Ferdinand Dhombres1, Babak Khoshnood2, Roger Bessis3, Nicolas Fries3, Marie-Victoire Senat4, Jean-Marie Jouannic5. 1. Faculté de Médecine Pierre et Marie Curie and Unité de Médecine Fœtale et d'Échographie, Centre Pluridisciplinaire de Diagnostic Prénatal Est Parisien, Hôpital Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France; Collège Français d'Échographie Fœtale, Angers, France. Electronic address: ferdinand.dhombres@trs.aphp.fr. 2. Institut National de la Santé et de la Recherche Médicale, Paris, France. 3. Collège Français d'Échographie Fœtale, Angers, France. 4. Faculté de Médecine Paris 11, Le Kremlin-Bicêtre, France. 5. Faculté de Médecine Pierre et Marie Curie and Unité de Médecine Fœtale et d'Échographie, Centre Pluridisciplinaire de Diagnostic Prénatal Est Parisien, Hôpital Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France; Collège Français d'Échographie Fœtale, Angers, France.
Abstract
OBJECTIVE: The purpose of this study was to evaluate the quality of crown-rump length (CRL) measurements in scans judged to be of high quality for the measurement of the nuchal translucency. STUDY DESIGN: We analyzed prospective data on 68,250 scans by 1913 sonographers that were collected by the French College of Fetal Echography (CFEF) national practice assessment program for the first-trimester scan. The scans were evaluated according to the CFEF image scoring method (CFEF-ISM), which includes items to measure the quality of the scan for both nuchal translucency and the CRL measurements. The scans were classified into 4 quality groups with the use of the full CFEF-ISM score and then a shortened version of the CFEF-ISM that excluded the item on quality of CRL measurement. The proportion of scans with an inaccurate CRL measurement was compared across the different quality groups. RESULTS: Overall, 21.67% of scans were of insufficient quality for CRL measurement. Among 23,764 "excellent" scans according to the full CFEF-ISM, 965 scans (4.06%) had insufficient CRL quality vs 9.24% of scans with "excellent" quality on the short CFEF-ISM (relative risk, 2.27; 95% confidence interval, 2.11-2.44; P < .001). CONCLUSION: High scores of the quality of nuchal translucency measurement do not guarantee accurate measurement of crown-rump length. Specific measures are needed to evaluate and to improve the quality of the measurement of crown-lump length.
OBJECTIVE: The purpose of this study was to evaluate the quality of crown-rump length (CRL) measurements in scans judged to be of high quality for the measurement of the nuchal translucency. STUDY DESIGN: We analyzed prospective data on 68,250 scans by 1913 sonographers that were collected by the French College of Fetal Echography (CFEF) national practice assessment program for the first-trimester scan. The scans were evaluated according to the CFEF image scoring method (CFEF-ISM), which includes items to measure the quality of the scan for both nuchal translucency and the CRL measurements. The scans were classified into 4 quality groups with the use of the full CFEF-ISM score and then a shortened version of the CFEF-ISM that excluded the item on quality of CRL measurement. The proportion of scans with an inaccurate CRL measurement was compared across the different quality groups. RESULTS: Overall, 21.67% of scans were of insufficient quality for CRL measurement. Among 23,764 "excellent" scans according to the full CFEF-ISM, 965 scans (4.06%) had insufficient CRL quality vs 9.24% of scans with "excellent" quality on the short CFEF-ISM (relative risk, 2.27; 95% confidence interval, 2.11-2.44; P < .001). CONCLUSION: High scores of the quality of nuchal translucency measurement do not guarantee accurate measurement of crown-rump length. Specific measures are needed to evaluate and to improve the quality of the measurement of crown-lump length.
Authors: N Fries; F Dhombres; M Massoud; J J Stirnemann; R Bessis; G Haddad; L J Salomon Journal: BMC Pregnancy Childbirth Date: 2021-02-27 Impact factor: 3.007