Version 1
: Received: 23 October 2024 / Approved: 24 October 2024 / Online: 25 October 2024 (07:48:46 CEST)
How to cite:
Combs, C. A.; Lee, R. C.; Lee, S. Y.; Amara, S.; Ashimi Balogun, O. Quantitative Approach to Quality Review of Prenatal Ultrasound Examinations: Estimated Fetal Weight and Fetal Sex. Preprints2024, 2024101973. https://doi.org/10.20944/preprints202410.1973.v1
Combs, C. A.; Lee, R. C.; Lee, S. Y.; Amara, S.; Ashimi Balogun, O. Quantitative Approach to Quality Review of Prenatal Ultrasound Examinations: Estimated Fetal Weight and Fetal Sex. Preprints 2024, 2024101973. https://doi.org/10.20944/preprints202410.1973.v1
Combs, C. A.; Lee, R. C.; Lee, S. Y.; Amara, S.; Ashimi Balogun, O. Quantitative Approach to Quality Review of Prenatal Ultrasound Examinations: Estimated Fetal Weight and Fetal Sex. Preprints2024, 2024101973. https://doi.org/10.20944/preprints202410.1973.v1
APA Style
Combs, C. A., Lee, R. C., Lee, S. Y., Amara, S., & Ashimi Balogun, O. (2024). Quantitative Approach to Quality Review of Prenatal Ultrasound Examinations: Estimated Fetal Weight and Fetal Sex. Preprints. https://doi.org/10.20944/preprints202410.1973.v1
Chicago/Turabian Style
Combs, C. A., Sushma Amara and Olaide Ashimi Balogun. 2024 "Quantitative Approach to Quality Review of Prenatal Ultrasound Examinations: Estimated Fetal Weight and Fetal Sex" Preprints. https://doi.org/10.20944/preprints202410.1973.v1
Abstract
Background/Objectives: Systematic quality review of ultrasound exams is recommended to assure accurate diagnosis. Our primary objectives were to develop a quantitative method for quality review of estimated fetal weight (EFW) and to assess accuracy of EFW for an entire practice and for individual personnel. A secondary objective was to evaluate accuracy of fetal sex determination. Methods: This is a retrospective cohort study. Eligible ultrasound exams included singleton pregnancies with live birth and known birth weight (BW). A published method was used to predict BW from EFW for exams with ultrasound-to-delivery intervals up to 12 weeks. Mean error and median absolute error (AE) were compared between different personnel. Image audits were performed for exams with AE>30% and exams with reported fetal sex different than newborn sex. Results: We analyzed 1,938 exams from 890 patients. In the last exam before birth, median AE was 5.9% and predicted BW was within ±20% of actual BW in 97.2% of patients. AE was >30% in 28 exams (1.4%); image audit found correct caliper placement in all 28. Only 2 patients (0.2%) had AE>30% on the last exam before birth. One sonographer systematically over-measured head and abdominal circumferences, leading to EFWs that were overestimated. Reported fetal sex differed from newborn sex in 7 exams (0.4%), 5 patients (0.6%). Images in 4 of these patients were annotated with correct fetal sex but a clerical error was made in the report. In 1 patient, the unclear image was labeled “probably female” but the newborn was male. Conclusions: Accuracy of EFW in this practice was similar to literature reports. Quantitative analysis identified a sonographer with outlier measurements. Time-consuming image audits could be focused on a small number of exams with large errors. We suggest some enhancements to ultrasound reporting software that may help to reduce clerical errors. We provide tools to help other practices perform similar quality reviews.
Keywords
diagnostic error; fetal biometry; fetal growth restriction; large for gestational age; small for gestational age
Subject
Medicine and Pharmacology, Obstetrics and Gynaecology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
