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Fetal Anomaly Scan: Importance of Anomaly Detection

According to a recent study, the prevalence of congenital anomaly affected births was 184.48 per 10,000 births (1.84%).

The 2nd trimester anomaly scan is therefore a crucial investigation.

Ideal time for optimal evaluation: 18 to 22 weeks of gestation.

Objective of the scan:

  • To predict with confidence, the structural normalcy of the fetus within reasonable limits of expectations.
  • To identify severe and lethal anomalies.
  • To raise the suspicion of an abnormality which could warrant further investigations and serial scanning.

Since this scan is primarily meant for exclusion or confirmation of fetal anomalies, it is important that a thorough examination of the fetus is done during this period. The scan is, effectively, a head-to-toe ultrasound examination of the fetus.

Detection rates for specific anomalies:

Anomaly (<24 weeks) Sensitivity Specificity
Anencephaly 87-100 % 99-100 %
Intracranial pathology 27-100 % 99-100 %
Renal agenesis 75-100 % 99-100 %
Cystic lung 0-100 % 99-100 %
Major cardiac anomaly 4-77 % 98-99 %
Congenital diaphragmatic hernia 0-100% 99-100 %
Exomphalos 0-100% 99-100 %
Gastroschisis 0-100% 0-100 %
Musculoskeletal anomaly 0-100% 0-100 %
Spina bifida 69-100% 99-100 %
Major renal anomaly 26-100% 99-100 %

Fetal anomaly scan is the most important of all scans and should not be missed. Every pregnant female should be offered this scan for detection of anomalies and subsequent management.

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