VP45.12: A cross‐sectional evaluation of fetal ultrasound utilisation and acuity during the COVID‐19 pandemic

Abstract

To evaluate the impact of the COVID-19 pandemic on fetal assessment utilisation and acuity of cases seen. This is a cross-sectional study comparing temporal trends in fetal assessment unit volumes and acuity at a single, tertiary-care centre. All fetal assessment scans performed during the first ‘wave’ of the pandemic (March to May 2020) were compared to scans from the same time last year (March to May 2019). Clinic lists and stored ultrasound reports were reviewed to collate maternal demographics and medical history, referral patterns, number of scans, ultrasound findings, and level of acuity, in order to compare outcomes between time periods. There were 5811 scans performed during the study period, and an overall reduction in the number of fetal assessment scans performed during the first wave of the COVID pandemic compared to last year. The most dramatic decline was seen in the number of scans performed for first-trimester complications (0.9% vs 0.2%; p < 0.001) and genetic ultrasounds including amniocentesis (2.5% vs 1.7%; p < 0.05). Interestingly, there was in increase in the relative proportion of nuchal translucency scans performed between the 2 periods (10.8% vs 13.7%; p < 0.001). The causes of these changes in volumes and acuity were attributable to changes in referral practices (including modified prenatal visit schedules), changes to timing of follow-up scans, and patient preferences. There was also a significant increase in the acuity of cases seen during the pandemic, with several referrals requiring emergency delivery or urgent hospital admission due to fetal and/or maternal complications (p < 0.05). There was a decrease in fetal assessment utilisation during the first wave of the pandemic combined with an overall increase in the level of acuity of cases seen, which appears multi-factorial in nature. An enhanced awareness of changes in fetal ultrasound volumes and the relationship with adverse outcomes will be essential in planning obstetrical care for the next wave of the pandemic.