The DOI matches its Crossref record; 112 of the 115 references it cites were found in a registry or an index; none of the 71 sources its claims cite is checked for support yet.
ISUOG Practice Guidelines (updated): performance of the routine mid‐trimester fetal ultrasound scan
Open accessAbstract
The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice, and high-quality teaching and research related to diagnostic imaging in women's healthcare. The ISUOG Clinical Standards Committee (CSC) has a remit to develop Practice Guidelines and Consensus Statements as educational recommendations that provide healthcare practitioners with a consensus-based approach, from experts, for diagnostic imaging. They are intended to reflect what is considered by ISUOG to be the best practice at the time at which they are issued. Although ISUOG has made every effort to ensure that Guidelines are accurate when issued, neither the Society nor any of its employees or members accepts liability for the consequences of any inaccurate or misleading data, opinions or statements issued by the CSC. The ISUOG CSC documents are not intended to establish a legal standard of care, because interpretation of the evidence that underpins the Guidelines may be influenced by individual circumstances, local protocol and available resources. Approved Guidelines can be distributed freely with the permission of ISUOG (info@isuog.org).
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Claims the paper makes
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In the paper
“Although head measurements (BPD and HC) and FL have all been used in the past, recent evidence from the INTERGROWTH-21 st study indicates that HC alone or HC plus FL may be the most accurate predictor of gestational age after 14weeks 19 .”
What the sources say
- Not checked yetcites [19] 19. Papageorghiou AT, Kemp B, Stones W, Ohuma EO, Kennedy SH, Purwar M, Salomon LJ, Altman DG, Noble JA, Bertino E, Gravett MG, Pang R, Cheikh Ismail L, Barros FC, Lambert A, Jaffer YA, Victora CG, Bhutta ZA, Villar J, for the International Fetal and Newborn Growth Consortium for the 21 st Century (INTERGROWTH-21st). Ultrasound-based gestational-age estimation in late pregnancy. Ultrasound Obstet Gynecol 2016; 48 : 719-726. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“It is likely that this policy has become even more effective since then, as the detection rate of congenital heart defects may have increased 6 .”
What the sources say
- Not checked yetcites [6] 6. Lytzen R, Vejlstrup N, Bjerre J, Petersen OB, Leenskjold S, Dodd JK, Jørgensen FS, Søndergaard L. Live-Born Major Congenital Heart Disease in Denmark: Incidence, Detection Rate, and Termination of Pregnancy Rate From 1996 to 2013. JAMA Cardiol 2018; 3 : 829-837. source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“as abnormalities are eventually detected in 0.5-5% of such cases 11,12 .”
What the sources say
- Not checked yetcites [11] 11. Silvestri MT, Pettker CM, Raney JH, Xu X, Ross JS. Frequency and Importance of Incomplete Screening Fetal Anatomic Sonography in Pregnancy. J Ultrasound Med 2016; 35 : 2665-2673. source
- Not checked yetcites [12] 12. Waller SA, O'Connell K, Carter A, Gravett MG, Dighe M, Richardson ML, Dubinsky TJ. Incidence of fetal anomalies after incomplete anatomic surveys between 16 and 22 weeks. Ultrasound Q 2013; 29 : 307-312. source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Recent evidence suggests that outer-to-outer placement of calipers eases standardization, reproducibility and quality control 22 .”
What the sources say
- Not checked yetcites [22] 22. Napolitano R, Donadono V, Ohuma EO, Knight CL, Wanyonyi SZ, Kemp B, Norris T, Papageorghiou AT. Scientific basis for standardization of fetal head measurements by ultrasound: a reproducibility study. Ultrasound Obstet Gynecol 2016; 48 : 80-85. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“In experts' hands, most clinically important structural anomalies can be detected 1 .”
What the sources say
- Not checked yetcites [1] 1. Edwards L, Hui L. First and second trimester screening for fetal structural anomalies. Semin Fetal Neonatal Med 2018; 23 : 102-111. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Increased or reduced umbilical cord coiling have no proven significance and should not be reported as part of the routine mid-trimester scan 52 .”
What the sources say
- Not checked yetcites [52] 52. Sebire NJ. Pathophysiological significance of abnormal umbilical cord coiling index. Ultrasound Obstet Gynecol 2007; 30 : 804-806. source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“All these characteristics can be visualized at the time of the head measurements, when the brain is evaluated for anatomical integrity also (Figure 2) 56 .”
What the sources say
- Not checked yetcites [56] 56. Aubry MC, Aubry JP, Dommergues M. Sonographic prenatal diagnosis of central nervous system abnormalities. Childs Nerv Syst 2003; 19 : 391-402. source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Mid-trimester sonographic measurements can be used to identify anomalies of fetal size 25 .”
What the sources say
- Not checked yetcites [25] 25. Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK. Estimation of fetal weight with the use of head, body, and femur measurements--a prospective study. Am J Obstet Gynecol 1985; 151 : 333-337. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“The heart axis deviates by approximately 45 ± 20 ◦ (2 SD) towards the left side of the fetus 72 .”
What the sources say
- Not checked yetcites [72] 72. Comstock CH. Normal fetal heart axis and position. Obstet Gynecol 1987; 70 : 255-259.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“The diaphragmatic interface can often be visualized as a hypoechoic dividing line between the thoracic and abdominal content (e.g. between heart and stomach or lung and liver) 69,70 .”
What the sources say
- Not checked yetcites [69] 69. Ruano R, Benachi A, Aubry MC, Bernard JP, Hameury F, Nihoul-Fekete C, Dumez Y. Prenatal sonographic diagnosis of congenital hiatal hernia. Prenat Diagn 2004; 24 : 26-30. source
- Not checked yetcites [70] 70. Blaas HG, Eik-Nes SH. Sonographic development of the normal foetal thorax and abdomen across gestation. Prenat Diagn 2008; 28 : 568-580. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
- Probably not a substantial claim. 16
- It may state two separate claims as one. 13
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Prenatal ultrasonography appears to be safe in clinical practice. To date, there has been no independently confirmed study to suggest otherwise.”
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“This finding can also lead to inaccurate estimates of fetal age when the BPD is used; in these cases, HC measurements are even more reliable 20,21 .”
What the sources say
- Not checked yetcites [20] 20. Malinger G, Paladini D, Haratz KK, Monteagudo A, Pilu GL, Timor-Tritsch IE. ISUOG Practice Guidelines (updated): sonographic examination of the fetal central nervous system. Part 1: performance of screening examination and indications for targeted neurosonography. Ultrasound Obstet Gynecol 2020; 56 : 476-484. source
- Not checked yetcites [21] 21. Hadlock FP, Deter RL, Carpenter RJ, Park SK. Estimating fetal age: effect of head shape on BPD. AJR Am J Roentgenol 1981; 137 : 83-85. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“A 2005 cost-effectiveness analysis concluded that strategies which include a mid-trimester ultrasound scan result in more abnormalities being detected and have lower costs per anomaly detected 5 .”
What the sources say
- Not checked yetcites [5] 5. Ritchie K, Bradbury I, Slattery J, Wright D, Iqbal K, Penney G. Economic modelling of antenatal screening and ultrasound scanning programmes for identification of fetal abnormalities. BJOG 2005; 112 : 866-874. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Technical improvements in modern ultrasound machines have reduced the beam width, which has affected fetal measurements in the lateral direction 23 .”
What the sources say
- Not checked yetcites [23] 23. Økland I, Bj˚ astad TG, Johansen TF, Gjessing HK, Grøttum P, Eik-Nes SH. Narrowed beam width in newer ultrasound machines shortens measurements in the lateral direction: fetal measurement charts may be obsolete. Ultrasound Obstet Gynecol 2011; 38 : 82-87. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Observational evidence comparing ultrasound with dye-determination of amniotic fluid volume has shown that DVP may be superior for identifying oligohydramnios and the AFI superior for identifying polyhydramnios 39 .”
What the sources say
- Not checked yetcites [39] 39. Hughes DS, Magann EF, Whittington JR, Wendel MP, Sandlin AT, Ounpraseuth ST. Accuracy of the Ultrasound Estimate of the Amniotic Fluid Volume (Amniotic Fluid Index and Single Deepest Pocket) to Identify Actual Low, Normal, and High Amniotic Fluid Volumes as Determined by Quantile Regression. J Ultrasound Med 2020; 39 : 373-378. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A renal pelvis ≥ 7mm indicates a need for reassessment in the third trimester 80,81 .”
What the sources say
- Not checked yetcites [80] 80. Sairam S, Al-Habib A, Sasson S, Thilaganathan B. Natural history of fetal hydronephrosis diagnosed on mid-trimester ultrasound. Ultrasound Obstet Gynecol 2001; 17 : 191-196. source
- Not checked yetcites [81] 81. Nguyen HT, Benson CB, Bromley B, Campbell JB, Chow J, Coleman B, Cooper C, Crino J, Darge K, Herndon CDA, Odibo AO, Somers MJG, Stein DR. Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system). J Pediatr Urol 2014; 10 : 982-998. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“however, chorionicity is better evaluated before 14-15weeks, when the lambda sign or T-sign can be determined;”
What the sources say
- Not checked yetcites [54] 54. ISUOG Practice Guidelines: role of ultrasound in twin pregnancy. Ultrasound Obstet Gynecol 2016; 47 : 247-263. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Estimated fetal weight (EFW) or AC can be used as a baseline parameter for the detection of subsequent growth problems 26 .”
What the sources say
- Not checked yetcites [26] 26. McCowan LM, Figueras F, Anderson NH. Evidence-based national guidelines for the management of suspected fetal growth restriction: comparison, consensus, and controversy. Am J Obstet Gynecol 2018; 218 (2S): S855-S868. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“However, it appears that AFI identifies more women as having oligohydramnios than does DVP, thereby increasing the rate of labor induction, but without improving the clinical outcome 37,38 .”
What the sources say
- Not checked yetcites [37] 37. Magann EF, Chauhan SP, Doherty DA, Magann MI, Morrison JC. The evidence for abandoning the amniotic fluid index in favor of the single deepest pocket. Am J Perinatol 2007; 24 : 549-555. source
- Not checked yetcites [38] 38. Kehl S, Schelkle A, Thomas A, Puhl A, Meqdad K, Tuschy B, Berlit S, Weiss C, Bayer C, Heimrich J, Dammer U, Raabe E, Winkler M, Faschingbauer F, Beckmann MW, S¨ utterlin M. Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial): a multicenter, open-label, randomized controlled trial. Ultrasound Obstet Gynecol 2016; 47 : 674-679. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Both AFI and DVP correlate poorly with the actual dye-calculated volume of amniotic fluid, and neither of them appears significantly better than the other 37 .”
What the sources say
- Not checked yetcites [37] 37. Magann EF, Chauhan SP, Doherty DA, Magann MI, Morrison JC. The evidence for abandoning the amniotic fluid index in favor of the single deepest pocket. Am J Perinatol 2007; 24 : 549-555. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“SUA is associated with congenital anomalies and FGR 49 , although it does not constitute an anomaly per se .”
What the sources say
- Not checked yetcites [49] 49. Hasegawa J. Ultrasound screening of umbilical cord abnormalities and delivery management. Placenta 2018; 62 : 66-78. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Two axial planes, commonly referred to as the transventricular and transthalamic planes, permit visualization of the cerebral structures relevant to the anatomical integrity of the brain (Figure 2).”
What the sources say
- Not checked yetcites [20] 20. Malinger G, Paladini D, Haratz KK, Monteagudo A, Pilu GL, Timor-Tritsch IE. ISUOG Practice Guidelines (updated): sonographic examination of the fetal central nervous system. Part 1: performance of screening examination and indications for targeted neurosonography. Ultrasound Obstet Gynecol 2020; 56 : 476-484. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Single umbilical artery (SUA) is the result of obliteration or atrophy of one of the arteries, most commonly the left 48 .”
What the sources say
- Not checked yetcites [48] 48. Santillan M, Santillan D, Fleener D, Stegmann B, Zamba G, Hunter S, Yankowitz J. Single umbilical artery: Does side matter? Fetal Diagn Ther 2012; 32 : 201-208. source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“reporting of distinguishing features (gender, unique markers, position in uterus), as it is critical to label twins correctly 55 .”
What the sources say
- Not checked yetcites [55] 55. Dias T, Arcangeli T, Bhide A, Napolitano R, Mahsud-Dornan S, Thilaganathan B. First-trimester ultrasound determination of chorionicity in twin pregnancy. Ultrasound Obstet Gynecol 2011; 38 : 530-532. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“There is insufficient evidence to support universal use of uterine or umbilical artery pulsed Doppler evaluation for the screening of low-risk pregnancies 53 .”
What the sources say
- Not checked yetcites [53] 53. Alfirevic Z, Stampalija T, Medley N. Fetal and umbilical Doppler ultrasound in normal pregnancy. Cochrane Database Syst Rev 2015; ( 4 ): CD001450. source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“The insertion of the umbilical cord is in the center of the placenta in about 80% of cases, paracentral in about 12% of cases and marginal (within 2 cm of the placental edge) in 5-8% of cases. Velamentous insertion occurs in approximately 1% of cases, and is defined as insertion of the umbilical vessels within the amniotic membranes instead of the placenta 46 .”
What the sources say
- Not checked yetcites [46] 46. Padula F, Lagan` a AS, Vitale SG, Mangiafico L, D'Emidio L, Cignini P, Giorlandino M, Gulino FA, Capriglione S, Giorlandino C. Ultrasonographic evaluation of placental cord insertion at different gestational ages in low-risk singleton pregnancies: a predictive algorithm. Facts Views Vis ObGyn 2016; 8 : 3-7.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Amniotic sheets are benign findings, to be distinguished from amniotic bands which may cause fetal deformities 40-42 .”
What the sources say
- Not checked yetcites [40] 40. Ples ¸ L, Sima RM, Moisei C, Moga MA, Dracea L. Abnormal ultrasound appearance of the amniotic membranes - diagnostic and significance: a pictorial essay. Med Ultrason 2017; 19 : 211-215. source
- Not checked yetcites [41] 41. Shetty P, Menezes LT, Tauro LF, Diddigi KA. Amniotic band syndrome. Indian J Surg 2013; 75 : 401-402. source
- Not checked yetcites [42] 42. Society for Maternal-Fetal Medicine,Gandhi M, Rac MWF, McKinney J. Amniotic Band Sequence. Am J Obstet Gynecol 2019; 221 : B5-B6. source
Strength:plain· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Fetal cardiac screening is performed for the detection of congenital heart disease during the mid-trimester scan (Figure 4) 71 .”
What the sources say
- Not checked yetcites [71] 71. International Society of Ultrasound in Obstetrics and Gynecology,Carvalho JS, Allan LD, Chaoui R, Copel JA, DeVore GR, Hecher K, Lee W, Munoz H, Paladini D, Tutschek B, Yagel S. ISUOG Practice Guidelines (updated): sonographic screening examination of the fetal heart. Ultrasound Obstet Gynecol 2013; 41 : 348-359. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“The biophysical profile is not considered part of the routine mid-trimester scan 45 .”
What the sources say
- Not checked yetcites [45] 45. Manning FA. Fetal biophysical profile. Obstet Gynecol Clin North Am 1999; 26 : 557-577. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Both lungs should appear homogeneous and without evidence of mediastinal shift or masses 68 .”
What the sources say
- Not checked yetcites [68] 68. Delacourt C, Bertille N, Salomon LJ, Benachi A, Henry E, Massardier J, Mottet N, Rosenblatt J, Sartor A, Thong-Vanh C, Valat-Rigot AS, Winer N, Lelong N, Khoshnood B, for the Prenatal MALFPULM Study Group, Alanio E, Bory J -P., Aquilue LN, Choupeaux L, Hauw C, Banaszkiewicz N, Bertorello S, Lebouar G, Biquard F, Sentilhes L, Bonfiglioli V, Carbillon L, Bonnard A, Bremont F, Bultez T, Roth P, Stirnemann J, Ville Y, Castaigne V, Touboul C, Coatleven F, Mangione R, Darras A -M., Guilbaud L, Jouannic J-M., Dazel-Salonne C, Ducoin H, Dugue-Marechaud M, Goua V, Eszto-Cambon M-L., Fange C, Prieur source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“prenatal knowledge of vasa previa significantly increases survival and decreases perinatal morbidity 96 .”
What the sources say
- Not checked yetcites [96] 96. Zhang W, Geris S, Al-Emara N, Ramadan G, Sotiriadis A, Akolekar R. Perinatal outcome of pregnancies with prenatal diagnosis of vasa previa: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2021; 57 : 710-719. source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“For these reasons, transvaginal ultrasound CL measurement is commonly recommended in the general population 104-106 .”
What the sources say
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Several medical societies recommend serial transvaginal sonographic CL measurement at 16-23 weeks in this population 104,105,108,109 .”
What the sources say
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The shape of the thorax should be regular, with a smooth transition to the abdomen 67 .”
What the sources say
- Not checked yetcites [67] 67. Azouz EM, Teebi AS, Eydoux P, Chen MF, Fassier F. Bone dysplasias: an introduction. Can Assoc Radiol J 1998; 49 : 105-109.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“There is, however, ongoing debate regarding whether routine screening for velamentous cord insertion and/or vasa previa should be performed at the mid-trimester scan; the evidence is of limited quality and fails to take into account the consequences of over-diagnosing such anomalies 47,88 .”
What the sources say
- Not checked yetcites [47] 47. Buchanan-Hughes A, Bobrowska A, Visintin C, Attilakos G, Marshall J. Velamentous cord insertion: results from a rapid review of incidence, risk factors, adverse outcomes and screening. Syst Rev 2020; 9 : 147. source
- Not checked yetcites [88] 88. Jauniaux E, Alfirevic Z, Bhide AG, Burton GJ, Collins SL, Silver R, Royal College of Obstetricians and Gynaecologists. Vasa Praevia: Diagnosis and Management: Green-top Guideline No. 27b. BJOG 2019; 126 : e49-e61. source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Other views of the fetal spine may identify other spinal malformations, including vertebral anomalies and sacral agenesis 20 .”
What the sources say
- Not checked yetcites [20] 20. Malinger G, Paladini D, Haratz KK, Monteagudo A, Pilu GL, Timor-Tritsch IE. ISUOG Practice Guidelines (updated): sonographic examination of the fetal central nervous system. Part 1: performance of screening examination and indications for targeted neurosonography. Ultrasound Obstet Gynecol 2020; 56 : 476-484. source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
There are significant differences in detection rates between centers and between operators.
“However, there are significant differences in detection rates between centers and between operators.”
The paper relies on this without support.
The mid-trimester fetal ultrasound scan serves as a baseline against which later scans can be compared for the evaluation of fetal growth.
“The mid-trimester fetal ultrasound scan also serves as a baseline against which later scans can be compared for the evaluation of fetal growth.”
The paper relies on this without support.
Most countries offer one mid-trimester scan as part of routine prenatal care.
“Most countries offer one mid-trimester scan as part of routine prenatal care.”
The paper relies on this without support.
Abnormal head shape can be associated with syndromes or be the result of oligohydramnios or breech presentation.
“Abnormal head shape (e.g. brachycephaly or dolichocephaly) can be associated with syndromes or be the result of oligohydramnios or breech presentation.”
The paper relies on this without support.
The degree of deviation from normal at mid-trimester that would justify action has not been established.
“However, the degree of deviation from normal at this early stage of pregnancy that would justify action (e.g. follow-up scan to assess fetal growth or fetal chromosomal analysis) has not been established.”
The paper relies on this without support.
From 16 weeks onwards, the amnion and chorion are usually fused.
“From 16weeks onwards, the amnion and chorion are usually fused.”
The paper relies on this without support.
Normal fetuses typically have a neutral position and show regular movements.
“Normal fetuses typically have a neutral position and show regular movements.”
The paper relies on this without support.
A velamentous cord insertion may be associated with vasa previa and fetal growth restriction.
“A velamentous cord insertion may be associated with vasa previa and FGR.”
The paper relies on this without support.
Single umbilical artery is more frequent in twin pregnancy.
“It is more frequent in twin pregnancy.”
The paper relies on this without support.
Rarely, brain tissue can extrude through defects, for example, of the frontal or occipital bones.
“Rarely, brain tissue can extrude through defects, for example, of the frontal or occipital bones.”
The paper relies on this without support.
Normally, high skull density manifests as a continuous echogenic structure that is interrupted only by cranial sutures in specific anatomical locations.
“normally, high skull density manifests as a continuous echogenic structure that is interrupted only by cranial sutures in specific anatomical locations.”
The paper relies on this without support.
Vasa previa is found in approximately 0.5 per 1000 pregnancies in the general population.
“Vasa previa, defined as unprotected fetal vessels running through the fetal membranes, over or within 2 cm of the internal cervical os, is found in approximately 0.5 per 1000 pregnancies in the general population.”
The paper relies on this without support.
The neck normally appears as cylindrical, with no protuberances, masses or fluid collections.
“The neck normally appears as cylindrical, with no protuberances, masses or fluid collections.”
The paper relies on this without support.
A normal, regular heart rate typically ranges from 120 to 160 bpm.
“A normal, regular heart rate typically ranges from 120 to 160 bpm.”
The paper relies on this without support.
The heart is positioned in the left chest (as is the fetal stomach) if the situs is normal.
“The heart is positioned in the left chest (as is the fetal stomach) if the situs is normal.”
The paper relies on this without support.
A normal heart is usually no larger than one-third of the area of the chest and is without pericardial effusion.
“A normal heart is usually no larger than one-third of the area of the chest and is without pericardial effusion.”
The paper relies on this without support.
Normal-appearing great vessels are approximately equal in size and should cross each other as they exit their respective ventricular chambers.
“Normal-appearing great vessels are approximately equal in size and should cross each other as they exit their respective ventricular chambers (Figure 4b,c).”
The paper relies on this without support.
Routine assessment of the cardiac outflow tracts in addition to the four-chamber view increases the screening performance for identifying conotruncal anomalies, such as tetralogy of Fallot, transposition of the great arteries, double-outlet right ventricle and truncus arteriosus communis.
“Routine assessment of the cardiac outflow tracts in addition to the four-chamber view increases the screening performance for identifying conotruncal anomalies, such as tetralogy of Fallot, transposition of the great arteries, double-outlet right ventricle and truncus arteriosus communis.”
The paper relies on this without support.
The fetal stomach should be clearly visible in its normal position on the left side and should occupy about one-third of the left half of the transverse section of the fetal abdomen used for AC measurement.
“The fetal stomach should be clearly visible in its normal position on the left side and should occupy about one-third of the left half of the transverse section of the fetal abdomen used for AC measurement.”
The paper relies on this without support.
An abnormal location of any of the stomach, umbilical vein and gallbladder may be associated with a congenital anomaly (e.g. persistent right umbilical vein, heterotaxy, portohepatic shunt).
“An abnormal location of any of these structures may be associated with a congenital anomaly (e.g. persistent right umbilical vein, heterotaxy, portohepatic shunt).”
The paper relies on this without support.
The bowel should be contained within the abdomen.
“The bowel should be contained within the abdomen.”
The paper relies on this without support.
The fetal bladder should not reach the level of the umbilical cord insertion.
“The fetal bladder should not reach the level of the umbilical cord insertion.”
The paper relies on this without support.
A satisfactory examination of the fetal spine requires expertise and meticulous scanning, and the results are very dependent upon fetal position.
“A satisfactory examination of the fetal spine requires expertise and meticulous scanning, and the results are very dependent upon fetal position.”
The paper relies on this without support.
In most cases, in the routine mid-trimester examination, transabdominal ultrasonography permits clear definition of the relationship between the placenta and the internal cervical os.
“In most cases, in the routine mid-trimester examination, transabdominal ultrasonography permits clear definition of the relationship between the placenta and the internal cervical os.”
The paper relies on this without support.
Women with a history of uterine surgery and low anterior placenta or placenta previa are at risk for placenta accreta spectrum disorders.
“Women with a history of uterine surgery and low anterior placenta or placenta previa are at risk for placenta accreta spectrum disorders.”
The paper relies on this without support.
Not all medical practices may have sufficient experience in transvaginal sonography or the resources for proper disinfection procedures.
“Furthermore, not all medical practices may have sufficient experience in transvaginal sonography or the resources for proper disinfection procedures.”
The paper relies on this without support.
Examples of abnormal placental findings include the presence of hemorrhage, multiple anechoic cysts (distinct from normal lacunae) in triploidy, and placental masses, such as chorioangioma.
“Examples of abnormal placental findings include the presence of hemorrhage, multiple anechoic cysts (distinct from normal lacunae) in triploidy, and placental masses, such as chorioangioma.”
The paper relies on this without support.
The ribs should have normal curvature, without deformity.
“The ribs should have normal curvature, without deformity.”
Claims other papers make about this one
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The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Systematic evaluation of fetal anatomy during this period allows for the identification of major structural anomalies, although until recently basic fetal anatomical assessments were primarily performed during the second trimester, which served as the gold standard [4].”
From First-Trimester Ultrasound: A Comparative Review of Guidelines (2026) · cites this paper as [4]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Systematic evaluation of fetal anatomy during this period allows for the identification of major structural anomalies, although until recently basic fetal anatomical assessments were primarily performed during the second trimester, which served as the gold standard [4].”
From First-Trimester Ultrasound: A Comparative Review of Guidelines (2026) · cites this paper as [4]
Experimental — accuracy not yet measuredIn the citing paper
“Such scanning guidelines comprise typically a checklist of standard planes, structures and anatomies to be surveyed, but do not dictate the order in which the checklist should be populated.”
From Clinical workflow of sonographers performing fetal anomaly ultrasound scans: Deep-learning-based analysis (2022) · cites this paper as [9]
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Self-citationFinal outcome of a second trimester low-positioned placenta: A systematic review and meta-analysis
Jansen, C. H. J. R., Kleinrouweler, C. E., van Leeuwen, L., Ruiter, L., Limpens, J., van Wely, M., Mol, B. W., & Pajkrt, E. (2019) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2019.06.020 · Cited by 23
Sonographic definition of the fetal situs
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Self-citationCerclage decreases preterm birth: finally the level I evidence is here
Berghella, V. (2011) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2011.02.079 · Cited by 19
Self-citationFrequency and Importance of Incomplete Screening Fetal Anatomic Sonography in Pregnancy
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Incidence of Fetal Anomalies After Incomplete Anatomic Surveys Between 16 and 22 Weeks
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Single Umbilical Artery: Does Side Matter?
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Approach to the diagnosis of skeletal dysplasias: Experience at a center with limited resources
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The prenatal ultrasonographic diagnosis of osteogenesis imperfecta lethalis.
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3 of the 115 references couldn’t be matched to a known paper.
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ISUOG Practice Guidelines (updated): fetal cardiac screening
Carvalho, J. S., Axt-Fliedner, R., Chaoui, R., Copel, J. A., Cuneo, B. F., Goff, D., Kopylov, L. G., Hecher, K., Lee, W., Moon‐Grady, A. J., et al. (2023) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.26224 · Cited by 261
Self-citationA review on deep-learning algorithms for fetal ultrasound-image analysis
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ISUOG Practice Guidelines: role of ultrasound in the prediction of spontaneous preterm birth
Coutinho, C. M., Sotiriadis, A., Odibo, A. O., Khalil, A. A., D'Antonio, F., Feltovich, H. M., Salomon, L. J., Sheehan, P. M., Napolitano, R., Berghella, V., et al. (2022) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.26020 · Cited by 189
Self-citationISUOG Practice Guidelines (updated): performance of fetal magnetic resonance imaging
Prayer, D., Malinger, G., Catte, L. D., Keersmaecker, B. D., Gonçalves, L. F., Kasprian, G. J., Laifer‐Narin, S., Lee, W., Millischer, A., Platt, L. D., et al. (2023) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.26129 · Cited by 141
Self-citationISUOG Practice Guidelines: performance of third‐trimester obstetric ultrasound scan
Khalil, A. A., Sotiriadis, A., D’Antonio, F., Costa, F. D. S., Odibo, A. O., Prefumo, F., Papageorghiou, A. T., & Salomon, L. J. (2024) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.27538 · Cited by 115
Self-citation
Metadata
- Authors
- Salomon, L. J., Alfirevic, Z., Berghella, V., Bilardo, C. M., Chalouhi, G. E., Da Silva Costa, F., Hernandez‐Andrade, E., Malinger, G., Munoz, H., Paladini, D., Prefumo, F., Sotiriadis, A., Toi, A., & Lee, W.
- Affiliations
- Hôpital Necker-Enfants Malades (FR)
- Department of Women's and Children's Health, University of Liverpool Liverpool UK
- Thomas Jefferson University (US)
- University Medical Center Groningen (NL)
- Maternal Fetal Medicine Unit, Gold Coast University Hospital and School of Medicine, Griffith University, Gold Coast Queensland Australia
- The University of Texas Health Science Center at Houston (US)
- Tel Aviv University (IL)
- University of Chile Hospital, Fetal Medicine Unit, Obstetrics & Gynecology Santiago Chile
- Istituto Giannina Gaslini (IT)
- University of Brescia (IT)
- Aristotle University of Thessaloniki (GR)
- Mount Sinai Hospital (CA)
- Baylor College of Medicine (US)
- ORCID
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2022-05-20
- Volume
- 59
- Issue
- 6
- Pages
- 840-856
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- OpenAlex
- W4280616996
- Semantic Scholar
- 3c0a6efe5b25ce7ec618babcfe77b2b4dea02d19
- Cited by
- 436
- References
- 115
- Citations by year
- 2026: 113 · 2025: 131 · 2024: 106 · 2023: 70 · 2022: 14
- FWCI
- 88.01
- Type
- journal article
- Language
- en
- Update notices
- erratum (2022-10-02)
- Open access
- bronze
- doi.org
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Griffith Research Online (submittedVersion, other-oa)
- Funders
- International Society of Ultrasound in Obstetrics and Gynecology
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- second-trimester ultrasound, prenatal ultrasound, best practice recommendations
- MeSH terms
- Female, Gestational Age, Humans, Pregnancy, Pregnancy Trimester, Second, Ultrasonography, Prenatal
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