Auditing fetal nasal bone images in the first trimester of pregnancy: results from a peer review program.
J Matern Fetal Neonatal Med
; 29(17): 2874-7, 2016 Sep.
Article
em En
| MEDLINE
| ID: mdl-26465391
OBJECTIVE: To establish a structured review process to facilitate the identification of the fetal nasal bone (NB) in the first trimester ultrasound scan to improve the quality images. METHODS: We conducted a retrospective observational study in fetal NB images obtained during ultrasound exams of singleton pregnancies that underwent first trimester screening (crown-rump length 45-84 mm). When the images were obtained the examiner was not aware of the study. Audit was conducted by an examiner according criteria established by the Fetal Medicine Foundation. Fetal NB images were assessed regarding adequate magnification, mid-sagittal view and transducer held parallel to the direction of the nose. The transvaginal and transabdominal as well as anterior and posterior fetal back groups were compared using χ(2) test. RESULTS: We considered 874 fetal NB images for auditing. Fetal NB was considered present in 865 images (99%). During the audit process, we identified 72 (8.2%) cases of disagreement between examiner and auditor assessments. Disagreement was higher when image quality was poor (62 cases = 7%). Transvaginal approach performed better in the following criteria: adequate magnification (p < 0.001), midline (p < 0.001) and completely adequate (p < 0.001). CONCLUSION: A peer reviewed audit program for fetal NB is feasible in a clinical scenario. Image quality appears to play an important role in compliance to image standards audited and in agreement between examiner and auditor.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ultrassonografia Pré-Natal
/
Auditoria Médica
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Osso Nasal
Tipo de estudo:
Diagnostic_studies
/
Guideline
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Observational_studies
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Prognostic_studies
Limite:
Female
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Humans
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Pregnancy
Idioma:
En
Revista:
J Matern Fetal Neonatal Med
Assunto da revista:
OBSTETRICIA
/
PERINATOLOGIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
Reino Unido