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Accuracy of qualitative and quantitative cranial ultrasonographic markers in first‐trimester screening for open spina bifida and other posterior brain defects: a systematic review and meta‐analysis

Abstract : Background: The significant number of qualitative and quantitative ultrasound markers described for first-trimester screening of open spina bifida (OSB) and other posterior brain defects (oPBD) has resulted in their complex implementation and interpretation for a widespread screening and in a lack of consensus regarding diagnostic accuracy. Objectives: To assess and compare the accuracy of qualitative and quantitative cranial sonographic markers at 11-14 weeks of gestation for the detection of OSB and oPBD. Search strategy: A systematic literature search was performed in MEDLINE and COCHRANE from 2009 to April 2020. Selection criteria: Studies assessing the diagnostic accuracy of quantitative and/or qualitative ultrasound signs to predict OSB and oPBD were included. Cohort studies and case-control studies were also considered. Data collection and analysis: Two reviewers independently extracted data and assessed the risk of bias. The overall pooled estimate and a summary receiver operating characteristic curve was estimated for each subgroup (qualitative and quantitative assessment). Main results: Twenty-three studies were included in our meta-analysis. The pooled sensitivity and specificity for qualitative assessment were 76.5% and 99.6%, and for quantitative assessment were 84.5% and 96.3%, respectively; specificity for the qualitative ultrasound signs was significantly higher (P = 0.001). The overall sensitivity of cranial sonographic markers for the screening of oPBD was 76.7% and specificity was 97.5%. Conclusions: The qualitative approach demonstrated greater specificity, so this would appear to be more appropriate for daily screening, as a first-line tool, whereas the quantitative approach should be reserved for expert ultrasound. Tweetable abstract: This study highlights the relevance of first-trimester qualitative ultrasound signs in the screening of open spina bifida.
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https://www.hal.inserm.fr/inserm-03106238
Contributor : Christine Dupuis <>
Submitted on : Monday, January 11, 2021 - 4:24:44 PM
Last modification on : Wednesday, January 13, 2021 - 3:35:06 AM
Long-term archiving on: : Monday, April 12, 2021 - 7:12:11 PM

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P Mace, J Mancini, G Gorincour, E Quarello. Accuracy of qualitative and quantitative cranial ultrasonographic markers in first‐trimester screening for open spina bifida and other posterior brain defects: a systematic review and meta‐analysis. BJOG: An International Journal of Obstetrics and Gynaecology, Wiley, 2021, 128 (2), pp.354-365. ⟨10.1111/1471-0528.16530⟩. ⟨inserm-03106238⟩

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