Basic versus detailed sonography: what do we miss?

Overview

OBJECTIVE: The purpose of this study was to evaluate the impact of restrictive versus routine use of "detailed" second-trimester sonography. METHODS: Records of singleton pregnancies undergoing evaluation from 2004 to 2008 were reviewed. A detailed examination (Current Procedural Terminology [CPT] code 76811) was routinely performed on all patients. Major structural abnormalities were categorized on the basis of whether the structure would be included in a "basic" examination (CPT code 76805). Risk factors for anomalies were identified. The Fisher exact test and Student t test were used for statistical comparison. RESULTS: Major anomalies were identified in 218 patients, 75 of whom elected to undergo abortion. In 88 patients (40.4%), the abnormal structure would not be included in a basic examination. Risk factors were not more prevalent in those with anomalies requiring a detailed examination for diagnosis or in those patients who chose to undergo abortion. CONCLUSIONS: Restricting detailed evaluation to those with risk factors would have prevented detection of a substantial proportion of anomalies.

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine Journal