83
THE PROBLEM OF DIAGNOSING MALFORMATIONS DURING ROUTINE ULTRASONIC EXAMINATION
Mecke, H., D. Veisner
The influence of ultrasound examinations in prenatal dia- gnostic becomes more important because of an increasing resolution of fetal details due to improvements of the technique and introduction of grey scale. The possibili- ties of early dlagnosis
of fetal malformations by rou- tine u l t r a s o u n d will he demonstrated. The ultrasound examinations had been performed for examination of the size and position of the fetus äs well äs for placenta localisation. Of interest was the relationship of ob- served fetal abnormalities after birth, to those prena- tally diagnosed by ultrasound, in the Department of Gy- naecology and OJbstetrics in Kiel. In 1978 and 1979
5.161 children have been delivered in our Department. 66 children, corresponding to 1.3 %, showed abnormalities of various severity. In 44 of these cases an ultrasound examination had been performed in our Department during pregnancy. In 14 of these, roalforraations could be diagno-
sed by ultrasound. In the routine ultrasound laboratory of the Department we found 6 ajbnorraali ties.
Jn cases of malfor-
Deformities diagnosed betöre birth by ultrasound at the Department of Obnetrics and Gynecology in Kiel in 1978 / 79
hydrocephalus
anencephalus withdefect diaphragma and enterothorax omphalooele with spina bif ida ap coccygeal teratoma
of unclear etiology
Ultrasound examination gestational week
21.resp. 37.
28.
«rta 32.
22.
31
n
2
1 1 1
1 total
Deformities that can be diagnosed betöre birth by ultrasound that have not been detected
Potter's syndrome
tumors or cysts up to 6 6cm in neck, head, Iower abdomen hydrocephalus with defect
gastroschisis with intestmal eventration
Ultrasound examinations gestational week
32.· 35.
32. - 35.
31.
24.- 34.
n
3
3
1
1
roations fetus com- bined with preterm labor, we did not stop delivery. Preg- nancies with early diagnosis of fetal abnormalities vere interrupted.
The only partial detection of fetal malformations by routinely performed ultrasound examina- tions should be of some concern.
Methodically, only an optimal technical equipment, an expe- rienced investigator and a systematic con- trol of all the or- gans can lead to im- provement in the dia-
gnosis of fetal mal- formations.
total
Department of Gynecology and Obstetrks, Unhrersity of Kiel , 1978/79
0300-5577/82/0102-0030 $ 2.00
Copyright by Walter de Gruyter & Co.
84
Beside an extensive improvement of the technical eguip- roen'vt and a more intensive training of the itivestigators, ve consequently perform äs a routine ulträsound exami- nation a systematic control of all organs äs well äs shape of the fetus. The aim is to achieve a higher dia- gnostic rate in the ulträsound examinations, with re^
spect to severe malformations. However, it should not be assumed that for every individuäl an early detec-*
tion of fetal abnormalities would be possible? With re*
spect to these findings, it remains questionable whether such an extensive diagnosis can routinely be carried o u t , äs has already been suggested by Campbell and Hansmann.
References
Prenatal Diagnosis, Campbell/ S., in: Proceedings of the 3rd European Conference on Prenatal Diagnosis of Genetic Disorders, Murken (Ed), Enke Stuttgart 1979 The antenatal Detection of Fetal Abnormalities by Ultra-
sound Diagnosis, Campbell/ S., Excerpta Medica Am- sterdam 1974, Birth Defects, Aida, T., Mötulsky, Lenz
(Eds)
Ultraschallscreening in der Schwangerschaft - Vorsicht vor übertriebenen Forderungen. Hansmann, M., Geburtsh*
u.Frauenheilk. 41 (1981), 725-725
Diagnosis and Assessment of Fetal Malformations and normalities by Ultrasound, Kurjak, A. et a l . , J.Peri- nat.Med. 8 (198O), 219-233
Grey Scale Ulträsound in Obstetric Diagnosis, Kurjak, A., Breyer, B., Gynec .Obstet .Invest. 1O (1979), 53-7O
Address corresponding to: Dr. H. Hecke
Universi tats-Frauenklinik He gewi sehst r. 4
D-23OO Kiel l / W.-*Germany
