Herman score in prenatal screening for Down syndrome: Can a junior assess a senior?

Abstract

Purpose: To compare Herman scores self-assessed prospectively during ultrasound first-trimester screening by a single senior radiologist with 15 years of experience, to those obtained retrospectively by an unexperienced junior radiologist.

Materials and methods: Over a 18-month period, a single senior radiologist measured the nuchal translucency thickness along with calculation of Herman scores. An independent junior radiologist subsequently reviewed and scored the images.

Results: A total of 301 patients were included. The mean Herman score was 8.2±0.9 (SD) for the senior radiologist and 7.8±0.9 (SD) after review by the independent junior radiologist (P<0.001). The scores for caliper position and fetal head position decreased significantly after the independent review. The two criteria on which the two operators disagreed the least were visualization of the nuchal translucency and the distinction between neck and amnios.

Conclusion: Herman score is lower after review by a junior radiologist, without any effect on patient's management and follow-up.

Keywords: Herman score; Nuchal translucency; Pregnancy; Trisomy 21.