The performance of routine ultrasonographic screening of pregnancies in the Eurofetus Study,☆☆,,★★

https://doi.org/10.1016/S0002-9378(99)70577-6Get rights and content

Abstract

Objectives: The purpose of the Eurofetus Study was to evaluate the accuracy of the antenatal detection of malformations by routine ultrasonographic examination in unselected populations. Study Design: All ultrasonographic diagnoses of malformations and the outcomes of the fetuses were prospectively recorded in 61 European obstetric units over a 3-year period (1990-1993). Also recorded were all cases of malformation diagnosed after abortion or birth for the mothers who underwent follow-up in these centers. Results: Of 3685 malformed fetuses, 2262 had received diagnoses during pregnancy (sensitivity, 61.4%). Of a total number of 4615 malformations, 2593 were detected (sensitivity, 56.2%). The detection sensitivity was higher for the major than for the minor abnormalities (73.7% vs 45.7%), and the diagnosis was made earlier in the pregnancy (24.2 weeks vs 27.6, P < .01). Overall, 55% of the major abnormalities were detected within 24 gestational weeks. Within each severity group the accuracy of detection depended on the system. For the major abnormalities it was better for the central nervous system (88.3%) and urinary tract (84.8%) but lower for the heart and great vessels (38.8%). Detection of minor abnormalities was also effective for the urinary tract (89.1%) but not for the heart and great vessels (20.8%) or the musculoskeletal system (18%). Detection of abnormalities had an influence on the rate of termination of pregnancy. The rate of live births for the mothers bearing fetuses with major abnormalities was lower than that for the mothers in whom no abnormalities were detected, mainly because of the higher rate of elective terminations of pregnancy in the former group. Conclusion: Systematic ultrasonographic screening during pregnancy can now detect a large proportion of fetal malformations, although some still escape detection. (Am J Obstet Gynecol 1999;181:446-54.)

Section snippets

Study design

During the study period January 1, 1990–June 30, 1993, the 61 centers participating in the Multicentric Eurofetus Study recorded prospectively all diagnoses of malformation made during pregnancy by ultrasonographic examination. Also included were the defects found at birth that had not been identified despite examination carried out in the participating centers. These centers were distributed throughout 14 countries in Europe (Austria, Belgium, Croatia, Finland, France, Great Britain, Hungary,

Abnormalities observed

During the study period 4615 malformations were recorded in 3686 fetuses, representing 1.25 abnormalities per malformed fetus. Of these 3686 malformed fetuses, 2907 (78.9%) had a single malformation, 484 (13.1%) had 2 malformations, and 295 (8.0%) had ≥3 malformations (including ICD-9 code 7597). In addition, 266 malformed fetuses had a chromosomal abnormality that was not recorded as an additional malformation.

For the total study population, the most common malformations were those of the

Comment

The Eurofetus Study included 3685 fetuses with structural malformations and represents the largest study to date on the evaluation of ultrasonographic screening for such defects. In view of the diversity of congenital malformations and the differences in performance of ultrasonographic diagnosis as a function of the type of malformation, only a survey of a large population can provide reliable data on routine ultrasonographic screening.

In our study the overall sensitivity of prenatal

Acknowledgements

The following persons and institutions constituted the Eurofetus Study Group.

Project Leader: Salvator Levi, Brussels, Belgium; Epidemiology manager: Hélène Grandjean, Toulouse, France. Participants and centers were as follows: Belgium—R. Coulon, Ath; P. Dehavay, Charleroi; P. Defoort, Gent; S. Levi, Bruxelles; J.P. Schaaps, Liège. France—M. Delcroix, Lommes; P. Grosieux, Angers; G. Magnin, Poitiers; F. Puech, Lille, M-F. Sarramon, Toulouse. Italy—M. Campogrande, Cuneo; G.C. Dolfin, Torino; D.

References (12)

There are more references available in the full text version of this article.

Cited by (434)

  • Maternal Diabetes

    2023, Avery's Diseases of the Newborn
  • Fetal Therapy for Renal Anhydramnios

    2022, Clinics in Perinatology
View all citing articles on Scopus

From the Institut National de la Santé et de la Recherche Médicalea and the Hopital Universitaire Brugmann, Université Libre de Bruxelles.b A complete listing of the Eurofetus Study Group and the participating institutions appears at the end of the article.

☆☆

The Eurofetus Study has received support from the European Union.

Reprint requests: Hélène Grandjean, MD, INSERM U518, Hôpital La Grave, 31052 Toulouse Cedex, France.

★★

0002-9378/99 $8.00 + 06/1/98331

View full text