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Use of the Genetic Sonogram in the United States in 2001 and 2007

Departments of Obstetrics and Gynecology (Y.M.V.F., J.F.X.E.) and Genetics and Developmental Biology (P.B.), University of Connecticut School of Medicine, Hartford, Connecticut USA.

Address correspondence to Yu Ming Victor Fang, MD, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Hartford Hospital, 85 Jefferson St, 625, Hartford, CT 06106 USA. E-mail: vicmail{at}pol.net

Objective. The purpose of this study was to determine whether there have been changes in the use of second-trimester genetic sonograms and in the second-trimester sonographic markers used to screen for fetal aneuploidy by maternal-fetal medicine specialists in the United States from 2001 to 2007. Methods. A survey was mailed to Society for Maternal-Fetal Medicine members in the United States in April 2007 inquiring about their practice patterns regarding the genetic sonogram. Specific sonographic markers used for risk adjustment as part of the genetic sonogram were also assessed. The responses from 2007 were compared with responses from a similar survey administered in 2001 (Am J Obstet Gynecol 2002; 187:1230–1234) using descriptive statistics, the ² test, and the Wilcoxon rank sum test. Results. A total of 991 responses were analyzed: 543 of 1638 (32%) in 2001 and 448 of 1756 (26%) in 2007. Significant increases (P < .0001) were noted in the number of specialists who used the genetic sonogram as a screening tool for Down syndrome and for every single sonographic marker used to adjust a woman’s risk for having a fetus with Down syndrome during a genetic sonogram, except for choroid plexus cyst, clinodactyly, sandal gap toes, and widened pelvic angle. Conclusions. Practitioners in the United States are using an increasing number of second-trimester sonographic markers to help identify aneuploid fetuses. The growing acceptance of sonography to screen for fetal aneuploidy and the recommendation by the American College of Obstetricians and Gynecologists for universal screening suggest that more resources may be necessary to meet the growing demand for second-trimester sonograms.

Key Words: aneuploidy • Down syndrome • fetal anomalies • genetic sonogram • nasal bone • second-trimester sonography

Abbreviations: SMFM, Society for Maternal-Fetal Medicine