Routine second-trimester ultrasonography in the United States: A cost-benefit analysis

Vintzileos, Anthony M.; Ananth, Cande V.; Smulian, John C.; Beazoglou, Tryfon; Knuppel, Robert A.

doi:10.1067/mob.2000.103943

Cited by 48 publications

(39 citation statements)

References 12 publications

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“…In the United States, estimates per one million women screened have ranged from 200 to 500 million dollars annually [25]. As ultrasound technology improves and utilization of ultrasound increases, health-care systems will undoubtedly face even higher associated costs [26,27]. This is of particular importance in low income settings where scarce resources need to be carefully allocated.…”

Section: Introductionmentioning

confidence: 99%

Utilization of antenatal ultrasound scan and implications for caesarean section: a cross-sectional study in rural Eastern China

Huang

Tao

Raven

et al. 2012

BMC Health Serv Res

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BackgroundAntenatal ultrasound scan is a widely accepted component of antenatal care. Studies have looked at the relationship between ultrasound scanning and caesarean section (CS) in certain groups of women in China. However, there are limited data on the utilization of antenatal ultrasound scanning in the general population, including its association with CS. The purpose of this study is to describe the utilization of antenatal ultrasound screening in rural Eastern China and to explore the association between antenatal ultrasound scan and uptake of CS.MethodsBased on a cluster randomized sample, a total of 2326 women with childbirth participated in the study. A household survey was conducted to collect socio-economic information, obstetric history and utilization of maternal health services.ResultsCoverage of antenatal care was 96.8% (2251/2326). During antenatal care, 96.1% (2164/2251) women received ultrasound screening and the reported average number was 2.55. 46.8% women received at least 3 ultrasound scans and the maximum number reached 11. The CS rate was found to be 54.8% (1275/2326). After adjusting for socio-demographic and clinical variables, it showed a statistically significant association between antenatal ultrasound scans and uptake of CS by multivariate logistic regression model. High husband education level, high maternal age, having previous adverse pregnant outcome and pregnancy complications during the index pregnancy were also found to be risk factors of choosing a CS.ConclusionsA high use of antenatal ultrasound scan in rural Eastern China is found and is influenced by socio-demographic and clinical factors. Evidence-based guidelines for antenatal ultrasound scans need to be developed and disseminated to clinicians including physicians, nurses and sonographers. Guidance about the appropriate use of ultrasound scans should also be shared with women in order to discourage unreasonable expectations and demands. It is important to monitor the use of antenatal ultrasound scan as well as the indications for caesarean section in rural China.

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Section: Introductionmentioning

confidence: 99%

Utilization of antenatal ultrasound scan and implications for caesarean section: a cross-sectional study in rural Eastern China

Huang

Tao

Raven

et al. 2012

BMC Health Serv Res

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“…There are many reports of prenatal detection of malformation in high-risk groups but few studies have been reported on the effectiveness of anomaly detection by routine ultrasound scans [7]. The clinical use of routine fetal ultrasound examination in low-risk pregnancies and its impact on the perinatal outcome are still under debate [8, 9]. …”

Section: Introductionmentioning

confidence: 99%

Detection of Congenital Anomalies by Fetal Ultrasonographic Examination across Europe

Stoll

Tenconi

Clementi

2001

Public Health Genomics

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Objectives: Birth defects are a major health burden. Primary prevention is at present emerging, i.e. folate supplementation. When it is not possible, as is still the case for most birth defects, research is needed to determine how an optimal provision of prenatal diagnosis and use of services can be achieved. Ultrasound scans in the midtrimester of pregnancy are now a routine part of antenatal care in most European countries. The objective of this study was to evaluate the prenatal diagnosis of congenital anomalies by fetal ultrasonographic examination across Europe. Methods: Data from 20 registries of congenital malformations in 12 European countries were included. The prenatal ultrasound screening programs in the countries ranged from no routine screening to 3 fetal scans offered, including 2 for biometric purposes and 1 for search of congenital anomalies, the anomaly scan. Results: There were 8,126 cases with congenital anomalies with an overall prenatal detection rate of 44.3%. Termination of pregnancy was performed in 1,657 cases (21.8%). There was significant variation in the prenatal detection rate between regions with the lowest detection rate in registries of countries without routine fetal screening (Denmark and The Netherlands) and the highest detection rate in registries of countries with at least 1 anomaly scan (France, Germany, Italy, Spain, UK). However, there were large variations among the registries with a high detection rate. There were significant differences in the prenatal detection rate and proportion of induced abortions between isolated anomalies and associated anomalies (chromosomal aberrations, recognized syndromes, and multiple without chromosomal aberrations or recognized syndromes). Conclusions: Prenatal detection rate of congenital anomalies by fetal scan varies significantly between registries of European countries even with the same screening policy. Prenatal detection of congenital anomalies is significantly higher when associated malformations are present. The rate of induced abortions varies between registries of countries even with the same detection rate of congenital anomalies. The variation described may be due to cultural and policy differences.

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“…Few published studies report actual costs associated with prenatal ultrasonography. However, in trials of anomaly screening, annual cost estimates for 2nd trimester sonographic screening in the United States have ranged between 200 and 500 million dollars per 1 million women screened [11,12]. Reports from European authors have provided similar cost estimates [13,14].…”

Section: Resource Utilizationmentioning

confidence: 80%

Prenatal ultrasonography: Implications for pediatric urology

Clayton

Brock

2011

Journal of Pediatric Urology

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Routine second-trimester ultrasonography in the United States: A cost-benefit analysis

Cited by 48 publications

References 12 publications

Utilization of antenatal ultrasound scan and implications for caesarean section: a cross-sectional study in rural Eastern China

Utilization of antenatal ultrasound scan and implications for caesarean section: a cross-sectional study in rural Eastern China

Detection of Congenital Anomalies by Fetal Ultrasonographic Examination across Europe

Prenatal ultrasonography: Implications for pediatric urology

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