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Schiermeier S, von Kaisenberg CS, Kehl S, Reister F, Mosimann B, Reif P, Harlfinger W, König K, Schwarz C, Matern E, Kühnert M, Schmitz R, Hoopmann M, Ramsell A, Kalberer BS, Heule PG, Heinzl S, Kayer B, Gruber P, Steiner H, Schäffer L. Fetal Assessment in Pregnancy (Indication and Methodology for Fetal Monitoring in a low-risk Population). Guideline of the DGGG, DEGUM, OEGGG and SGGG (S3-Level, AWMF Registry No. 015/089, February 2023). ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2024; 45:147-167. [PMID: 37582399 DOI: 10.1055/a-2113-7638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
PURPOSE The aim of this guideline was to find evidence on whether carrying out Doppler examinations and CTGs in low-risk cohorts of pregnant women improves outcomes. METHODS First, a systematic search for guidelines was carried out. Identified guidelines were evaluated using the DELPHI instrument of the AWMF. Three guidelines were found to be suitable to evaluate CTG. Two DEGUM best practice guidelines were judged suitable to describe the methods. All studies on this issue were additionally analyzed using 8 PICO questions. A structured consensus of the participating professional societies was achieved using a nominal group process and a structured consensus conference moderated by an independent moderator. RECOMMENDATIONS No antepartum Doppler sonography examinations should be carried out in low-risk cohorts in the context of antenatal care. No antepartum CTG should be carried out in low-risk cohorts. NOTE: The guideline will be published simultaneously in the official journals of both professional societies (i. e., Geburtshilfe und Frauenheilkunde for the DGGG and Ultraschall in der Medizin/European Journal of Ultrasound for the DEGUM).
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Affiliation(s)
- Sven Schiermeier
- Lehrstuhl für Frauenheilkunde und Geburtshilfe der Universität Witten/Herdecke, Marien-Hospital Witten, Witten, Germany
| | | | - Sven Kehl
- Gynecology and Obstetrics, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Frank Reister
- Sektion Geburtshilfe, Univ.-Frauenklinik, Univ.-Klinikum Ulm, Ulm, Germany
| | - Beatrice Mosimann
- University Women's Hospital, Department of Obstetrics, Inselspital, Bern, Switzerland
| | - Philipp Reif
- Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | | | - Klaus König
- Berufsverband der Frauenärzte, Eschborn, Germany
| | - Christiane Schwarz
- Institute of Health Sciences, Department of Midwifery Science, Universität zu Lübeck, Lübeck, Germany
| | - Elke Matern
- Medical Department, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Maritta Kühnert
- Geburtshilfe, Philipps-Universität Marburg, Marburg, Germany
| | - Ralf Schmitz
- Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| | - Markus Hoopmann
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | | | | | | | | | - Beate Kayer
- Österreichisches Hebammengremium, Wien, Austria
| | | | - Horst Steiner
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Landeskrankenhaus Salzburg, Paracelsus, Salzburg, Austria
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Merz E. Passing of the baton. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2023; 44:579-581. [PMID: 38048781 DOI: 10.1055/a-2180-6817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
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Sun H, Wu A, Lu M, Cao S. Liability, risks, and recommendations for ultrasound use in the diagnosis of obstetrics diseases. Heliyon 2023; 9:e21829. [PMID: 38045126 PMCID: PMC10692788 DOI: 10.1016/j.heliyon.2023.e21829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
This literature review will summarize the liability issues, risks, and ultrasound recommendations for diagnosing obstetrics diseases. One liability issue is related to misdiagnosis or failure to detect abnormalities during an ultrasound examination. Ultrasound images can be subjective interpretations, and errors may occur due to factors such as operator skill, equipment limitations, or fetal positioning. Another liability concern is related to the potential adverse effects of ultrasound exposure on both the mother and fetus. While extensive research has shown that diagnostic ultrasound is generally safe when used appropriately, there are still uncertainties regarding long-term effects. Some studies suggest a possible association between prolonged or excessive exposure to ultrasound waves and adverse outcomes such as low birth weight, developmental delays, or hearing impairment. Additionally, obtaining informed consent from patients is crucial in mitigating liability risks. Patients should be informed about the purpose of the ultrasound examination, its benefits, limitations, potential risks (even if minimal), and any alternative diagnostic options available. This ensures that patients know the procedure and can make informed decisions about their healthcare. Proper documentation helps establish a clear record of the care provided and can serve as evidence in any legal disputes.
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Affiliation(s)
- Haiting Sun
- Department of Ultrasound, The Affiliated Xiangshan Hospital of Wenzhou Medical University, Ningbo, 315700, Zhejiang Province, PR China
| | - An Wu
- Department of Ultrasound, The Affiliated Xiangshan Hospital of Wenzhou Medical University, Ningbo, 315700, Zhejiang Province, PR China
| | - Minli Lu
- Department of Ultrasound, The Affiliated Xiangshan Hospital of Wenzhou Medical University, Ningbo, 315700, Zhejiang Province, PR China
| | - Shan Cao
- Department of Obstetrics, The Affiliated Second People's Hospital of Yuhang District, Hangzhou City, Hangzhou, 311100, Zhejiang Province, PR China
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Schiermeier S, von Kaisenberg CS, Kehl S, Reister F, Mosimann B, Reif P, Harlfinger W, König K, Schwarz C, Matern E, Kühnert M, Schmitz R, Hoopmann M, Ramsell A, Kalberer BS, Heule PG, Heinzl S, Kayer B, Gruber P, Steiner H, Schaeffer L. Fetal Assessment in Pregnancy (Indication and Methodology for Fetal Monitoring in a Low-risk Population). Guideline of the DGGG, DEGUM, OEGGG and SGGG (S3-Level, AWMF Registry No. 015/089, February 2023). Geburtshilfe Frauenheilkd 2023; 83:996-1016. [PMID: 37588256 PMCID: PMC10427199 DOI: 10.1055/a-2096-1182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 08/18/2023] Open
Abstract
Purpose The aim of this guideline was to find evidence on whether carrying out Doppler examinations and CTGs in low-risk cohorts of pregnant women improves outcomes. Methods First, a systematic search for guidelines was carried out. Identified guidelines were evaluated using the DELPHI instrument of the AWMF. Three guidelines were found to be suitable to evaluate CTG. Two DEGUM best practice guidelines were judged suitable to describe the methods. All studies on this issue were additionally analyzed using 8 PICO questions. A structured consensus of the participating professional societies was achieved using a nominal group process and a structured consensus conference moderated by an independent moderator. Recommendations No antepartum Doppler sonography examinations should be carried out in low-risk cohorts in the context of antenatal care. No antepartum CTG should be carried out in low-risk cohorts. Note The guideline will be published simultaneously in the official journals of both professional societies (i.e., Geburtshilfe und Frauenheilkunde for the DGGG and Ultraschall in der Medizin/European Journal of Ultrasound for the DEGUM).
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Affiliation(s)
- Sven Schiermeier
- Lehrstuhl für Frauenheilkunde und Geburtshilfe der Universität Witten/Herdecke, Marien-Hospital Witten, Witten, Germany
| | | | - Sven Kehl
- Gynecology & Obstetrics, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Frank Reister
- Sektion Geburtshilfe, Univ.-Frauenklinik, Univ.-Klinikum Ulm, Ulm, Germany
| | - Beatrice Mosimann
- University Womenʼs Hospital, Department of Obstetrics, Inselspital, Bern, Switzerland
| | - Philipp Reif
- Obstetrics & Gynecology, Medical University of Graz, Graz, Austria
| | | | - Klaus König
- Berufsverband der Frauenärzte, Eschborn, Germany
| | - Christiane Schwarz
- Institute of Health Sciences, Department of Midwifery Science, Universität zu Lübeck, Lübeck, Germany
| | - Elke Matern
- Medical Department, Martin Luther University Halle Wittenberg, Halle, Germany
| | - Maritta Kühnert
- Geburtshilfe, Philipps-Universität Marburg, Marburg, Germany
| | - Ralf Schmitz
- Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| | - Markus Hoopmann
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | | | | | | | | | - Beate Kayer
- Österreichisches Hebammengremium, Wien, Austria
| | | | - Horst Steiner
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Landeskrankenhaus Salzburg, Paracelsus, Salzburg, Austria
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