Clinical audit for first-trimester ultrasound screening: A single center experience

Xining WuYixiu Zhang^*Hua Meng^*Yunshu OuyangZhonghui XuQing DaiPeipei Zhang

• Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Objective The purpose of this study was to assess the quality of 11–14-week fetal ultrasound images and physician scanning performance in a large general hospital to inform future quality improvement initiatives. Methods A retrospective audit of ultrasound scans of normal fetuses at 11–14 weeks was conducted from November 2021 to March 2023 at a large tertiary general hospital in Beijing, China. Ten anatomical views were analyzed by two experienced assessors. Scan completeness and view completeness rates ≥70%, and logbook quality scores ≥42 (i.e., ≥70% of the maximum possible score), were considered acceptable. Results The overall scan completeness of 256 logbooks was 77.4%. The scan completeness of 189 logbooks (73.8%) was acceptable. The median image quality score for the 256 logbooks was 37 (interquartile range, 28–46), and 96 logbooks (37.5%) had acceptable image quality, with a score ≥42. The scan completeness of 23 sonographers (63.9%) was > 70%. Sonographers with intermediate titles performed a higher average number of fetal ultrasound scans than those with senior titles (148 vs. 115 scans), and their scan completeness and logbook image quality scores were also superior (87% vs. 69% and 43.24 ± 6.38 vs. 31.62 ± 11.28, respectively; both p < 0.05). Conclusion The majority of sonographers met the expectations of the audit. Sonographers performing more fetal ultrasound scans may have an advantage in terms of scan completeness and image quality.