Cervical assessment certification and its impact on performance quality in the context of universal cervical screening.

Autor: Stratulat V; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Dan Women & Babies Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.; Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Melamed N; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Dan Women & Babies Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Barrett J; Department of Obstetric and Gynecology, McMaster University, Hamilton, Ontario, Canada., Ladhani NNN; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Dan Women & Babies Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Anabusi S; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Dan Women & Babies Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Quaglietta P; Department of Genetics and Genome Biology, Institute of Medical Science, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada., Hack K; Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Ronzoni S; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Dan Women & Babies Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Mar; Vol. 164 (3), pp. 951-958. Date of Electronic Publication: 2023 Sep 07.
DOI: 10.1002/ijgo.15078
Abstrakt: Objective: To assess the impact of the introduction of universal transvaginal cervical screening and certification on the quality of cervical length ultrasound images.
Methods: The present study included a retrospective cohort of singleton pregnancies that underwent transvaginal cervical length measurement at the anatomical scan (18 0/7 and 23 6/7 weeks) before (period A, 2015-2017) and after (period B, 2017-2019) the introduction of universal transvaginal cervical length screening. Independent observers blindly evaluated the images obtained for cervical length using a qualitative scoring method based on five criteria, according to the Fetal Medicine Foundation.
Results: In all, 6013 patients met the inclusion criteria, 3333 in period A and 2680 in period B. Maternal characteristics and risk factors for preterm birth were similar between the two periods. The acceptance of transvaginal cervical length measurement in period B was 95.5% in the overall cohort and 100% in the subgroup of high-risk patients. The quality score was significantly higher in period B than in period A. Among the image quality criteria, the anterior/posterior ratio, the correct magnification of the images, and the calipers' placement contributed significantly to the improved quality score in period B. Most of the sonographers performed better in period B, irrespective of the years of experience, but certificate holders obtained higher scores than non-certified sonographers, particularly those in mid-career. The identification of short cervix was significantly higher in period B than in period A.
Conclusion: The implementation of universal transvaginal cervical length screening and the certification process are associated with improved quality of cervical length images, even among expert sonographers and in the presence of anatomical pitfalls.
(© 2023 International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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