Transcript Fetal Medicine Report 2012

Obstetric Ultrasound
+
Fetal Medicine
Annual report
History
• 1979
– First screening for abnormality
• 1984
– Serum screening for Downs
• Fetal Anomaly Scan (FAS) - screening for
structural anomalies by ultrasound
• Popular - ‘Shoe-horned’ into screening
The purpose of the audit
Pregnancy and Newborn screening CEL 31 - 2010
• Structural anomalies – Fetal Anomaly Scan(FAS)
• Downs - Age/ Serum/ Nuchal translucency
• Haemoglobinopathy
• Newborn hearing
• Key Performance indicators 2013
– targets set for all except FAS!
Fetal Anomalies 2009 - 12
CNS, head, neck
Anomalies by System
25
9
Cardiovascular
Renal
6
57
10
Abdominal
35
40
Skeletal
5
Thoracic
31
Inc NT <15wks
19
112
Hydrops
Chromosomal
Genetic
Longer term trends
Fetuses with one or more false positive diagnosis
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Prenatally Diagnosed ‘Serious’ cases
Non Lethal'
Terminated
Continued
Totals
Lethal'
Terminated
Continued
Totals
All
Terminated
Continued
Totals
03- 05
2006
2007
2008
2008
2009
2010
2011
2012
Totals
29
25
54
12
9
21
13
8
21
10
8
18
10
8
18
17
4
21
9
6
15
5
8
13
17
3
20
122
79
201
61%
39%
10
1
11
4
1
5
10
1
11
13
1
14
13
1
14
17
1
18
11
1
12
13
1
14
10
1
11
101
9
110
92%
8%
39
26
65
16
10
26
23
9
32
23
9
32
23
9
32
34
5
39
20
7
27
18
9
27
27
4
31
223
88
311
72%
28%
Anomaly rates / 1000 bookers
35
30
25
Anomalies
20
15
10
5
0
Babies
Uptake of T21 screening
90.0%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
Uptake Diagnostic testing
90.0%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%