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The value of adding a universal booking scan to an existing protocol of routine mid‐gestation ultrasound scan
Author(s) -
Poggenpoel Elizabeth J.,
Geerts Lutgart T.G.M.,
Theron Gerhardus B.
Publication year - 2012
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2011.10.027
Subject(s) - medicine , ultrasound , gestation , workload , obstetrics , pregnancy , protocol (science) , radiology , nuclear medicine , alternative medicine , pathology , biology , computer science , genetics , operating system
Objective To compare 2 routine obstetric ultrasound protocols regarding number of clinically relevant events detected and total ultrasound workload. Methods An interventional before‐and‐after study comparing 2 groups of 750 consecutive low‐risk pregnant women was conducted. The 1st group was routinely offered mid‐trimester ultrasound and selective ultrasound examinations for specific indications; the 2nd group was, in addition to this, offered a scan at 1st prenatal visit. Results The groups were comparable at baseline, and 78% underwent booking scan. The expanded protocol showed no improvement in detection of most clinically relevant findings but did detect twins slightly earlier ( P = 0.3) and significantly reduced the number of presumed post‐term deliveries (8.4% vs 13.1%; OR 0.61 [95% CI, 0.41–0.90]). Although more women were scanned at any point or < 24 weeks ( P < 0.001), the increase in women receiving a properly timed fetal anomaly scan was small (60.7% vs 52.3%; P = 0.003). Total ultrasound workload increased by 74%, mainly because of more follow‐up scans (323 vs 122) and more women being scanned for the 1st time > 24 weeks (146 vs 51; P < 0.001). Conclusion The results do not support a policy of routine booking scans and revealed no significant benefit apart from a small reduction in presumed post‐term pregnancies.