Comparison of a Two (32/38 Weeks) versus One (36 Weeks) Ultrasound Protocol for the Detection of Decreased Fetal Growth and Adverse Perinatal Outcome

Author:

Nieto-Tous Mar1ORCID,Novillo-Del Álamo Blanca1ORCID,Martínez-Varea Alicia123ORCID,Satorres-Pérez Elena1,Morales-Roselló José145ORCID

Affiliation:

1. Departamento de Obstetricia y Ginecología, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain

2. Departmen of Medicine, CEU Cardenal Herrera University, 12006 Castellón de la Plana, Spain

3. Faculty of Health Sciences, Universidad Internacional de Valencia, 46002 Valencia, Spain

4. Instituto de Investigación Sanitaria La Fe de Valencia, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain

5. Departamento de Pediatría, Obstetricia y Ginecología, Facultad de Medicina, Universitat de València, 46010 Valencia, Spain

Abstract

Third-trimester ultrasound has low sensitivity to small for gestational age (SGA) and adverse perinatal outcomes (APOs). The objective of this study was to compare, in terms of cost-effectiveness, two routine third-trimester surveillance protocols for the detection of SGA and evaluate the added value of a Doppler study for the prediction of APO. This was a retrospective observational study of low-risk pregnancies that were followed by a two growth scans protocol (P2) at 32 and 38 weeks or by a single growth scan at 36 weeks (P1). Ultrasound scans included an estimated fetal weight (EFW) in all cases and a Doppler evaluation in most cases. A total of 1011 pregnancies were collected, 528 with the P2 protocol and 483 with the P1 protocol. While the two models presented no differences for the detection of SGA in terms of sensitivity (47.89% vs. 50% p = 0.85) or specificity (94.97 vs. 95.86% p = 0.63), routine performance of two growth scans (P2) led to a 35% cost increase. The accuracy of EFW for the detection of SGA showed a noteworthy improvement when reducing the interval to labor, and the only parameter with predictive capacity of APO was the cerebroplacental ratio at 38 weeks. In low-risk pregnancies, the higher costs of a two-scan growth surveillance protocol at the third trimester are not justified by an increase in diagnostic effectivity.

Publisher

MDPI AG

Reference30 articles.

1. Population-based risks of mortality and preterm morbidity by gestational age and birth weight;Baer;J. Perinatol.,2016

2. Diagnosis and surveillance of late-onset fetal growth restriction;Figueras;Am. J. Obstet. Gynecol.,2018

3. Routine ultrasound in late pregnancy (after 24 weeks’ gestation);Bricker;Cochrane Database Syst. Rev.,2015

4. Does serial 3rd trimester ultrasound improve detection of small for gestational age babies: Comparison of screening policies in 2 European maternity units;Agarwal;Eur. J. Obstet. Gynecol. Reprod. Biol.,2017

5. Impact on obstetric outcome of third-trimester screening for small-for-gestational-age fetuses;Callec;Ultrasound Obstet. Gynecol.,2015

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3