April 5th, 2020

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Patient and Practitioner Understanding of Ultrasound Screening in Pregnancy
Authors:  Loralei L. Thornburg, M.D., Susan Bradford, M.D., Stefanie J. Hollenbach, M.D., M.S., Arie Shaw, M.D., and J. Christopher Glantz, M.D., M.P.H.
  OBJECTIVE: To evaluate how patients and obstetrical providers perceive ultrasound examinations in pregnancy, including indications, safety, and accuracy.

STUDY DESIGN: Patients presenting for screening ultrasound at a tertiary medical center and the providers who refer patients to the medical center’s ultrasound unit completed anonymous surveys regarding their knowledge and perception of screening ultrasound.

RESULTS: Surveys were completed by 298 patients (141 first trimester screening [FTS] and 157 anatomic screening [AS]) as well as 140 obstetrical care providers. The FTS patients were more likely than AS patients to identify the correct purpose of ultrasound (70% vs. 56%, p=0.02). Among AS patients, 59% indicated that their doctor had sent them to determine fetal sex (vs. 48% for AS). Patients’ (5%) and providers’ (29%) understanding of the 5% baseline anomaly risk was poor. Few patients (5%) and only 57% of clinicians understood the 1% residual anomaly risk after normal anatomic ultrasound. Despite these knowledge gaps, 86% of patients believed they had adequate information before their ultrasound.

CONCLUSION: Both pregnant women and obstetrical providers have significant gaps in their knowledge regarding sonographic screening tests. Despite this, most patients feel adequately counseled.
Keywords:  congenital abnormalities/diagnosis; congenital abnormalities/prevention & control; diagnostic ultrasound; Doppler ultrasound; education of patients; fetal anomalies; fetal development; fetus/abnormalities; informed consent; mass screening; predictive value of tests; pregnancy; risk factors; ultrasonography; ultrasonography, prenatal
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