Family practice obstetric ultrasound in an urban community health center. Birth outcomes and examination accuracy of the initial 227 cases.

The initial 227 consecutive prenatal ultrasound examinations by two family physicians in an urban community health center were compared with actual birth outcomes. Of 186 examinations for which follow-up information was available, 162 infants were represented. The sampling rate was 81%. No serious anomalies were noted by ultrasound. One placenta previa, one fetal death, and two unsuspected cases of twins were detected by ultrasound. These data represent one of the first detailed reports of outcomes reflecting family physicians' psychomotor and cognitive skill in the use of obstetric ultrasound. The high accuracy (92% to 96%) of correct ultrasound dating suggests that a short postgraduate continuing medical education course was effective for these two family physicians. The accuracy rate compares favorably to more rigorous training. This structured format utilizing the average of four direct measurements for ultrasound-estimated gestational age and three anatomy ratios for assessing proper imaging relationships or growth symmetry may be useful as other family physicians develop educational methods and quality-assurance protocols in this area.