Poster Abstracts

Abstract

Objectives: To assess the effectiveness of detection of fetal congenital anomalies by Ultrasound Scan in our Fetal Medicine Unit and if an anomaly was detected if we were appropriately referring patients to pediatric and tertiary care teams. An additional aim of this audit was to determine if we are adequately offering patients the option for invasive testing to confirm anomalous diagnoses as early as possible, thus allowing patients to be educated on the outcomes and risks or benefits of further intervention. With early detection patients are allowed more time to make an informed decision in regards to future planning. Method: A retrospective audit was performed by looking at the total number of patients who had an anomaly on ultrasound scan over a one-year period between 2015-2016 at Wexham Park Hospital. It was established that 57 patients were identified as having an anomaly on ultrasound scan. There were no discriminating factors that prevented women from being included in our audit such as age, parity or ethnicity. Transabdominal ultrasound was the imaging method of choice by which the congenital anomalies were detected. Ultrasound scans were performed by sonographers or physicians and were interpreted by consultant physicians. Results: The majority of congenital anomalies identified were between 20-27 weeks representing 61.4% of patients. Additionally, 26.3% of anomalies were detected between 12-20 weeks, 8.8% of anomalies were detected over 27 weeks and 3.5% of anomalies detected below 12 weeks. Of the 106 anomalies detected among the 57 patients, 28.3% were identified as lethal, and 71.7% were found to be non-lethal. Invasive testing was accepted in 31.6% and declined in 22.8% of cases. Invasive testing was not offered in 45.6% of cases, and referrals for joint antenatal or post-natal care were made in 51.8% and 17.5% of cases respectively. Conclusions: During the period of study the total number of deliveries in our unit was 4500 . Routine ultrasound scans detected 57 of patients (1.26%) with fetuses having congenital anomalies. However 9 patients (.2%) with fetuses having anomalies were missed by USS. Overall, detection rate for identifying anomalies with ultrasound scan remains high at 86% which is comparable to the NICE, UK recommendation for detection of congenital anomalies in fetuses during the routine Antenatal screening. Ultrasound remains the most effective tool for detection of fetal anomalies, which is highly acceptable to the patient and cost effective.