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How often do we identify fetal abnormalities during routine third‐trimester ultrasound? A systematic review and meta‐analysis

Drukker, L; Elizabeth, B; Rodriguez, GB; Roberts, NW; Impey, L; Papageorghiou, AT (2021) How often do we identify fetal abnormalities during routine third‐trimester ultrasound? A systematic review and meta‐analysis. BJOG, 128 (2). pp. 259-269. ISSN 1471-0528 https://doi.org/10.1111/1471-0528.16468
SGUL Authors: Papageorghiou, Aris

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Abstract

Background Routine third‐trimester ultrasound is frequently offered to pregnant women to identify fetuses with abnormal growth. Infrequently, a congenital anomaly is incidentally detected. Objective To establish the prevalence and type of fetal anomalies detected during routine third‐trimester scans using a systematic review and meta‐analysis. Search strategy Electronic databases (MEDLINE, Embase and the Cochrane library) from inception until August 2019. Selection criteria Population‐based studies (randomised control trials, prospective and retrospective cohorts) reporting abnormalities detected at the routine third‐trimester ultrasound performed in unselected populations with prior screening. Case reports, case series, case‐control studies and reviews without original data were excluded. Data collection and analysis Prevalence and type of anomalies detected in the third trimester. We calculated pooled prevalence as the number of anomalies per 1000 scans with 95% confidence intervals. Publication bias was assessed. Main results The literature search identified 9594 citations: 13 studies were eligible representing 141 717 women; 643 were diagnosed with an unexpected abnormality. The pooled prevalence of a new abnormality diagnosed was 3.68 per 1000 women scanned (95% CI 2.72–4.78). The largest groups of abnormalities were urogenital (55%), central nervous system abnormalities (18%) and cardiac abnormalities (14%). Conclusion Combining data from 13 studies and over 140 000 women, we show that during routine third‐trimester ultrasound, an incidental fetal anomaly will be found in about 1 in 300 scanned women. This information should be taken into account when taking consent from women for third‐trimester ultrasound and when designing and assessing cost of third‐trimester ultrasound screening programmes.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Drukker, L, Bradburn, E, Rodriguez, GB, Roberts, NW, Impey, L, Papageorghiou, AT. How often do we identify fetal abnormalities during routine third‐trimester ultrasound? A systematic review and meta‐analysis. BJOG: Int J Obstet Gy. 2021; 128: 259– 269., which has been published in final form at https://doi.org/10.1111/1471-0528.16468. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Keywords: anomaly scan, congenital malformation, fetal abnormality, fetal anomaly, incidental finding, pregnancy care, systematic review, third-trimester, 11 Medical and Health Sciences, Obstetrics & Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: BJOG
ISSN: 1471-0528
Language: eng
Dates:
DateEvent
3 January 2021Published
20 September 2020Published Online
6 August 2020Accepted
Publisher License: Publisher's own licence
PubMed ID: 32790134
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112295
Publisher's version: https://doi.org/10.1111/1471-0528.16468

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