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Prenatal diagnosis of fetal anomalies in a regional tertiary center: the role of a maternal fetal medicine unit--a review of 6,877 deliveries.

OBJECTIVE
To determine the accuracy of anomalies detection and to evaluate the role of maternal-fetal medicine (MFM) specialists.


METHODS
This was a retrospective study of birth defects. Patients were divided into: 1) if ultrasound was reviewed by MFM specialists; 2) Others, if reviewed by other ultrasonologists. Fisher's exact test or Pearson's chi2 test were used for statistical analysis.


RESULTS
Birth defects occurred in 204/6,877 (3%) neonates with 291 distinct birth defects. Prenatal diagnosis was possible in 181 (62%). In 16 (5.5%) late prenatal diagnosis was possible. MFM specialists correctly diagnosed 53/62 (85%) vs. 56/132 (42%) in Others (P < 0.001). Late diagnosis was possible in 12 cases of gastrointestinal anomalies, three of hydrocephaly and one of skeletal dysplasia; five were correctly diagnosed by MFM specialists and two by Others.


CONCLUSIONS
Involvement of ultrasonologists with particular expertise in fetal scanning may improve accuracy of prenatal diagnosis. A repeat third trimester ultrasound may be useful in detecting late-evolving anomalies.