Arkansas fetal diagnosis and management: identifying and coordinating care for anomalous fetuses

Abstract

Objective: Describe a novel system of coordinating the identification and management of fetal anomalies in a rural state, where there is a large proportion of impoverished and Medicaid eligible patients, and centralization of the majority of tertiary care resources.

Methods: The Arkansas Fetal Diagnosis and Management program was initiated to coordinate the care of anomalous fetuses. Data from the beginning of the program (2009) to 2013 was collected and analyzed. The data is reported in a descriptive fashion, to report the outcomes of this program. The specific type and number of anomalies diagnosed and managed were tabulated and analyzed.

Results: From 2009 to 2013, data from 1300 pregnancies was collected. From 2009 to 2013, there were 7.9%, 10.9%, 15.0%, 18.6%, and 22.3% of ultrasound referrals with fetal anomalies. The anomalies were grouped by physiologic system, and despite the total numbers increasing each year, the frequency and distribution of anomalies remained constant.

Conclusions: The Arkansas Fetal Diagnosis and Management Program streamlined the coordination of care for pregnancies affected by anomalous fetuses.

• Fetal anomalies
• telemedicine
• tele-ultrasound

Acknowledgements

The authors would like to acknowledge the contribution of the ANGELS Call Center nurses and UAMS Genetics sonographers.

Declaration of interest

The authors have no conflict of interest.