlinePlus