Abstract
To validate ultrasound diagnoses of fetal anomalies made in a Fetal Medicine Center in Pernambuco. A cross sectional study was performed to validate the diagnosis test, including all high risk pregnant women submitted to obstetrical morphological ultrasound at the 'Instituto de Medicina Integral Professor Fernando Figueira (I.M.I.P.)', from March 2002 to March 2006. Prenatal diagnosis was confirmed after birth. Socio demographic characteristics and pre and postnatal frequencies of fetal anomalies were the variables studied. Agreement between pre and postnatal diagnoses from congenital anomalies were evaluated with the Kappa indicator. Youden's test was applied to validate prenatal ultrasound diagnoses. Nine hundred and eighty nine patients were eligible. After evaluation of inclusion and exclusion criteria 457 patients were included in study. The average maternal age was 24.8 + 6.5 years. Fetal anomaly diagnoses postnatal were confirmed in 257 (56.2%) pregnant women. Prenatal ultrasound diagnosis of fetal anomalies disclosed 96% of sensibility and 79% of specificity, good agreement (K=0.76) between pre and postnatal diagnoses when compared to postnatal results and good diagnostic validity (Y=0.75). Prenatal diagnoses of fetal anomalies at a Fetal Medicine center in Pernambuco demonstrate good sensibility, specificity, agreement pre and postnatal and good diagnostic validity.
Highlights
The progress that has been made in the field of ultrasonography has contributed to an increase in the detection of fetuses with structural anomalies both among low-risk[1] and high-risk populations.[2,3,4] The great potential of ultrasonography for screening for morphological abnormalities throughout all trimesters of the pregnancy[1] has meant that its use with obstetric patients is becoming a routine part of prenatal care.[5]Recent hospital-based research, covering a short time period, reported a 2.6% prevalence of congenital anomalies among the study population.[4]
The accuracy of ultrasound for the diagnosis of congenital malformations has been the subject of many studies, it has been fo und that low sensitivity in combination with low rates of falsepositives was associated with tracking low-risk pregnancies, leading to the belief that ultrasonography is most applicable to pregnancies involving fetal abnormalities and/or high levels of risk.[4]
The sample size calculation was performed using the STATCALC function in Epi-Info 2007, version 3.4.1, with a predicted frequency of congenital malformations, among highrisk gestations diagnosed during the prenatal period, of 27%11 and a relative accuracy of 20%
Summary
Recent hospital-based research, covering a short time period, reported a 2.6% prevalence of congenital anomalies among the study population.[4] the accuracy of ultrasound for the diagnosis of congenital malformations has been the subject of many studies, it has been fo und that low sensitivity in combination with low rates of falsepositives was associated with tracking low-risk pregnancies, leading to the belief that ultrasonography is most applicable to pregnancies involving fetal abnormalities and/or high levels of risk.[4]. The majority of studies located were carried out with patients in hospital and reported high rates of detection and an elevated incidence of major malformations.[6,7,8] a population study carried out over a long period found a low level of sensitivity (28.4%), detection of certain structural anomalies was relatively good.[4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
