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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:1015-1018 • 0278-4297

Basic Versus Detailed Sonography

What Do We Miss?

Stephen T. Chasen, MD, Robin B. Kalish, MD and Frank A. Chervenak, MD

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Weill Medical College of Cornell University, New York, New York USA.

Address correspondence to Stephen T. Chasen, MD, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Weill Medical College of Cornell University, 525 E 68th St, Room J130, New York, NY 10021 USA. E-mail: stchasen{at}med.cornell.edu

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.

Key Words: fetal anomalies • prenatal diagnosis • sonography

Abbreviations: CPT, Current Procedural Terminology

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