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- I Want to Be Sure My Baby is HealthyLast Updated: 6/11/2011
Isn’t that a good reason to have an ultraound?
Many women are reassured by a normal scan, yet RPU actually detects only between 17 and 85 percent of the 1 in 50 babies that have major abnormalities at birth .* A recent study from Brisbane showed that ultrasound at a major women’s hospital missed around 40 percent of abnormalities, with most of these being difficult or impossible to detect. Major causes of intellectual disability such as cerebral palsy and Down’s syndrome are unlikely to be picked up on a routine scan, as are heart and kidney abnormalities.
When an abnormality is detected, there is a small chance that the finding is a "false positive”, where the ultrasound diagnosis is wrong. A UK survey showed that, for one in 200 babies aborted for major abnormalities, the diagnosis on post-mortem was less severe than predicted by ultrasound and the termination was probably unjustified. In this survey 2.4 percent of the babies diagnosed with major malformations, but not aborted, had conditions that were significantly over or underdiagnosed.
There are also many cases of error with more minor abnormalities, which can cause anxiety and repeated scans, and there are some conditions which have been seen to spontaneously resolve.
As well as false positives, there are also uncertain cases, where the ultrasound findings cannot be easily interpreted, and the outcome for the baby is not known. In one study involving women at high risk, almost 10 percent of scans were uncertain. This can create immense anxiety for the woman and her family, and the worry may not be allayed by the birth of a normal baby. In the same study, mothers with "questionable” diagnoses still had this anxiety three months after the birth of their baby.
* Ewigman BG, et al. Effect of prenatal ultrasound screening on perinatal outcome. RADIUS Study Group. N Engi J Med 1993;329(12):821-7.
Luck CA. Value of routine ultrasound scanning at 19 weeks: a four year study of 8849 deliveries. Br Med J 1992;304(6840):1474-8.
Chan F. Limitations of Ultrasound. Perinatal Society of Australia and New Zealand 1st Annual Congress. Freemantle, Australia, 1997.
Brand IR, et al. Specificity of antenatal ultrasound in the Yorkshire Region: a prospective study of 2261 ultrasound detected anomalies ACOG Committee Opinion. Number 297, August 2004. Nonmedical use of obstetric ultrasonography. Bri Obstet Gynaecol 1994;101(5):392-7.
June 11, 2011
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