. To determine how many ultrasound examinations are performed during pregnancy in the European countries, at what stage, by which method
. To provide information on European countries having a policy for ultrasound scanning during pregnancy and what is this policy
. To evaluate the effectiveness and the efficiency of ultrasound scanning during gestation and its effect on the fetal outcome.
Major congenital anomalies occur in 3 % of all newborn. They are becoming the most important cause of perinatal mortality (about a quarter of all perinatal deaths) in the countries of Europe and, after prematurity, the second cause of infant morbidity. Primary and tertiary prevention are at present limited. Regarding secondary prevention research is needed to determine how an optimal provision of prenatal diagnosis and use of services can be achieved. Prenatal diagnosis of chromosomal abnormalities and neonatal screening of metabolic defects are now performed in almost all European countries following well known policies, but they are able to prevent only around three per cent of all congenital anomalies. Therefore other methods of prenatal diagnosis are needed ; among them ultrasound examination of the fetus is now a routine part of antenatal care in many countries in Europe. How many fetal anomalies are actually detected by these procedures ? Registries of congenital anomalies can be used to answer this question. Several benefits can be obtained from ultrasound screening programmes. These are both medical and financial. Informed parents are prepared for problems to come, and appropriate delivery sites can be arranged where necessary. Antenatal diagnosis can reduce the number of postnatal investigations and hopefully, avoid a late clinical presentation. In the case of severe disabling conditions cordocentesis can be performed and the fetus be treated if appropriate. It also gives the parents the benefit of expert knowledge of rare conditions, allow further counselling, and helps parents to realise that they are not alone in having a fetus with an abnormality. Data from various countries and areas of Europe with differing policies will be quantified and compared in terms of prevalence, using previously calculated trends as baselines. Since the birth defects registries participating to the study represent all countries of European Union, we will be in a strong position to evaluate the effectiveness of prenatal screening.