The effects on maternal anxiety of two‐dimensional versus two‐ plus three‐/four‐dimensional ultrasound in pregnancies at risk of fetal abnormalities: a randomized study

Leung, Kwok; Ngai, C. S. W.; Lee, A.; Chan, Huan; Leung, Wing Cheong; Lee, C. P.; Tang, Mary Hoi Yin

doi:10.1002/uog.2844

Cited by 18 publications

(14 citation statements)

References 26 publications

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“…17 The mean and standard deviation for T-AI and S-AI score in Hong Kong Chinese pregnant women were 42.6 (SD 6.8) and 40.7 (SD 10.5). 18 In this study, both the T-AI and the S-AI were used in the first interview, but only the S-AI was used in the second interview (because the underlying anxiety trait should not have changed).…”

Section: Psychometric Scalesmentioning

confidence: 99%

A longitudinal observational study of preference for elective caesarean section among nulliparous Hong Kong Chinese women

Pang

Lee

Leung³

et al. 2007

BJOG

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Objective To establish whether women's preference for elective caesarean section (ELCS) changes as gestation advances.Design A prospective longitudinal observational study.Setting Two units providing obstetric care in Hong Kong, one public and one private.Sample Five hundred and one nulliparous Chinese pregnant women attending their routine fetal anomaly scan in either unit.Methods Consented subjects had two interviews using a structured questionnaire at 18-22 weeks and 35-37 weeks of gestation, respectively. Multivariate analysis was performed to identify determinants for preferring ELCS at the two gestational ages.Main outcome measure The preferences for the mode of delivery at the two gestational ages.Results The prevalence of maternal preference for ELCS in the study cohort was 17.2% (95% CI 13.9-20.5) and 12.7% (95% CI 9.6-15.8) at mid-trimester and at term, respectively. Significantly more women who preferred ELCS at mid-trimester changed to a trial of vaginal delivery (VD) at term than vice versa (42.0 versus 3.8%). The partner's preference for ELCS was a significant determinant for women preferring ELCS throughout the antenatal period. Among the women booked in the public sector, more women who preferred ELCS at term changed to deliver in private hospitals than those who preferred VD (46.2 versus 9.7%).Conclusions Many women changed from preferring ELCS to preferring VD as their pregnancy approached term. The partner's preference was a significant determinant for the women's choice. If a decrease in the proportion of women preferring ELCS is desired, the intervention programme should target the women and their partners who hold such a preference at 20 weeks.

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Section: Psychometric Scalesmentioning

confidence: 99%

A longitudinal observational study of preference for elective caesarean section among nulliparous Hong Kong Chinese women

Pang

Lee

Leung³

et al. 2007

BJOG

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“…34,35 However, others have stated that when comparing 3D/4D with traditional 2D, recognition of fetal anatomy by the mothers-to-be was, indeed, improved but bonding was not better, 36,37 and there was no benefit in terms of anxiety reduction in pregnancies at risk of fetal abnormalities. 38 In addition, even assuming an improvement in maternal-fetal bonding, there are no studies showing benefits to the fetus. In fact, one can generalize and state that despite undisputable improved diagnostic capabilities, 3D/4D US has not allowed improved fetal outcome.…”

Section: Clinical Application Of 3d/4d Ultrasound In Prenatal Diagnosismentioning

confidence: 98%

3D/4D Ultrasound in Prenatal Diagnosis

Merz

Abramowicz

2012

Clinical Obstetrics &Amp; Gynecology

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During the past 22 years 3-dimensional/4-dimensional ultrasonography (3D/4D US) has evolved into a powerful technique. In contrast to conventional 2-dimensional (2D) US that only allows imaging of single planes, 3D/4D US offers several image displays that do not exist in 2D imaging. In obstetrics, in particular, where amniotic fluid surrounds the embryo/fetus, this offers ideal preconditions for the assessment of the surface of the embryo/fetus. 3D/4D US offers a precise demonstration of the normal and abnormal anatomy of the fetus to the parents. Digital storage of volumes permits virtual examinations by reloading of volumes and navigating through them in the absence of the patient. The value of 3D/4D US is undisputable in specific clinical situations, such as facial clefts, brain anomalies, and spinal defects. Is it time, however, to recommend it in routine obstetrical scanning?

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“…Additionally, 3D/4D ultrasound in women at risk for having a fetus with congenital anomalies does not reduce maternal anxiety compared to conventional 2D ultrasound alone (26).…”

Section: D Ultrasoundmentioning

confidence: 99%

Ultrasound

March¹,

Chauhan²,

Abuhamad³

2012

Obstetric Evidence Based Guidelines

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There is no evidence that ultrasound examination during pregnancy is harmful. Prenatal exposure to ultrasound is not associated with adverse influence on school performance and physical or neurological function. l Ultrasound should be performed by trained and experienced professionals, with continuing education and ongoing quality-monitoring programs. l Routine use of ultrasound increases early detection of multiple pregnancies, increases earlier detection of major fetal anomalies when termination of pregnancy is possible, and increases detection rates of fetal malformations. l Ultrasound examination is the best method to estimate gestational age dating in pregnancy.l Ultrasound examination at first prenatal visit (usually first trimester) versus at 18 to 20 weeks provides more precise estimate of gestational age and may be associated with less women feeling worried about their pregnancy. First-trimester ultrasound also allows earlier detection of multiple pregnancies, screening for Down's syndrome with nuchal translucency (NT), and diagnosis of nonviable pregnancies. l All pregnant women should be offered a second-trimester ultrasound for optimal anatomy evaluation. Until more evidence accumulates regarding the detection of fetal anomalies on the first-trimester ultrasound, if only one ultrasound will be done in pregnancy, it should be a second-trimester scan at about 18 to 22 weeks. l In low-risk or unselected populations, routine third-trimester (>24 weeks) pregnancy ultrasound has not been associated with improvements in perinatal mortality, though these studies lack sufficient sample size. Routine use of ultrasound in the third trimester significantly decreases the rate of intrauterine growth restriction (IUGR). l Routine use of ultrasound reduces the incidence of postterm pregnancies and rates of induction of labor for postterm pregnancy. l In low-risk or unselected populations, routine Doppler ultrasound examination, usually around 28 to 34 weeks, does not result in reduced perinatal mortality. l In high-risk populations, such as those with IUGR, umbilical artery Doppler assessment is associated with a reduction in perinatal deaths and obstetric interventions.l Measurement of cervical length (CL) by transvaginal ultrasound (TVU) has been shown to be an effective predictor of preterm birth (PTB). When a short CL is detected before 24 weeks, interventions such as vaginal progesterone in singletons without prior PTB (using TVU CL < 21 mm) and cerclage in singletons with prior PTB (using TVU CL < 25 mm) have been associated with decrease in PTB and perinatal morbidity and mortality.

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The effects on maternal anxiety of two‐dimensional versus two‐ plus three‐/four‐dimensional ultrasound in pregnancies at risk of fetal abnormalities: a randomized study

Abstract: Objective To test the hypothesis that the use of two-dimensional (2D) ultrasonography with threedimensional/four-dimensional (3D/4D

Cited by 18 publications

References 26 publications

A longitudinal observational study of preference for elective caesarean section among nulliparous Hong Kong Chinese women

A longitudinal observational study of preference for elective caesarean section among nulliparous Hong Kong Chinese women

3D/4D Ultrasound in Prenatal Diagnosis

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