Why (not) do obstetric ultrasound? An observation on uncertainty

Ultrasound for Screening Fetal Malformations— Has 3-D Made a Difference?

Ultrasonography as a universal screening tool augers well for detection of most of in utero congenital abnormalities, particularly with help of color Doppler, 3-D and 4-D scanning. Argument against universal screening is existing anomalies, not detected by USG, manifesting during childhood. Despite many variables of cost and ethics, poorly trained sonographer, it can be ardently stated that a routine scan is warranted for each pregnancy but only if well-performed at the least, level scan II.

Routine ultrasound screening in pregnancy and the children's subsequent growth, vision and hearing

OBJECTIVE

To test a hypothesis of no association between ultrasound exposure in early fetal life and growth or impaired vision or hearing during childhood.

DESIGN

Follow up of eight to nine year old children born to women who participated in a randomised controlled trial on ultrasound screening during pregnancy.

SETTING

Nineteen antenatal care clinics run by three central hospitals in Sweden from 1985 to 1987.

POPULATION AND METHODS

Of 4637 eligible singleton pregnancies, 3265 (71%) were followed up through a questionnaire sent to their mothers. Analyses were performed both according to randomised groups and to ultrasound exposure.

MAIN OUTCOME MEASURES

Parents' report of vision and hearing tests as recorded on child's record card. Parents' report of their child's weight and height at 1, 4 and 7 years of age.

RESULTS

Reduced hearing was reported by 3.4% in the screening group compared with 3.5% in the nonscreening group (odds ratio [OR] 1.0; 95% confidence interval [CI] 0.67-1.41). The same prevalences were found when analysed according to ultrasound exposure (OR 1.0; 95% CI 0.67-1.42). Reduced vision was reported by 6.3% in the screening group compared with 7.8% in the nonscreening group (OR 0.8; 95% CI 0.60-1.03). Corresponding figures for ultrasound exposed and unexposed were 6.2% and 8.0%, respectively (OR 0.8; 95% CI 0.58-1.00). No statistically significant differences in body weight or height at 1, 4 or 7 years of age between screened and not screened children or between exposed and unexposed were found.

CONCLUSION

This study found no association between ultrasound exposure in early fetal life and growth or impaired vision or hearing during childhood.