Later Pregnancy Scans

Routine:
Bricker L, Neilson JP.
Routine ultrasound in late pregnancy (after 24 weeks gestation) (Cochrane Review).
In: The Cochrane Library, Issue 1, 2002. Oxford: Update Software, Abstract.

A review of 7 studies of 25036 women. There was no difference in obstetric, antenatal or neonatal interventions between those women undergoing routine Doppler ultrasound compared with those who did not. Likewise there was no difference in outcome measures and long term safety was not assessed.

Targeted:
Harding K, Evans S, Newham J (1995).
Screening for the small fetus: a study of the relative efficiency of ultrasound biometry and symphysiofundal height. Aust N Z Obstet Gynaecol; 35(2):160-4, Abstract.

1135 women were screened for birthweight <10th centile using 3 different methods alone and in combination; symphysiofundal height measurement, amniotic fluid index and ultrasound imaging at 18, 24, 28, 34 and 38 weeks. The best test was fetal abdominal circumference measurement by ultrasound. Selecting at risk pregnancies by symphysiofundal height measurement first prior to ultrasound reduces the false positive rate at the expense of sensitivity.

Neilson JP, Alfirevic Z.
Doppler ultrasound for fetal assessment in high risk pregnancies (Cochrane Review).
In: The Cochrane Library, Issue 4, 2001. Oxford: Update Software, Abstract

A review of 11 randomised studies involving nearly 7000 women. Doppler ultrasound compared with no Doppler ultrasound in high risk pregnancy was associated with a trend in reduction in perinatal deaths. There was also a reduction in induction of labour and admissions to hospital. There was no difference in fetal distress in labour or Caesarean section rate between the two groups.

Placenta Praevia: Diagnosis and Management
RCOG Green Top Guidelines Number 27.
http://www.rcog.org.uk/guidelines.asp?PageID=106&GuidelineID=17
Evidence based review of diagnosis and management.

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