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Am J Obstet Gynecol. 2014 Dec;211(6):672.e1-5. doi: 10.1016/j.ajog.2014.06.012. Epub 2014 Jun 6.

Quality of first-trimester measurement of crown-rump length.

Author information

1
Faculté de Médecine Pierre et Marie Curie and Unité de Médecine Fœtale et d'Échographie, Centre Pluridisciplinaire de Diagnostic Prénatal Est Parisien, Hôpital Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France; Collège Français d'Échographie Fœtale, Angers, France. Electronic address: ferdinand.dhombres@trs.aphp.fr.
2
Institut National de la Santé et de la Recherche Médicale, Paris, France.
3
Collège Français d'Échographie Fœtale, Angers, France.
4
Faculté de Médecine Paris 11, Le Kremlin-Bicêtre, France.
5
Faculté de Médecine Pierre et Marie Curie and Unité de Médecine Fœtale et d'Échographie, Centre Pluridisciplinaire de Diagnostic Prénatal Est Parisien, Hôpital Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France; Collège Français d'Échographie Fœtale, Angers, France.

Abstract

OBJECTIVE:

The purpose of this study was to evaluate the quality of crown-rump length (CRL) measurements in scans judged to be of high quality for the measurement of the nuchal translucency.

STUDY DESIGN:

We analyzed prospective data on 68,250 scans by 1913 sonographers that were collected by the French College of Fetal Echography (CFEF) national practice assessment program for the first-trimester scan. The scans were evaluated according to the CFEF image scoring method (CFEF-ISM), which includes items to measure the quality of the scan for both nuchal translucency and the CRL measurements. The scans were classified into 4 quality groups with the use of the full CFEF-ISM score and then a shortened version of the CFEF-ISM that excluded the item on quality of CRL measurement. The proportion of scans with an inaccurate CRL measurement was compared across the different quality groups.

RESULTS:

Overall, 21.67% of scans were of insufficient quality for CRL measurement. Among 23,764 "excellent" scans according to the full CFEF-ISM, 965 scans (4.06%) had insufficient CRL quality vs 9.24% of scans with "excellent" quality on the short CFEF-ISM (relative risk, 2.27; 95% confidence interval, 2.11-2.44; P < .001).

CONCLUSION:

High scores of the quality of nuchal translucency measurement do not guarantee accurate measurement of crown-rump length. Specific measures are needed to evaluate and to improve the quality of the measurement of crown-lump length.

KEYWORDS:

crown-rump length; prenatal screening; quality of care

PMID:
24912098
DOI:
10.1016/j.ajog.2014.06.012
[Indexed for MEDLINE]

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