Repeat Detailed Second Trimester Ultrasound: Hawaii Experience

Abstract This review is about clinical value of repeat second trimester ultrasound performed in a tertiary center in the detection of fetal anomalies. A retrospective record review was performed on all of the second trimester obstetrical ultrasounds (15 to 22 weeks) performed during a four month period. The ultrasound reports were reviewed to determine if repeat studies resulted in a change of diagnoses with respect to fetal anomalies. Ultrasound diagnoses were compared to newborn records to determine the accuracy of ultrasound diagnoses. 1,470 ultrasound examinations were performed on 1,344 patients. The rate of repeat examination was 8.41% after the exclusion of 13 patients with suboptimal views as the indication for the repeat ultrasound. 943 (70.16%) newborn birth records were available for analysis. Fifty six (6%) of the newborns were coded as having an anomaly at birth. 55% of these anomalies were detected by ultrasound, 36% were not detectable by ultrasound, and 9% were not detected by ultrasound. The overall fetal anomaly rate was 3.8%. The overall detection rate was 86.1%. There were no diagnosis changes nor additional anomalies identified after repeat second trimester ultrasound. Objectives Describe the role of comprehensive ultrasound in detection of fetal anomalies Present one highly specialized fetal diagnostic center experience Discuss the value of repeat ultrasound exams in order to increase anomaly detection rate