Late Ultrasound Scan May Prevent Thousands Of C-Section Births Per Year

Pregnant women who undergo at least one additional ultrasound session before giving birth have a better chance of avoiding caesarean section deliveries.
In a study featured in the journal PLOS Medicine
, researchers from the University of East Anglia and Cambridge University found that a second ultrasound scan about a month before delivery can reduce the risk of babies being born with their feet or buttocks first.
The condition
, known as undiagnosed breech presentation, poses a significant health risk to the mother and her child. Doctors often recommend an emergency caesarean section to make sure that both go through delivery safely.
If cases of breech presentation are detected weeks before child birth, the researchers believe it can help cut as much as 4,000 instances of emergency caesarean procedures every year.
Undiagnosed Breech Presentations
Gordon Smith, a professor of Obstetrics and Gynaecology at Cambridge, led his colleagues in examining
undiagnosed breech presentations in the UK. They asked 3,879 women, who were going through their first pregnancy, to undergo an ultrasound test at 36 weeks.
While only 179 of expectant mothers (4.6 percent) were diagnosed with breech presentation, more than half of them said they have received no prior indication that their baby was in such a condition.
Pregnant women typically receive an ultrasound scan by the time they reach their 20th week. However, since assessments are highly dependent on the skill of doctors to feel their patients' baby bumps, most cases of breech presentations are often left undetected.
Asking the patients to undergo screening during their 36th week of pregnancy gave them a chance to opt for external cephalic version, where doctors would attempt to turn the baby to place them in the correct birthing position.
The study suggests that having the procedure a month before giving birth
significantly increases its success rate than if done close to delivery.
Some of the participants opted for external cephalic version. For patients who declined, or where the procedure did not work, the researchers arranged for them to have a planned caesarean section.
None of the pregnant women chose to undergo a vaginal breech birth. The procedure can be an option for breech presentation cases, though it still carries some safety risks
.
Of the 179 women diagnosed with breech presentations, 19 were able to give birth vaginally, 110 underwent planned caesarean section, and 50 had to undergo an emergency caesarean.
Implications Of Late Ultrasound Scan
Smith and his colleagues are already looking into the feasibility of implementing late ultrasound scans at a low cost. This can be done by incorporating the screening to the standard midwife appointments and using portable ultrasound devices that are more affordable than regular machines.
If the cost of the diagnostic were to be lowered to only £20 ($26) per patient, Smith said
it would be more cost-effective. Even if the procedure were to done for under £13 ($17), it would still allow the National Health Service to save up more money in the long run.
Some doctors are now calling on the NHS to explore
the possibility of making ultrasound screening more cost-effective, while others are still asking for more trials to be done before implementing such a move.
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