HealthGate Document

Title

Effect of prenatal ultrasound screening on perinatal outcome. RADIUS Study Group [see comments]

Author

Ewigman BG; Crane JP; Frigoletto FD; LeFevre ML; Bain RP; McNellis D

Address

Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia.

Source

N Engl J Med, 1993 Sep 16, 329:12, 821-7

Abstract

BACKGROUND. Many clinicians advocate routine ultrasound screening during pregnancy to detect congenital anomalies, multiple-gestation pregnancies, fetal growth disorders, placental abnormalities, and errors in the estimation of gestational age. However, it is not known whether the detection of these conditions through screening leads to interventions that improve perinatal outcome. METHODS. We conducted a randomized trial involving 15,151 pregnant women at low risk for perinatal problems to determine whether ultrasound screening decreased the frequency of adverse perinatal outcomes. The women randomly assigned to the ultrasound-screening group underwent one sonographic examination at 15 to 22 weeks of gestation and another at 31 to 35 weeks. The women in the control group underwent ultrasonography only for medical indications, as identified by their physicians. Adverse perinatal outcome was defined as fetal death, neonatal death, or neonatal morbidity such as intraventricular hemorrhage. RESULTS. The mean numbers of sonograms obtained per woman in the ultrasound-screening and control groups were 2.2 and 0.6, respectively. The rate of adverse perinatal outcome was 5.0 percent among the infants of the women in the ultrasound-screening group and 4.9 percent among the infants of the women in the control group (relative risk, 1.0; 95 percent confidence interval, 0.9 to 1.2; P = 0.85). The rates of preterm delivery and the distribution of birth weights were nearly identical in the two groups. The ultrasonographic detection of congenital anomalies had no effect on perinatal outcome. There were no significant differences between the groups in perinatal outcome in the subgroups of women with post-date pregnancies, multiple-gestation pregnancies, or infants who were small for gestational age. CONCLUSIONS. Screening ultrasonography did not improve perinatal outcome as compared with the selective use of ultrasonography on the basis of clinician judgment.

Language of Publication

English

Unique Identifier

93361063

MeSH Heading (Major)

Pregnancy Outcome|*/EP; Ultrasonography, Prenatal|EC/*UT

MeSH Heading

Adolescence; Adult; Diagnostic Tests, Routine; Female; Fetal Death; Human; Infant Mortality; Infant, Newborn; Morbidity; Pregnancy; Pregnancy, Multiple; Risk Factors; Support, U.S. Gov't, P.H.S.; Technology Assessment, Biomedical; United States

Publication Type

CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL

ISSN

0028-4793

Country of Publication

UNITED STATES