Abdominal palpation has poor sensitivity (50% to 70%) for the determination of fetal presentation. The role of a routine third ultrasound assessment of fetal presentation has been reported but the impact on neonatal outcomes is yet to be determined.
There are limited reports on antenatal use of handheld point-of-care ultrasound (POCUS) for the determination of fetal presentation, but the impact of their systematic use for this purpose is largely unknown.
Advertisement
Seeing is Believing: Third-Trimester Ultrasound Scans
The primary objective of the study was to compare the impact of routine third-trimester ultrasound or point-of-care ultrasound (POCUS) with standard antenatal care, on the incidence of overall and proportion of all term breech presentations that were undiagnosed at term, and on the related adverse perinatal outcomes.
This was a retrospective multicentre cohort study where data from St. George’s (SGH) and Norfolk and Norwich University Hospitals (NNUH) were included. Pregnancies were grouped according to whether they received routine third-trimester scans (SGH) or POCUS (NNUH).
Women with multiple pregnancies, preterm birth before 37 weeks, congenital abnormality, and those undergoing planned cesarean section for the breech presentation were excluded.
The impact of routine third-trimester ultrasound or POCUS on the percentage of all term breech presentations that were undiagnosed and adverse neonatal outcomes, in pre-and post-screening epochs were studied.
Prevent Breech Birth Risks
It was observed that both a policy of routine facility-based third-trimester ultrasound or POCUS are associated with a reduction in the proportion of term breech presentations that were undiagnosed, with an improvement in neonatal outcomes.
Hence, this study supports the policy of third-trimester ultrasound scans for fetal presentation. Future studies should focus on exploring the cost-effectiveness of POCUS for fetal presentation.
Study findings imply that a policy of either a third-trimester ultrasound by sonographers or POCUS by trained midwives was effective in reducing the proportion of all term breech presentations at the time of birth that were undiagnosed and associated neonatal complications.
The cost-effectiveness of POCUS needs to be explored further for the feasibility of implementation on a wider scale for assessment of fetal presentation at term.
Source: Eurekalert
Source link
#Improving #Newborn #Outcomes #Routine #Ultrasound #Scans
