The accuracy of antenatal ultrasound screening in Malta

Abstract

Introduction: In Malta, antenatal scans may be done either privately or within government-run clinics. This study sought to elucidate the accuracy of said service, with comparison between the private and Division of Health services, along with detection of any trends in scan accuracy.

Method: The performance of the antenatal ultrasound screening service for babies born between the beginning of 2016 and the end of 2018 was analysed using the Malta Congenital Anomalies Registry. The results were also split between cases scanned privately and those scanned with the Division of Health. Chi-square testing was utilised to find out whether a significant difference exists between the private service and the Division of Health service. Chi-for-trend testing was also used to find out whether any significant trends in the accuracy rates existed over time. EUROCAT data collected between 2015 and 2019 allowed the comparison between the number of cases antenatally diagnosed correctly in Malta and in other EUROCAT centres.

Results: The local rate of cases of congenital anomalies not-detected on antenatal ultrasound screening during this period was 62% for scans carried out within the Division of Health and 83.9% for scans carried out in private clinics. Local trends over the three-year period showed an improvement in accuracy rates in detecting isolated syndromes (p=0.05), anomalies of the genito-urinary system (p=0.02) and craniofacial anomalies (p=0.05).

Discussion and conclusions: Scans carried out within the division of health appear to be more accurate than scans performed privately, although Malta’s performance compared to overseas centres appears to be similar.