ULTRASOUND Messages for April, 2005: Fw: Fw:

Fw: Fw:
From: Prof. Yaron Zalel (zalel_y@netvision.net.il)
Fri Apr 22 03:31:16 2005

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>----- Original Message -----
From: Prof. Yaron Zalel To: ultrasound@obgyn.net ; Multiple recipients of list ULTRASOUND Cc: novakov@EUnet.yu Sent: Friday, April 22, 2005 10:04 AM Subject: Re: Fw:
Dear Alexandra!
I'm attaching to you some slides (part of a presentation called "Diagnostic accuracy of fetal anomalies") in which you'll be able to find first of all the accuracy of detecting fetal anomalies as a whole and of skeletal malformations in particular.
You have to remember some facts!
First of all it depends whether the examination was targeted or screening, low rish or high risk!. Secondly, it depends on the local regulations.
In low risk populations, the sensitivity of ultrasound ranges between 14-85%, with specificity of 93-99%. This suggests, that in low risk patients, ultrasound may be helpful at ruling out anomalies, but it is not particularly reliable in terms of detection. In high-risk patients, targeted ultrasound is more accurate in anomaly detection, with sensitivities of 27-99% and specificities that range between 91-100%.
.Faber (2001) - accuracy of 56% with 11% false positive and 28% false negative. .Magriples (1998) - The sensitivity, specificity, and negative and positive predictive values of the screening ultrasonography were 71.4%, 99.4%, 99.1%, and 80%, respectively. .Ogunyemi (2000)- Prenatal diagnosis was possible in 62%and in 5.5% late prenatal diagnosis was possible.
Accuracy of detection of cong. Anomalies Goncalves, Jeanty, Piper
26 (all), 16 (club feet) Musculo-skeletal
The AIUM/ACR antepartum obstetrical sonographic guidelines: Expectations for detection of anomalies R. Filly, R. FilG Filly, Goldstein & Callen oldstein, P. Callen
Observable in the majority of cases
.Anencephaly (100%), Hydranencephaly (100%), Hydrocephalus (97%), Alobar holoprocencephaly (95%), Large posterior fossa cyst (85%), open SB (88%). .Severe (>20 mm) unilateral & bilateral (98%) hydronephrosis, Bilateral renal agenesis (93%). .Large amount of ascites (100%), Omphalocele (100%), gastroschisis (95%), Limb-body wall complex (88%), prox small bowel obstruction with hydramnios (95%), Diaph. Hernia (88%). .Ectopia cordis (58%), HLH (74%), HRH (66%). .Hydrothorax & mediastinal shift (95%). .OI (88%), achondroplasia (81%), amputation (55%).
SKELETAL DYSPLASIAS
.Parilla (2003) - Diagnostic accuracy of 65%. There were 2 false-positive - both had mild long-bone shortening (3-4 weeks discrepancy at 30 weeks' gestation).
Holder-Espinasse et al (2004) - Limb abnormalities: .107 cases - Limb anomalies were detected in 45% of cases. .Can be isolated, syndromic or associated with multiple malformations. ."These limb malformations are Developmental anomalies!"
Hope this will help
Prof. Yaron Zalel

> ----- Original Message -----
From: Aleksandra Novakov Mikic To: Multiple recipients of list ULTRASOUND Sent: Thursday, April 21, 2005 11:52 PM Subject: Fw:

> ----- Original Message -----
From: Aleksandra Novakov Mikic To: ultrasound@dns.obgyn.net Sent: Thursday, April 21, 2005 11:49 PM
Dear friends, a colleague of mine has missed a shorter leg with a rudiment of a foot and the family is now going to court. Is anybody aware of a paper(s) where the issue of false positives and false negatives of ultrasound diagnosis is discussed and any kind of data base where one can see what is the detection rate of skeletal dysplasias of all kinds. Thanks a lot...Friend in need is a friend indeed, let us remember... ALeksandra
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>
----- Original Message -----
From: Prof. Yaron Zalel

To: ultrasound@obgyn.net ; Multiple recipients of list ULTRASOUND

Cc: novakov@EUnet.yu

Sent: Friday, April 22, 2005 10:04 AM

Subject: Re: Fw:

Dear Alexandra!

I'm attaching to you some slides (part of a presentation called "Diagnostic accuracy of fetal anomalies") in which you'll be able to find first of all the accuracy of detecting fetal anomalies as a whole and of skeletal malformations in particular.

You have to remember some facts!

First of all it depends whether the examination was targeted or screening, low rish or high risk!.

Secondly, it depends on the local regulations.

In low risk populations, the sensitivity of ultrasound ranges between 14-85%, with specificity of 93-99%.

This suggests, that in low risk patients, ultrasound may be helpful at ruling out anomalies, but it is not particularly

reliable in terms of detection.

In high-risk patients, targeted ultrasound is more accurate in anomaly detection, with sensitivities of 27-99% and specificities

that range between 91-100%.

•
Faber (2001) – accuracy of 56% with 11% false positive and 28% false negative.

•
Magriples (1998) - The sensitivity, specificity, and negative and positive predictive values of the screening ultrasonography were 71.4%, 99.4%, 99.1%, and 80%, respectively.

•
Ogunyemi (2000)- Prenatal diagnosis was possible in 62%and in 5.5% late prenatal diagnosis was possible.

Accuracy of detection of cong. Anomalies
Goncalves, Jeanty, Piper

26 (all), 16 (club feet)

Musculo-skeletal

The AIUM/ACR antepartum obstetrical sonographic guidelines:
Expectations for detection of anomalies
R. Filly, R. FilG
Filly, Goldstein & Callen
oldstein, P. Callen

Observable in the majority of cases

•
Anencephaly (100%), Hydranencephaly (100%), Hydrocephalus (97%), Alobar holoprocencephaly (95%), Large posterior fossa cyst (85%), open SB (88%).

•
Severe (>20 mm) unilateral & bilateral (98%) hydronephrosis, Bilateral renal agenesis (93%).

•
Large amount of ascites (100%), Omphalocele (100%), gastroschisis (95%), Limb-body wall complex (88%), prox small bowel obstruction with hydramnios (95%), Diaph. Hernia (88%).

•
Ectopia cordis (58%), HLH (74%), HRH (66%).

•
Hydrothorax & mediastinal shift (95%).

•
OI (88%), achondroplasia (81%), amputation (55%).

SKELETAL DYSPLASIAS

•
Parilla (2003) – Diagnostic accuracy of 65%. There were 2 false-positive – both had mild long-bone shortening (3-4 weeks discrepancy at 30 weeks’ gestation).

Holder-Espinasse et al (2004) – Limb abnormalities:

•
107 cases - Limb anomalies were detected in 45% of cases.

•
Can be isolated, syndromic or associated with multiple malformations.

•
“These limb malformations are Developmental anomalies!”

Hope this will help

Prof. Yaron Zalel

----- Original Message -----

From: Aleksandra Novakov Mikic

To: Multiple recipients of list ULTRASOUND

Sent: Thursday, April 21, 2005 11:52 PM

Subject: Fw:

----- Original Message -----

From: Aleksandra Novakov Mikic

To: ultrasound@dns.obgyn.net

Sent: Thursday, April 21, 2005 11:49 PM

Dear friends,

a colleague of mine has missed a shorter leg with a rudiment of a foot and the family is now going to court. Is anybody aware of a paper(s) where the issue of false positives and false negatives of ultrasound diagnosis is discussed and any kind of data base where one can see what is the detection rate of skeletal dysplasias of all kinds.

Thanks a lot...Friend in need is a friend indeed, let us remember...

ALeksandra
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