[Routine prenatal care in Europe: comparison of the experience of nine gynecologic-obstetric services in eight different countries].
OBJECTIVE
The purpose of this study was to compare the routine pre-natal surveillance carried out in nine European Gyneco-Obstetric units.


METHODS
A survey was carried out between October 1992 and November 1993 with the aid of a questionnaire. The questionnaire contained 118 questions covering clinical examinations and explorations undertaken systematically during the first, second and third trimesters and at the end of pregnancy before delivery. To ensure that the replies were accurate, the survey was carried out on the spot in the units concerned with the head of the unit.


RESULTS
The survey revealed a certain number of differences in the surveillance carried out in the various units. The units did not all carry out systematic blood tests for toxoplasmosis, AIDS and hepatitis B at the first examination. The same applied to fasting blood glucose and the bacterial culture of the urine. Nor did all the units automatically undertake vaginal examination during the second and third trimesters and the English departments were not all convinced of the need for systematic ultrasound tests. Only five of the nine units undertook routinely cardiotocographic recordings of the fetal heart rate at the end of the pregnancy.


CONCLUSIONS
The differences observed in the various surveillance procedures simply reflect our uncertainty regarding the different tests we use to monitor pregnancies. At a time when financial constraints are forcing us to make choices, there is an urgent need to assess the effectiveness and the cost of the various elements of our prenatal monitoring.
Langer
B
B
Service de Gynéco-Obstétrique II, Hôpital de Hautepierre, Strasbourg.
Caneva
M P
MP
Schlaeder
G
G
D015148:Cardiotocography; D003955:Diagnostic Tests, Routine; D005060:Europe; D005260:Female; D006801:Humans; D009775:Obstetrics and Gynecology Department, Hospital; D010808:Physical Examination; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D011795:Surveys and Questionnaires; D016216:Ultrasonography, Prenatal; D014556:Urine / Q000382:microbiology; D014621:Vagina