Ultrasound screening for fetal structural anomalies.
Ultrasound prenatal diagnosis of structural anomalies has become almost a separate branch of obstetrics. The advantages of performing ultrasound in pregnancies at high risk for fetal structural anomalies are clear. Patients and the news media have placed ever-increasing expectations on persons performing diagnostic ultrasound of the fetus. However, the benefits and cost-effectiveness of routine ultrasound screening during pregnancy remain unclear. This review focuses on three controversial topics related to the use of screening ultrasound for fetal structural anomalies: routine ultrasound screening, the four-chamber view, and amniocentesis versus ultrasound for detection of neural tube defects.