This is ironic after what has just been posted about the
latest possible risks of ultrasound....Helen
Breech baby checks 'miss cases'
Routine pregnancy
exams to check a baby is in a good position before birth are not sensitive
enough, experts warn.
They say simple palpation - feeling the mother's bump - misses about 24 in
100 cases of abnormal lie, where a baby is not in the normal head-down
position.
Knowing the lie of a baby is important because some positions, like foot
first or breech, make vaginal delivery difficult or impossible.
Routine ultrasound tests may be needed, says the British Medical Journal.
Missed diagnoses
A team at the University of Sydney studied 1,633 women in their 35th to
37th week of pregnancy who were attending an antenatal clinic at a local
obstetric hospital.
Each woman was examined in the usual way by a doctor to assess the position
of their baby. Afterwards the women also underwent an ultrasound scan to
confirm the position.
Simple palpation detected 70% of the babies who were not in the ideal
head-down position but missed the other 30%.
|
It is crucial that women are provided with
unbiased information and with the choice about whether they have an
additional scan or not
Sue Macdonald of
the Royal College of Midwives |
The researchers reason that if this figure is applied to a general
maternity population of 1,000 women, clinical examination would identify 101
women as having an abnormal lie but in only 56 would this be correct and 24
women with abnormal lie would be missed altogether.
They suggested routine ultrasound scans for women late in pregnancy might
help spot more babies with abnormal lie, but stressed that the cost
effectiveness of such screening would have to be assessed before any services
could be rolled out.
Sue Macdonald of the Royal College of Midwives said: "It is possible that
some babies in breech position are missed and this reinforces the need to use
information from this research to inform current education and training of
midwives and obstetricians."
But she questioned whether routine ultrasound checks would be cost and
resource effective.
She added that the long-term effects of such scans on the unborn baby were
not known and that doctors might come to rely on scans and become less skilled
at examining.
"The use of scans as a second opinion, when there is difficulty in
palpation, perhaps for overweight women, is already used," she said.
"However, it is crucial that women are provided with unbiased information
and with the choice about whether they have an additional scan or not."
