Routine ultrasound for fetal assessment before 24 weeks' gestation

Agten, Andrea Kaelin; Xia, Jun; Servante, Juliette; Thornton, Jim; Jones, Nia

doi:10.1002/14651858.cd014698

Cited by 8 publications

(8 citation statements)

References 72 publications

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“…This was also supported by the feedback from multiple midwives, who were interviewed pregnant women later in this study (data not shown). In Japan, because of the large number of antenatal checkups and frequent ultrasound examinations, 17 which can also detect abnormal findings other than aneuploidy, 18 some patients may choose not to undergo genetic testing in the early stages of the pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Change in client choice under multiple prenatal genetic testing options including noninvasive prenatal testing (NIPT) after genetic counseling in a Japanese maternity hospital

Naruse

Pooh

Kyukawa³

et al. 2023

J of Obstet and Gynaecol

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ObjectiveThis study examined how clients' selection and preference for noninvasive prenatal testing (NIPT) for aneuploidy changed with genetic counseling (GC) performed by certified geneticists at a primary hospital specializing in obstetrics, where other multiple prenatal genetic tests options were available.MethodsA total of 334 couples who underwent GC between 2017 and 2019 were included in the study. The average age of the pregnant women who underwent GC was 35.1 years.ResultsAmong the 95 couples (28.4%) who wanted NIPT at the start of GC, 10 (10.5%) switched to other tests, and 4 (4.2%) chose not to undergo any test. Among the 106 (31.7%) couples who wanted the combination of ultrasonography and the serum marker test, 12 (11.3%) chose not to undergo the test. Among the 92 (27.5%) couples who were undecided before GC, 21 (22.8%) wanted NIPT, 31 (33.7%) selected combined tests, and 18 (19.6%) did not undergo any test.ConclusionWe have demonstrated the significance of GC before prenatal genetic testing under widespread use of NIPT. Ideally, obstetric facilities should provide GC, or at least, pre‐counseling at their own facilities, and offer multiple prenatal genetic testing options or refer to other facilities for the same.

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Section: Discussionmentioning

confidence: 99%

Change in client choice under multiple prenatal genetic testing options including noninvasive prenatal testing (NIPT) after genetic counseling in a Japanese maternity hospital

Naruse

Pooh

Kyukawa³

et al. 2023

J of Obstet and Gynaecol

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“…The sonographic screening recommended by the SOGC has been shown to reduce adverse pregnancy outcomes. 22 , 28 , 29…”

Section: Methodsmentioning

confidence: 99%

Receipt of adequate prenatal care for privately sponsored versus government-assisted refugees in Ontario, Canada: a population-based cohort study

Evans¹,

Ray²,

Austin³

et al. 2023

CMAJ

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Background: Canada has 2 main streams of resettlement: government-assisted refugees and privately sponsored refugees, whereby citizens can privately sponsor refugees and provide resettlement services, including health care navigation. Our objective was to compare receipt of adequate prenatal care among privately sponsored and government-assisted refugees. Methods: This population-based study used linked health administrative and demographic databases. We included all resettled refugees classified as female who landed in Ontario, Canada, between April 2002 and May 2017, and who had a live birth or stillbirth conceived at least 365 days after their landing date. Our primary outcome — adequacy of prenatal care — was a composite that comprised receipt of a first-trimester prenatal visit, the number of prenatal care visits recommended by the Society of Obstetricians and Gynaecologists of Canada and a prenatal fetal anatomy ultrasound. We accounted for potential confounding with inverse probability of treatment weighting, using a propensity score. Results: We included 2775 government-assisted and 2374 privately sponsored refugees. Compared with privately sponsored refugees (62.3% v. 69.3%), government-assisted refugees received adequate prenatal care less often, with a weighted relative risk of 0.93 (95% confidence interval 0.88–0.95). Interpretation: Among refugees resettled to Canada, a government-assisted resettlement model was associated with receiving less adequate prenatal care than a private sponsorship model. Government-assisted refugees may benefit from additional support in navigating health care beyond the first year after arrival.

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“…1 Ultrasound is widely recommended as it is more reliable in estimating the date of birth and reduces the proportion of post-term births compared to LMP in population studies. 2,3 However, it is important to be aware of the limitations of the method as foetal size does not always equal age. The method assumes homogenous foetal growth velocities preceding the examination and is a simplification of biological variation.…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…The biometry is based on standardized sonographic measurements of foetal anatomy, most frequently biparietal diameter or head circumference in the second trimester or CRL (crown–rump length) in the first trimester 1 . Ultrasound is widely recommended as it is more reliable in estimating the date of birth and reduces the proportion of post‐term births compared to LMP in population studies 2,3 . However, it is important to be aware of the limitations of the method as foetal size does not always equal age.…”

Section: Introductionmentioning

confidence: 99%

Unveiling sex bias and adverse neonatal outcomes in ultrasound estimation of gestational age: A population‐based cohort study

Einum,

Sørbye,

Nilsen

et al. 2023

Paediatric Perinatal Epid

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BackgroundGestational age estimation by second‐trimester ultrasound biometry introduces systematic errors due to sex differences in early foetal growth, consequently increasing the risk of adverse neonatal outcomes. Ultrasound estimation earlier in pregnancy may reduce this bias.ObjectivesTo investigate the distribution of sex ratio by gestational age and estimate the risk of adverse outcomes in male foetuses born early‐term and female foetuses born post‐term by first‐ and second‐trimester ultrasound estimations.MethodsThis population‐based study compared two cohorts of births with gestational age based on first‐ and second‐trimester ultrasound in the Medical Birth Registry of Norway between 2016 and 2020. We used a log‐binomial regression model to estimate adjusted relative risk (RR) with 95% confidence interval (CI) for Apgar score <7 at 5 min, umbilical artery pH <7.05, neonatal intensive care unit (NICU) admission and respiratory morbidity in relation to foetal sex.ResultsThe sex ratio at birth in gestational weeks 36–43 showed less male predominance in pregnancies estimated in first compared to second trimester. Any adverse outcome was registered in 627 of 4470 male infants born in gestational weeks 37–38 and 618 of 6406 females born ≥41 weeks. Male infants born in weeks 37–38 had lower risk of NICU admission (RR 0.76, 95% CI 0.58, 0.99), Apgar score <7 at 5 min (RR 0.63, 95% CI 0.28, 1.41) and respiratory morbidity (RR 0.68, 95% CI 0.37, 1.25) in first‐ compared to second‐trimester estimations. Female infants estimated in first trimester born ≥41 weeks had lower risk of umbilical artery pH <7.05, NICU admissions and respiratory morbidity; however, CIs were wide.ConclusionsEarly ultrasound estimation of gestational age may reduce the excess risk of adverse neonatal outcomes and highlight the role of foetal sex and the timing of ultrasound assessment in the clinical evaluation of preterm and post‐term pregnancies.

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Routine ultrasound for fetal assessment before 24 weeks' gestation

Cited by 8 publications

References 72 publications

Change in client choice under multiple prenatal genetic testing options including noninvasive prenatal testing (NIPT) after genetic counseling in a Japanese maternity hospital

Change in client choice under multiple prenatal genetic testing options including noninvasive prenatal testing (NIPT) after genetic counseling in a Japanese maternity hospital

Receipt of adequate prenatal care for privately sponsored versus government-assisted refugees in Ontario, Canada: a population-based cohort study

Unveiling sex bias and adverse neonatal outcomes in ultrasound estimation of gestational age: A population‐based cohort study

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