OnMedica – News – Extra routine ultrasounds benefit mothers and babies

An additional routine ultrasound could eliminate the presentation of undiagnosed siege and reduce emergency cesarean section

Providing Universal End-of-Pregnancy Ultrasound at 36 weeks would be beneficial for mothers and babies and would save money, according to research * published in Plos Medicine suggests.

The study revealed that such an additional routine ultrasound could eliminate the presentation of the seat by the undiagnosed seat, reduce the rate of emergency cesarean section and improve the health of mothers and babies.

The research team performed screening ultrasounds at 36 weeks of gestation in 3,879 pregnant women for the first time in England. A total of 179 women (4.6%) were diagnosed with a CT scan and in more than half of these cases (55%), there was no previous suspicion that the baby was in a siege position. Currently, midwives and doctors are trying to detect births by the seat by feeling the bump of the pregnant mother to badess the position of the baby.

The detection of the seat position at 36 weeks allowed the women to opt for an attempt to transform the baby, called the external cephalic version (ECV). For women who refused this procedure or who failed, a planned caesarean section was organized.

None of the women chose to attempt badl birth by birth, which is known to be badociated with an increased risk of complications, particularly during the first pregnancy.

Dr. Ed Wilson, of the Health Economics Group at Norwich Medical School, said: "We estimate that a routine check in the UK could avoid about 15,000 undiagnosed siege presentations, more than 4,000 emergency caesareans and between 7 and 8 babies a year.

"We also looked at the costs of the additional badyzes and found that if the badyzes could be done at less than £ 12.90 each, this could be a saving for the NHS.

"If ultrasound screening could be offered at such a low cost, for example by integrating it into a standard midwifery appointment, consistently offering ultrasound scans might well represent a wise use of NHS resources. "

Professor Andrew Shennan, a professor of obstetrics at King's College London, said: "The breech can be difficult to handle during work if it was previously unsuspected because the work can be fast."

He added: "Analyzes are currently available routinely and minimal skills are needed to determine the layout of the headquarters. This should be implemented. "

Professor Jean Golding, emeritus professor of pediatric and perinatal epidemiology at the University of Bristol, said that one of the main advantages of early detection of panties is the ability to change the presentation of the baby with the help of a procedure called ECV. However, she noted that the ECV had a low success rate in the study, asking whether current obstetricians were sufficiently trained in the procedure.

"Although the current opinion is that a baby at full-term birth should be delivered by caesarean section, it is not a benign procedure, and there are consequences to long term for the mother (eg, increased risk of endometriosis) and for the child (increased risk of obesity even in adulthood), "she said .

* Wastlund D, Moraitis AA, Dacey A, et al. Screening of the presentation of the seat by universal ultrasound at the end of pregnancy: a prospective cohort study and a cost-effectiveness badysis. PLoS. Posted: April 16, 2019. DOI: 10.1371 / journal.pmed.1002778