Factors affecting ultrasonography during second trimester fetal anatomic scan

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Ultrasonography (USG) has become an important part of antenatal care. It is used for various reasons during pregnancy such as locating the pregnancy, viability, fetal biometry and fetal anatomic evaluation. As technology advances, both patients and physicians are expecting to diagnose more medical conditions in utero. However several factors are still need to be overcome in order to visualize properly during the USG examinations. Both maternal and fetal factors affect the quality of imaging. These include maternal obesity, previous abdominal/pelvic surgeries, subcutaneous injections, multiple pregnancies etc. As there is more negative factors for imaging quality, the quality of imaging decreases; which in turn makes the examination times longer and accuracy of diagnoses lesser. These may also cause some medicolegal problems for the physicians. Furthermore, standardization of reporting imaging quality will be beneficial for USG studies for describing the patient characteristics more clearly. Therefore, there is a need for standardization of imaging quality during reporting. In this study it is aimed to evaluate the effects of various factors in order to standardize the reporting of imaging quality during second trimester fetal anatomic scan. Materials and Methods In this prospective cohort study, patients who were admitted for routine second trimester fetal anatomic evaluation with USG between May 2018 and June 2018 were included. Patients between 19-23 weeks of gestation were included. All dating were confirmed with the first trimester CRL measurements. Patients with fetal anatomic/chromosomal anomalies were excluded from the study. All examinations were done by the same physician using Voluson E6 (GE) with the abdominal curved probe RAB6-D. The examination was done as the standards set by ISUOG. As there was no intervention, ethical committee approval was not required, however all patients gave informed consent that their data for use for scientific purposes. Skin to uterus distance was measured in the midpoint between symphysis- umbilicus distance.

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