A RANDOMIZED TRIAL OF PRENATAL ULTRASONOGRAPHIC SCREENING - IMPACT ONMATERNAL MANAGEMENT AND OUTCOME

ObJECTIVES: This randomized clinical trial of 15,530 women was designe d to test the hypothesis that screening ultrasonography in low-risk pr egnancies would improve perinatal outcome. A secondary hypothesis addr essed in this article was that screening ultrasonography would have a favorable impact on maternal management or outcome. STUDY DESIGN: Preg nant women without a specific indication for ultrasonographic examinat ion in early pregnancy were randomly assigned to have either two scree ning sonograms or conventional obstetric care. Pregnancy interventions and maternal outcomes were compared in the two groups. RESULTS: No si gnificant differences were found in maternal outcomes. Use of ultrason ography was markedly higher in the screened group. The rates of induce d abortion, amniocentesis, tests of fetal well-being, external version , induction, and cesarean section and the distribution of total hospit al days were similar in the two groups. Use of tocolytics and the rate of postdate pregnancy were both slightly lower in the screened group. CONCLUSION: Screening ultrasonography resulted in no clinically signi ficant benefit.