Background: As with all new diagnostic options in medicine, great hope was placed in the introduction of high-resolution prenatal sonography. Progress tends to carry with it a demanding attitude of higher expectations. Patients and doctors alike may initially overestimate the possibilities of medical advances.
Questions: The question at hand is whether objective criteria can validate a positive influence of prenatal ultrasound on fetal outcome. How should a sonographic routine screening be structured, and what legal aspects need to be taken into consideration?
Material and methods: This is an attempt to survey the heterogeneous pool of internationally published data with regard to these critical questions. Only a rationally devised analysis of possibilities and restrictions of routine prenatal sonography can answer the question of "what--if anything--may be missed?"
Results and conclusions: Screening ultrasound matches sonography on indication. Despite controversial data a discussion of different studies leads to a positive conclusion on the benefits of ultrasound monitoring in pregnant women. Ultrasound-screening has an explicit effect on medical and economic issues as well as on litigation.