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Ultrasound of Congenital Fetal Anomalies

 The first years of this century probably qualify as being mutational for fetal imaging, and this outstanding review of the ability and performance of fetal ultrasound imaging is being timely published.
Screening and diagnosis are the two faces of fetal imaging. They differ mainly because of their indications, the level of expertise they require and, to a certain extent, the complexity of the technology supporting the imaging modality. These largely determine the availability of the investigation, its reproducibility and accuracy. The number of, and gestational age at which these examinations are performed are not driven only by technical and developmental factors, but also by economic and social considerations, as well as legal aspects surrounding termination of pregnancy. As a result, screening has moved towards earlier gestations while diagnostic accuracy is increasing at later gestations, when [TOP] is either not an options or has stopped being relevant to the management of the pregnancy. Ultrasound screening in pregnancy can be seen as the offer to check the largest number of pregnancies, by the largest number of operators for simple and reproducible criteria in order to make important choices on the management of pregnancy and delivery.
Most established screening programs claim figures of around 40–70% sensitivity (for a 5% false-positive rate) for different conditions such as congenital heart defects and Down syndrome. However divergent their directions can be, both screening and diagnosis are demanding an ever increasing knowledge of fetal development and mastering of the technology.
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