Obstetric ultrasonography has grown in popularity since it was introduced over four decades ago.An article in the Canadian Medical Association Journal has found that the use of prenatal ultrasounds has increased by 55% in singleton pregnancies since 1996.The article highlights the fact that the usage is more pronounced in low risk pregnancies without any complications. Current guidelines recommend two ultrasounds in an uncomplicated pregnancy – one in the first trimester and one in the second to screen for fetal and genetic abnormalities.But it is found that almost 1 in 5 of all pregnant women – including those at low-risk of complications – now receive 4 or more ultrasounds in the second and third trimesters. The study took into account 1.4 million singleton pregnancies between 1996 and 2006 in Ontario, Canada’s most populous province and included both low-risk and high-risk pregnancies, the latter defined by the presence of a maternal comorbidity, need for genetics counselling or a prior complicated pregnancy. The study accounted for the recent introduction of first trimester nuchal translucency scanning.
According to Dr. John You of McMaster University and coauthors, frequent ultrasounds that is rather beneficial for high risk pregnancies is unfortunately being targeted at low risk population as well which does not benefit from them and could be avoided. Since the detection of minor benign findings is increasingly more common with technological advances such as pregnancy ultrasound, they can cause anxiety and lead to invasive procedures such as amniocentesis. Increasing screening in low-risk women may also be contributing to increasing health care costs. The authors conclude that though the use of prenatal ultrasounds in low-risk women is required,the best approach to balance frequency and medical need must be sought as well. ultrasound can be a useful tool in the antenatal period when employed judiciously based on sound clinical judgement. It should not be used indiscriminately.
