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Routine use of prenatal ultrasound wasteful.

The routine use of prenatal ultrasound screening does not improve the outcome of pregnancies for low-risk women, according to the results of a study of 1,530 low-risk pregnancies. Excessive screening could be wasting more than $1 billion per year. The study, the results of which were published in the September 16, 1993, issue of the New England Journal of Medicine and widely reported in the national media, was the largest ever conducted on prenatal ultrasound screening.

The authors of the study concluded that ultrasound should be used more selectively. Women who received routine ultrasound at 15 to 22 weeks gestation and again at 31 to 35 weeks (as typically recommended) had the same rate of early deliveries and low-weight babies as women who received no ultrasound screening. Both groups also had a 5 percent rate of fetal defects at birth. All the women studied had no indications of complication in their pregnancies. The investigators estimate that about $500 million could be saved each year if screening were limited to women who are considered to be clearly at risk of complication, a group they placed at about 40 percent of all pregnant women.

Although routine ultrasound detected more defective fetuses at an earlier stage, the researchers said this made no significant difference to the outcome of the pregnancies. More than half of the defects were detected at or after 24 weeks' gestation, when legal abortion is not available in most states. Most women in whom fetal abnormalities were discovered earlier decided to continue their pregnancies. The rate of abortion was roughly the same for both groups.

"The psychology and culture of America is that to do something is to do good, and that is not always the case," said Dr. Frederic D. Frigoletto of Brigham and Women's Hospital in Boston, a co-author of the study. "This is an example of some of the unnecessary testing that is driving up our health care costs," remarked Dr. Bernard B. Ewigman of the University of Missouri at Columbia, the lead investigator of the national study, at a news briefing.

The six-year, $7 million study was conducted with women at 109 obstetrical and family practices in six states.
COPYRIGHT 1993 Association of Labor Assistants & Childbirth Educators
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1993, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Publication:Special Delivery
Date:Sep 22, 1993
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