The 3-Sweep Approach: A Standardized Technique for Fetal Anatomic Assessment in the Limited Resource Setting

Abstract

This retrospective study aims to describe a standardized screening technique “the 3-sweep approach” for fetal anatomic assessment in the outreach setting. The study was carried out on 1396 pregnant women referred for an obstetric ultrasound for pregnancy dating and detection of abnormalities in a limited resource setting in Lebanon. All pregnancies were scanned utilizing a previously described standardized 6-step approach and the 3-sweep approach for fetal anatomic assessment. The first sweep examines the fetal head and face, the second examines the spine, and the third examines the chest, abdomen, and pelvis. Positive findings were referred for a detailed ultrasound examination at a referral center. There were a total of 1157 women, at >14 weeks gestation, included in the study. The median gestational age was 24 weeks 4 days (14 weeks 0 day–41 weeks 1 day). The 3-sweep approach was completed in all pregnancies with a total time of under 1 min. A total of 33/1157 (2.9%) fetuses had structural abnormalities detected. Confirmation of the 3-sweep findings was made by comprehensive imaging at a referral center (8/33 = 24.2%) or thorough review of 3-sweep images (25/33 = 75.8%). We found the 3-sweep approach to be an effective mode of screening for structural fetal abnormalities. Though it requires skill in probe manipulation and knowledge of fetal anatomy, its incorporation into routine evaluation in the outreach setting will help identify at-risk fetuses. Depending on the available facilities, this may facilitate proper referral and management to optimize neonatal outcomes and minimize maternal risks. Based on our experience, it is a time-efficient and complementary technique to the 6-step approach.

Keywords

Obstetrical ultrasound - Outreach setting - Limited resource setting - Fetal anatomic assessment - 3-Sweep approach

Publication History

Received: 17 December 2016

Accepted: 23 January 2017

Article published online:
08 May 2023