A community-based obstetric ultrasound service.
OBJECTIVE
To investigate the impact of an ultrasound dating service on obstetric services.


METHODS
A prospective trial with 3009 unselected women presenting for antenatal care at two Midwife Obstetric Units in a socioeconomically deprived urban area, South Africa. In the study unit, student ultrasonographers provided a basic ultrasound service. In the control unit, obstetric ultrasound was only available for specific indications. The main outcome measures were number of antenatal visits and referrals for fetal surveillance.


RESULTS
The two cohorts were comparable except for the number of primigravidas but stratified analysis according to parity did not affect the results. Ultrasonography did not alter pregnancy outcome but reduced the number of perceived preterm labors/ruptured membranes (12.0 vs. 16.7%, P<0.003), post-term deliveries (8.1 vs. 10.8%, P<0.04) and referrals for fetal surveillance [15.9 vs. 29.6%, P<0.000, RR 0.79 (0.71-0.88)].


CONCLUSIONS
This community-based basic ultrasound service significantly reduced referrals to a regional center for fetal surveillance and delivery.
Geerts
L
L
Department of Obstetrics and Gynaecology, MRC Perinatal Mortality Research Unit, Tygerberg Hospital and University of Stellenbosch, Tygerberg, South Africa. lgeerts@sun.ac.za
Theron
A M
AM
Grove
D
D
Theron
G B
GB
Odendaal
H J
HJ
D000328:Adult; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics; D005260:Female; D006801:Humans; D011204:Poverty Areas; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics / Q000379:methods*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data; D013019:South Africa / Q000453:epidemiology; D016216:Ultrasonography, Prenatal / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D014504:Urban Health; D014505:Urban Population