Improving Newborn Outcomes With Routine Ultrasound Scans

Third-trimester ultrasound scans can reduce undetected breech pregnancy rates by 71%, leading to improved maternal and neonatal care and outcomes.

Accurate knowledge of fetal presentation is essential for optimal care during pregnancy and birth. Vaginal breech delivery is associated with adverse maternal and perinatal outcomes.

Fetal Heart Ultrasound
Fetal heart ultrasound is used to view your unborn baby’s heart, assess fetal heart circulation, flow of blood in the various chambers of heart and fetal heartbeat.

‘Routine third-trimester ultrasound scans for pregnant women can significantly decrease undetected breech pregnancy by 71%, resulting in better care during labor and better outcomes for newborns.’

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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.

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.

About Ultrasound
Ultrasound scan or sonogram uses sound waves to obtain images of the internal organs. Ultrasound scan is used during pregnancy and to examine breast, abdomen, renal and thyroid.

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.

Doppler Ultrasound Scan - Preparation, Types, Risks
Doppler ultrasound scan is a non-invasive diagnostic procedure used to evaluate blood flow to our body. It is usually done for arms and legs, carotid arteries, brain and heart.

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