Routine antenatal ultrasound in low- and middle-income countries: first look - a cluster randomised trial.

BJOG : an International Journal of Obstetrics and Gynaecology
Robert L GoldenbergElizabeth M McClure

Abstract

Ultrasound is widely regarded as an important adjunct to antenatal care (ANC) to guide practice and reduce perinatal mortality. We assessed the impact of ANC ultrasound use at health centres in resource-limited countries. Cluster randomised trial. Clusters within five countries (Democratic Republic of Congo, Guatemala, Kenya, Pakistan, and Zambia) METHODS: Clusters were randomised to standard ANC or standard care plus two ultrasounds and referral for complications. The study trained providers in intervention clusters to perform basic obstetric ultrasounds. The primary outcome was a composite of maternal mortality, maternal near-miss mortality, stillbirth, and neonatal mortality. During the 24-month trial, 28 intervention and 28 control clusters had 24 263 and 23 160 births, respectively; 78% in the intervention clusters received at least one study ultrasound; 60% received two. The prevalence of conditions noted including twins, placenta previa, and abnormal lie was within expected ranges. 9% were referred for an ultrasound-diagnosed condition, and 71% attended the referral. The ANC (RR 1.0 95% CI 1.00, 1.01) and hospital delivery rates for complicated pregnancies (RR 1.03 95% CI 0.89, 1.20) did not differ between intervention a...Continue Reading

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Citations

Sep 19, 2019·Global Health, Science and Practice·Robert L Goldenberg, Elizabeth M McClure
Oct 14, 2020·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Nicole SantosDilys Walker
Nov 8, 2020·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Yuichi KodairaMichael M Koroma
Mar 27, 2021·BMC Pregnancy and Childbirth·Kimberly PevenUNKNOWN EN-BIRTH Study Group
May 12, 2021·Obstetrics and Gynecology Clinics of North America·Alice Self, Aris T Papageorghiou
Jun 2, 2021·Pediatric Surgery International·Alhassan Abdul-MuminUNKNOWN Global Initiative for Children Surgery
Mar 25, 2021·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·N VrachnisUNKNOWN Collaborators
Aug 27, 2021·The Cochrane Database of Systematic Reviews·Andrea Kaelin AgtenNia W Jones
Aug 30, 2021·Lancet·Lucia HugUNKNOWN UN Inter-agency Group for Child Mortality Estimation and its Core Stillbirth Estimation Group
Oct 17, 2021·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Erica BåvenäsJenny Löfgren
Oct 18, 2021·American Journal of Obstetrics & Gynecology MFM·Georgios DoulaverisVincenzo Berghella
Oct 27, 2020·Physiological Measurement·Camilo E ValderramaGari D Clifford

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