Fetal Review Clinical Sources

1.  First and Second Trimester Screening for Fetal Structural Anomalies  (2017)

The RADIUS study — a randomised trial of more than 15,000 women — found a 2.7× higher fetal anomaly detection rate in tertiary centres compared to non-tertiary settings (95% CI: 1.3–5.8).

Citation: ScienceDirect — Best Practice & Research Clinical Obstetrics & Gynaecology, December 2017

Link: https://www.sciencedirect.com/science/article/abs/pii/S1744165X17301361

2.  Prenatal Diagnosis of Congenital Anomalies  (2011)

Sensitivity for detectable fetal malformations was 35% at tertiary facilities compared to 13% at community hospitals, indicating that operator experience and training are key determinants of detection.

Citation: PMC / NIH — Todros et al.

Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC3232499/

3.  The Fetal Anomaly Screening Scan: An International Perspective  (2024)

Confirmed 2.7× higher detection in tertiary vs non-tertiary settings. Overall detection rates for major structural malformations range from 15% to over 90% depending on care setting and scanning protocol.

Citation: ScienceDirect — Best Practice & Research Clinical Obstetrics & Gynaecology, May 2024

Link: https://www.sciencedirect.com/science/article/abs/pii/S1751721424000782

Suboptimal image quality can limit anomaly detection

4.  FDA Clears Sonio Suspect AI for Fetal Anomaly Detection  (2025)

Poor image quality has been linked to 49% of missed fetal anomaly cases, and misinterpretation to 31%. Data cited in the context of FDA clearance for an AI fetal anomaly detection system.

Citation: Contemporary OB/GYN, 2025

Link: https://www.contemporaryobgyn.net/view/fda-clears-sonio-suspect-ai-for-fetal-anomaly-detection

5.  Effect of Increased Maternal Body Habitus on Image Quality and Fetal Anomaly Detection  (2019)

Suboptimal ultrasound visualisation increases with larger maternal body habitus, resulting in incomplete scans, repeat examinations, and misdiagnosis of fetal anomalies at the 18–20 week morphology scan.

Citation: Hennig et al. — Sonography (Wiley), 2019

Link: https://onlinelibrary.wiley.com/doi/abs/10.1002/sono.12202

6.  Enhancing Fetal Anomaly Detection in Ultrasonography Images: A Review of ML-Based Approaches  (2023)

Image quality can be impaired by maternal body environment, fetal position, bone shadowing, and low amniotic fluid. Poor image quality and lack of discrete edges can lead to inaccurate prenatal diagnosis.

Citation: Abdelrahim et al. — MDPI Biomimetics, November 2023

Link: https://www.mdpi.com/2313-7673/8/7/519

Additional context

7.  Impact of First-Trimester Ultrasound on Early Detection of Major Fetal Anomalies  (2025)

A nationwide study of over 1 million pregnancies in England found substantial variation in anomaly screening across care settings — 100% first-trimester anatomy assessment at tertiary centres vs 69% at district general hospitals.

Citation: PLOS Medicine, November 2025

Link: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004709

8.  Detection of Fetal Abnormalities by Second-Trimester Ultrasound Screening in a Non-Selected Population  (2017)

In a non-selected population, overall sensitivity for prenatal detection of fetal abnormalities was 44.0% (95% CI: 37.8–50.2), with significant variation between hospital types.

Citation: Rydberg et al. — Acta Obstetricia et Gynecologica Scandinavica (Wiley), 2017

Link: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.13037