Analysis of the Results of Sonographic Screening Examinations According to the Maternity Guidelines Before and After the Introduction of the Extended Basic Screening (IIb Screening) in Hesse

Abstract

Aim of the Study The aim of the study is to examine the detection rates of malformations before and after the introduction of extended basic screening in Hesse by the Federal Joint Committee (Gemeinsamer Bundesausschuss, GQH) on July 1, 2013.

Method This is a retrospective, mainly exploratory data analysis of quality assurance data from the Office for Quality Assurance in Hesse (GQH). The data was collected in the period from January 1, 2010 to December 31, 2016 in the obstetric departments of the Hessian hospitals using documentation forms. The classification and evaluation of the diagnoses is based on ICD-10-GM-2019.

Results At least one malformation is present in 0.7% of the cases. With a share of 30.0%, most of the congenital malformations are from the musculoskeletal system. 12.2% of the malformations come from the facial cleft, closely followed by malformations of the circulatory system with 11.3%. The highest prenatal detection rate (PDR) is found in congenital malformations of the nervous system at 56.8%. The lowest PDR is found in those of the genital organs with 2.1%. The PDR of cardiovascular malformations is 32.9%. Overall, a PDR of 25.2% is achieved. There was no change in the number of prenatal malformation diagnoses after the introduction of extended basic ultrasound. The distribution of malformation diagnoses not detected prenatally to the organ systems also has not changed after the introduction.

Conclusion The introduction of extended basic ultrasound did not bring the desired improvement with regard to the PDR in Hesse. Alternative approaches should be considered.

Zusammenfassung

Studienziel Ziel der Arbeit ist es, die Entdeckungsraten von Fehlbildungen vor und nach Einführung des erweiterten Basis-Screenings in Hessen durch den Gemeinsamen Bundesausschuss (G-BA) am 01.07.2013 zu untersuchen.

Methode Es handelt sich um eine retrospektive, überwiegend explorative Datenanalyse von Qualitätssicherungsdaten der Geschäftsstelle für Qualitätssicherung in Hessen (GQH), die im Zeitraum vom 01.01.2010 bis 31.12.2016 in den geburtshilflichen Abteilungen der hessischen Krankenhäuser mittels Dokumentationsbögen erhoben wurden. Die Einteilung und Auswertung der Diagnosen erfolgen auf Grundlage der ICD-10-GM-2019.

Ergebnisse In 0,7% der Fälle liegt mindestens eine Fehlbildung vor. Mit einem Anteil von 30,0% sind die meisten angeborenen Fehlbildungen aus dem Bereich des Muskel-Skelett-Systems, 12,2% stammen aus dem Bereich der Lippen-, Kiefer- und Gaumenspalte und 11,3% aus dem Bereich des Kreislaufsystems. Die höchste pränatale Detektionsrate (PDR) findet sich bei den angeborenen Fehlbildungen des Nervensystems mit 56,8%. Die niedrigste PDR findet sich bei denen der Genitalorgane mit 2,1%. Insgesamt wird eine PDR von 25,2% erreicht. Es konnte keine Veränderung in der Anzahl der pränatalen Fehlbildungsdiagnosen nach Einführung des erweiterten Basis-Ultraschalls gezeigt werden. Auch die Verteilung der pränatal nicht entdeckten Fehlbildungsdiagnosen auf die Organsysteme hat sich nach der Einführung nicht verändert.

Schlussfolgerungen Die Einführung des erweiterten Basis-Ultraschalls hat nicht die erwünschte Verbesserung im Hinblick auf die PDR in Hessen gebracht. Es sollte über alternative Vorgehensweisen nachgedacht werden.

Keywords

Obstetrics - Gynecology - Education, Training, Quality Assurance

Publication History

Received: 13 September 2021

Accepted after revision: 02 February 2022

Article published online:
18 March 2022

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