The Completion Rate of the Mid‐Trimester Fetal Anatomy Scan: A Clinical Audit

Introduction Auditing of imaging examinations for completion and quality assurance purposes is often utilized in diagnostic imaging, comparing the performance of examinations to accepted protocols. Clinical audits of the mid‐trimester anatomy ultrasound (AUS) can identify areas for improvement and training. The aims of this audit were to determine the rate of successful completion of the AUS, determine the causes of incomplete AUS, and identify commonly unobtained views. Methods Retrospective chart review of AUS reports completed between August 2022–July 2024 at a specialized obstetric/gynecology center. Outcomes assessed included AUS duration, completion, reported limitations, incomplete anatomical views, and practitioner experience. Descriptive statistics were used for categorical variables and Chi‐square tests for independence and goodness‐of‐fit assessed for associations between variables. Results Of the 1080 AUS analyzed, based on physician report, 520/1080 (48.1%) were reported as complete. Gestational age > 19 weeks and increased sonographer experience resulted in increased completion rate (CR). Reasons for incomplete scans included fetal position and maternal habitus. The views most frequently missed were cardiac views and skeletal elements. Conclusion This audit demonstrated 48.1% of AUS were completed. Scheduling the AUS after 19 weeks' gestation may improve CR. Sonographer training in fetal cardiac and skeletal imaging should be considered with the inclusion of cine clips to better demonstrate fetal anatomy. Auditing AUS CR may benefit all ultrasound departments, enabling identification of causes of incomplete AUS, helping to improve efficiency and potentially reduce the need for repeat scans. Improved CR may limit expectant parent anxiety and decrease the cost of repeat scans on health care resources.