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Home Wellness Research Ultrasound Does Ultrasound Improve Perinatal Outcome?

Does Ultrasound Improve Perinatal Outcome?

Sunday, 23 November 2008 14:11
Many clinicians advocate routine ultrasound screening during pregnancy to detect congenital anomalies, multiple-gestation pregnancies, fetal growth disorders, placental abnormalities, and errors in the estimation of gestational age. However, it is not known whether the detection of these conditions through screening leads to interventions that improve perinatal outcome. The rates of preterm delivery and the distribution of birth weights were nearly identical in the two groups. The ultrasonographic detection of congenital anomalies had no effect on perinatal outcome. There were no significant differences between the groups in perinatal outcome in the subgroups of women with post-date pregnancies, multiple-gestation pregnancies, or infants who were small for gestational age. Screening ultrasonography did not improve perinatal outcome as compared with the selective use of ultrasonography on the basis of clinician judgment.

Ewigman BG, Crane JP, Frigoletto FD   Effect of prenatal ultrasound screening on perinatal outcome   N Engl J Med. 1993 (Sep 16);   329 (12):   821-827

Another study from Norway looks at outcomes of antenatal ultrasound diagnosis in thirty-six children with serious congenital problems. It sought to determine how many of the problems were detected by ultrasound before birth, and whether outcomes were better when the problem was known before birth than for babies where the problem was missed on the ultrasound and not seen until after delivery. The women had had an average of five scans, but the average was seven in women who had a problem detected. Only two of eight congenital diaphragmatic hernias were picked up on ultrasound, half the cases of abdominal wall defects (six our of twelve), five of thirteen cases of meningomyelocele and none of the three cases of bladder extroversion.

All thirteen babies with prenatal diagnosis were delivered by cesarean section. Nineteen of the twenty-three with postnatal diagnosis had an uncomplicated vaginal delivery. Those with prenatal diagnosis had shorter gestational age (about two weeks), lower birthweights, and slightly lower Apgar scores. Three out of thirteen (23 percent) died compared with one out of twenty-three (4 percent) of those diagnosed after birth.

AIMS Journal, Vol. 10 No. 2