Objective To learn the capability and functioning status of prenatal ultrasound screening institutions in Beijing and inform decision-making on the optimization of prenatal screening management. Method By using the data from the second and the third National Special Survey on Prenatal Screening and Prenatal Diagnostic Services in Beijing,we analyzed the distribution,human resources,workload,technology,and equipment of ultrasound screening institutions in Beijing as well as their changing trends. Results From 2013 to 2015,there were 100 prenatal ultrasound screening institutions,833 technicians,and 383 prenatal ultrasound screening instruments in Beijing,offering over 600 000 service sessions.In contrast,there were 93 institutions with a total service volume of 644 100 between 2010 and 2012.The general hospitals,tertiary hospitals,and urban areas(especially urban functional development areas and new urban development areas)were the main sources of the services.In particular,the maternal and child health care hospitals in Beijing provided the highest amount of services per unit of resources.The average prenatal ultrasound screening rate was about 98.05%.The service delivery trended to transfer from urban areas to remote county areas and from secondary institutions to tertiary institutions.Conclusion The operation and management of prenatal ultrasound screening institutions in Beijing are relatively standard.The ultrasound screening rate is relatively high in the second trimester,and the distribution of the services has constantly been improved since 2010.
Beijing ; Female ; Hospitals, General ; Humans ; Mass Screening ; statistics & numerical data ; Pregnancy ; Prenatal Diagnosis ; statistics & numerical data ; Ultrasonography ; Ultrasonography, Prenatal

OBJECTIVE: To provide reference ranges of the fetal gall bladder in the Korean population. MATERIALS AND METHODS: Fetal gall bladder development was evaluated in well-dated, non-anomalous fetuses in the Korean population between February and April 2003 and the visualization rate and reference values were determined from the obtained data. RESULTS: The visualization rate of the fetal gall bladder increased as gestation advanced to a plateau above 90%, which was maintained between 16 and 34 weeks. The measured parameters from the fetal gall bladder had a significant positive relationship with gestational age (p = 0.000 for all cases), and the correlation of length and area with the gestational age (r = 0.741 and r = 0.690, respectively) was better than the correlation of width, height, and volume with gestational age. The repeatability coefficients and coefficients of variation between the two operators were 5.56 mm and 12.9% for the length and 344.11 mm(2) and 33.52% for the area. The median length of the fetal gall bladder in the Korean population was not significantly different from the mean length of gall bladders in the Caucasian and African-American populations (p = 0.915). CONCLUSION: We have provided reference values for the fetal gall bladder throughout the gestation period in the Korean population.
Female ; Gallbladder/*embryology/ultrasonography ; Gestational Age ; Humans ; Korea ; Pregnancy ; Reference Values ; Statistics, Nonparametric ; Ultrasonography, Doppler, Color ; *Ultrasonography, Prenatal

OBJECTIVETo analyse the effect of the reduction of multiple pregnancy through transvaginal ultrasonic monitoring on the pregnancy outcome.

METHODSEighty-four cases were divided into two groups according to whether they had vaginal hemorrhage before operation. And the pregnancy outcomes were analyzed.

RESULTSThe abortion rate and preterm birth rate of the vaginal hemorrhage group were higher, and the difference was statistically significant.

CONCLUSIONSThe reduction of multiple pregnancy through transvaginal ultrasonic monitoring is a safe operative method. But it is only a remedial treatment for multiple pregnancy, and how to prevent multiple pregnancy is of more practical value.

Adult ; Female ; Humans ; Pregnancy ; Pregnancy Outcome ; Pregnancy Reduction, Multifetal ; statistics & numerical data ; Pregnancy, Multiple ; statistics & numerical data ; Ultrasonography, Prenatal

Developmental dysplasia of the hip (DDH) is an intriguing condition that evolves during infancy. It would be thus foolhardy to expect a screening tool at birth to be both highly sensitive and specific. Uncertainty regarding an optimal screening method is compounded by a general lack of sound epidemiological data. Clinical screening remains widely used. Some reports estimated that it did not pick up 60% of children who eventually needed surgery. Ultrasonography, it was hoped, would improve detection rates. There are 2 approaches to ultrasound; universal screening, which is adopted by some European countries, or selective screening of high risk infants. The problems with universal ultrasound screening are high false positive rates and high costs. The benefit was a possible 6- to 10-fold reduction in surgery for late DDH. Similar reductions though had also been reported if ultrasound was used selectively for infants with clinical and historical risk factors. A literature review on this topic is presented. There are pros and cons for both screening strategies. This is reflected in the different protocols that exist among various countries. For healthcare systems that are considering their options, universal ultrasound screening is generally not cost-effective and should not be the preferred screening strategy.
Hip Dislocation, Congenital ; diagnostic imaging ; Humans ; Infant ; Mass Screening ; statistics & numerical data ; Patient Selection ; Ultrasonography

OBJECTIVE: To evaluate the interobserver variability and performance in the interpretation of ultrasonographic (US) findings of thyroid nodules. MATERIALS AND METHODS: 72 malignant nodules and 61 benign nodules were enrolled as part of this study. Five faculty radiologists and four residents independently performed a retrospective analysis of the US images. The observers received one training session after the first interpretation and then performed a secondary interpretation. Agreement was analyzed by Cohen's kappa statistic. Degree of performance was analyzed using receiver operating characteristic (ROC) curves. RESULTS: Agreement between the faculties was fair-to-good for all criteria; however, between residents, agreement was poor-to-fair. The area under the ROC curves was 0.72, 0.62, and 0.60 for the faculties, senior residents, and junior residents, respectively. There was a significant difference in performance between the faculties and the residents (p < 0.05). There was a significant increase in the agreement for some criteria in the faculties and the senior residents after the training session, but no significant increase in the junior residents. CONCLUSION: Independent reporting of thyroid US performed by residents is undesirable. A continuous and specialized resident training is essential to enhance the degree of agreement and performance.
Adult ; Aged ; Clinical Competence/*statistics & numerical data ; Diagnosis, Differential ; Faculty, Medical/*statistics & numerical data ; Female ; Humans ; Internship and Residency/*statistics & numerical data ; Male ; Middle Aged ; Observer Variation ; ROC Curve ; Radiology/education ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland/ultrasonography ; Thyroid Neoplasms/*ultrasonography

OBJECTIVETo study the value of detecting fetal congenital heart disease (CHD) using the five transverse planes technique of fetal echocardiography.

METHODSNine hundred and eighty-two high-risk pregnancies for fetal CHD were included in this study, the fetal heart was scanned with the five transverse planes technique of fetal echocardiography described by Yagel, autopsy was conducted when pregnancy was terminated. Blood from fetal heart was collected for fetal chromosome analysis. A close follow-up was given for normal fetal heart pregnancies and neonatal echocardiography was performed to check the accuracy of prenatal diagnosis.

RESULTS(1) Forty-six cases (4.68%) were found to have fetal heart abnormalities in this study, 69.56% of them were diagnosed by single four-chamber view, another 30.43% fetal CHD were found by combining other views; (2) Forty-one parents of prenatal fetuses with CHD chose to terminate pregnancy, thirty-two of them gave consent to conduct autopsy, 93.75% of which yielded unanimous conclusion between prenatal fetal echocardiography and autopsy; (3) Thirty-two of 46 cases underwent fetal chromosome analysis, 8 cases (25%) were found to have abnormal chromosome; (4) Five cases were found to have right ventricle and atrium a little bigger than those on the left side, with the unequal condition being the same after birth, but there were no clinical manifestations and they are healthy for the time being; (5) Nine hundred and thirty-six cases were not found with abnormality in this study, but one case was diagnosed with ventricular septal defect after birth, one case was diagnosed with patent ductus arteriosus, one case had atrial septal defect after birth.

CONCLUSIONS(1) The detected CHD rate was 4.68% by screening fetal heart with five transverse planes according to Yagel's description of high risk population basis for CHD. The coinciding rate of prenatal diagnosis and autopsy was 93.75%; (2) The sensitivity of detecting fetal heart abnormality is 92%, the specificity is 99.6% using the five transverse planes technique of fetal echocardiography; (3) Fetuses with mild or moderate disproportion of right and left side in the heart are potentially healthy babies.

Adult ; China ; Chromosome Aberrations ; Echocardiography ; methods ; statistics & numerical data ; Female ; Heart Defects, Congenital ; diagnostic imaging ; genetics ; Humans ; Infant, Newborn ; Pregnancy ; Sensitivity and Specificity ; Ultrasonography, Prenatal ; methods ; statistics & numerical data

Objective: This study aims to investigate the correlation of an ultrasonic scoring system with intraoperative blood loss (IBL) in placenta accreta spectrum (PAS) disorders. Methods: A retrospective cohort study was conducted between January 2015 and November 2019. Clinical data for patients with PAS have been obtained from medical records. Generalized additive models were used to explore the nonlinear relationships between ultrasonic scores and IBL. Logistic regressions were used to determine the differences in the risk of IBL ≥ 1,500 mL among groups with different ultrasonic scores. Results: A total of 332 patients participated in the analysis. Generalized additive models showed a significant positive correlation between score and blood loss. The amount of IBL was increased due to the rise in the ultrasonic score. All cases were divided into three groups according to the scores (low score group: ≤ 6 points, Conclusions The risk of blood loss equal to or greater than 1,500 mL increases further when ultrasonic score greater than or equal to 10 points, the preparation for transfusion and referral mechanism should be considered.
Adult ; Blood Loss, Surgical/statistics & numerical data* ; Female ; Gestational Age ; Humans ; Logistic Models ; Placenta Accreta/surgery* ; Predictive Value of Tests ; Pregnancy ; Retrospective Studies ; Risk ; Ultrasonography, Prenatal/statistics & numerical data*

OBJECTIVE: To explore the main reasons of medical malpractice of fetal abnormalities and to analyze the key points and the ideas in judicial appraisal. METHODS: According to the related laws, regulations and clinical practice guidelines, the medical faults and the contribution degree in 12 medical malpractice cases about fetal abnormalities were analyzed. RESULTS: There were medical faults in five cases. Among them, the doctors did not fulfill the duty of inform in 2 cases, did not analyze the abnormal results comprehensively in 2 cases, did not have qualified medical conditions and normative reports in 1 case. The hospitals needed to take the minor responsibility in 2 cases and slight responsibility in 2 cases. CONCLUSION The key points in the judicial appraisal are whether the doctors abide by the related laws, regulations and clinical practice guidelines in prenatal examination, screen and diagnosis, and whether the doctors realize the limitations of ultrasonic testing and fulfill the obligation of inform.
Expert Testimony ; Female ; Fetus/abnormalities* ; Forensic Medicine ; Humans ; Informed Consent ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Pregnancy ; Prenatal Diagnosis ; Retrospective Studies ; Ultrasonography, Prenatal

PURPOSE: The purpose was to compare the frequency of metastatic and nonmetastatic lymph nodes diagnosed by fine needle aspiration biopsy cytology (FNAC) and thyroglobulin concentration from fine needle aspiration biopsy washout fluid (FNAB-Tg) in an indeterminate range (0.2-100 ng/mL), and to evaluate the most appropriate threshold value of FNAB-Tg in an indeterminate range. MATERIALS AND METHODS: We performed ultrasound-guided FNAB and FNAB-Tg in suspicious metastatic cervical lymph nodes of papillary thyroid carcinoma and performed surgery. Ninety-five lymph nodes with indeterminate values of FNAB-Tg ranging from 0.2-100 ng/mL in ninety-two patients were included in this study. The diagnostic performances in multiple Tg levels (0.7, 1.0, 5.0, 10.0, 20.0, 50.0) were evaluated to compare with FNAB cytology using sensitivity, specificity, and accuracy with area under the curve (AUC) analysis. RESULTS: Forty-two were metastatic lymph nodes and fifty three were nonmetastatic lymph nodes. FNAB-Tg ranged from 0.22 to 90.9 ng/mL in metastatic lymph nodes (mean; 34.3+/-33.3 ng/mL) and 0.20 to 56.7 ng/mL in nonmetastatic lymph nodes (mean; 4.9+/-11.1 ng/mL) (p<0.001). The most excellent diagnostic performance was displayed in 5 ng/mL of FNAB-Tg with AUC of 0.76, sensitivity, specificity, accuracy, 69.0, 83.0, and 76.8, respectively. However, there was no significant difference from 10 ng/mL FNAB. CONCLUSION: We ascertained that 5 ng/mL yielded the most excellent diagnostic performance among FNAB-Tg levels in the present setting with a large series with the indeterminate range (0.2-100 ng/mL) of FNAB-Tg values. These results need additional confirmation under different laboratory conditions.
Biopsy, Fine-Needle/*methods/standards/statistics & numerical data ; Body Fluids/metabolism ; Carcinoma, Papillary/*metabolism/*secondary/ultrasonography ; Humans ; Lymph Nodes/metabolism/pathology/ultrasonography ; Lymphatic Metastasis ; Retrospective Studies ; Sensitivity and Specificity ; Thyroglobulin/*metabolism ; Thyroid Neoplasms/*metabolism/*secondary/ultrasonography ; Ultrasonography, Interventional

OBJECTIVE: To evaluate the usage of duplex power Doppler ultrasound (PDUS) for the differentiation of benign and malignant thyroid nodules. MATERIALS AND METHODS: We prospectively examined 77 thyroid nodules in 60 patients undergoing ultrasound-guided fine needle aspiration biopsy (FNAB). Each nodule was described according to size, inner structure, borders, parenchymal echogenicity, peripheral halo formation, and the presence of calcification (B-mode ultrasound findings). Vascularity as determined by PDUS imaging was defined as non-vascular, peripheral, central, or of mixed type. For each nodule, the pulsatility index (PI) and resistive index (RI) values were obtained. Results of FNAB and surgical pathological examination (if available) were used as a proof of final diagnosis to categorize all nodules as benign or malignant. A receiver operating characteristic (ROC) curve analysis was performed to establish cut-off, sensitivity, and specificity values associated with RI-PI values. RESULTS: A significant relationship was observed between malignancy and irregular margins, microcalcifications, and hypoechogenicity on ultrasound examination (p < 0.05). The pattern of vascularity as determined by PDUS analysis was not a statistically significant criterion to suggest benign or malignant disease in this study (p > 0.05). The central, peripheral, and mean RI-PI values were higher in malignant nodules when compared to the other cytologies (p < 0.05). CONCLUSION: Vascularity is not a useful parameter for distinguishing malignant from benign thyroid nodules. However, RI and PI values are useful in distinguishing malignant from benign thyroid nodules.
Adult ; Aged ; Biopsy, Fine-Needle ; Chi-Square Distribution ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Statistics, Nonparametric ; Thyroid Neoplasms/pathology/*ultrasonography ; Thyroid Nodule/pathology/*ultrasonography ; *Ultrasonography, Doppler, Duplex ; Ultrasonography, Interventional