U.S. CitiesCity-Data Forum Index
Go Back   City-Data Forum > General Forums > Parenting > Pregnancy
 [Register]
Please register to participate in our discussions with 1.5 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Jump to a detailed profile or search
site with Google Custom Search

Search Forums  (Advanced)
Business Search - 14 Million verified businesses
Search for:  near: 
View Poll Results: Where Should people give Birth at?
Home 15 42.86%
Hospital 20 57.14%
Voters: 35. You may not vote on this poll

Reply Start New Thread
 
Old 01-11-2011, 06:57 PM
 
Location: Georgia, USA
10,328 posts, read 9,877,160 times
Reputation: 10237

Advertisements

Quote:
Originally Posted by NJGOAT View Post
Here is some interesting information on routine ultrasounds. It does back up what Dorthy is saying, but not necessarily for the reasons Dorthy is citing. In general the debate over universal routine ultrasound in the U.S. is one of cost. The RADIUS study which was first released in the American Journal of Obstetrics and Gynecology in 1993 is the study that found no benefit of ultrasound screening among low risk women in terms of neonatal death or illness.
Excellent, NJ.

The fact is that most U. S. obstetricians do routinely scan all their patients.

I agree that the quality of those scans is very dependent on the skill of the person doing the scan. That really affects the rate at which anomalies are detected. How zealously to look for anomalies may depend on the wishes of the parents. Some are willing to accept whatever their child brings with him; others would want to terminate the pregnancy (and let's not turn this discussion into an abortion debate, please!)
And even if the statistics do not show an effect on neonatal mortality, for an individual baby knowing ahead of time about certain birth defects could be life saving. Knowing about a lethal birth defect could even prevent a futile Cesarean for fetal distress.

But the main issue in scanning low risk patients is that some of them become high risk patients later in pregnancy. At that point, an accurate due date can be a huge factor in making decisions. There is no "do-over" for scanning for due date. Late pregnancy scans cannot accurately determine due date. The OB either does it for every patient he sees, or he is presented with a patient in premature labor and must make a decision to try to stop labor based solely on menstrual dates. Or the menstrual dates say the patient is overdue and the decision must be made to induce labor. Or the mother develops a condition for which early delivery becomes an issue.

So, whether ACOG formally recommends routine scans, most obstetricians do scan routinely. And most insurance companies pay for 1 or 2 scans.

Last edited by suzy_q2010; 01-11-2011 at 06:59 PM.. Reason: fix formatting
Reply With Quote Quick reply to this message

 
Old 01-11-2011, 07:04 PM
 
4,267 posts, read 3,035,085 times
Reputation: 3579
Quote:
Originally Posted by NJGOAT View Post
So, while Dorthy is spot on regarding the fact that it is not recomended in the U.S. for low risk women, that position is very debatable and is more or less centered around cost-efficacy and availability of quality ultrasound than it is about it showing no benefit as evidenced in the European study.
Routine ultrasound screening in pregnancy
Yep. This was all that I was trying to convey. Routine use of ultrasound in low risk pregnancies is not recommended in the US. Nothing more and nothing less. I don't take issue with the potential benefits.

The reason why I brought this up in the first place was in response to this comment:

Quote:
The fact that some of the babies who died had anomalies concerns me. This supports my contention that the ability to triage a pregnancy as low risk is not good enough. Why were infants with anomalies not considered high risk? Were they not identified prior to labor? Good quality fetal ultrasound should pick up nearly all of theses babies.
My point being that not all low risk pregnant women will have an ultrasound during their prenatal care so anomalies may not be detected beforehand no matter where Mom plans to deliver. That's seriously all that I was trying to say.
Reply With Quote Quick reply to this message
 
Old 01-11-2011, 08:30 PM
 
745 posts, read 752,240 times
Reputation: 417
Quote:
Originally Posted by NJGOAT View Post
Historically, the average of maternal death is around 1 per 100 births. That figure is based on all available recorded data. Maternal mortality peaked through the 1700's and 1800's at up to 40 per 100 births in some areas. Since the beginning of the 20th Century, modern medical techniques have reduced this ratio in the United States down to a rate of 11 per 100,000. Given that the prevailing method of past deliveries was home birth with no medical intervention, outside of all your "current stats" I think the above numbers speak for themselves.
Actually, many of the deaths in that time period can be attributed to puerperal fever (childbed fever), because in that time period physicians did not think they had to wash their hands when examining a laboring woman. Google Ignaz Semmelweiss.
Reply With Quote Quick reply to this message
 
Old 01-12-2011, 09:27 AM
 
Location: Chicago's burbs
1,013 posts, read 3,136,807 times
Reputation: 883
Quote:
Originally Posted by suzy_q2010 View Post
So, whether ACOG formally recommends routine scans, most obstetricians do scan routinely. And most insurance companies pay for 1 or 2 scans.
Even if the ACOG does not formally recommend routine scans, I would love to see the percentage of OB/GYN's that do routinely scan all their patients. I suspect the number of docs that do is overwhelming. I've honestly never heard of any OB/GYN not recommending at least 1 scan on all pregnant women.

Last edited by sbd78; 01-12-2011 at 09:39 AM..
Reply With Quote Quick reply to this message
 
Old 01-12-2011, 09:39 AM
 
745 posts, read 752,240 times
Reputation: 417
Quote:
Originally Posted by sbd78 View Post
Even if the ACOG does not formally recommend routine scans, I would love to see the percentage of OB/GYN's that do routinely scan all their patients. I suspect the number of docs that do is overwhelming. I've honestly never heard of any OB/GYN not recommending at least 1 scan on a pregnant woman.
See, I have had both models of care, OBs and home birth midwives. And both insisted I get at least one ultrasound (the 20 week anatomy scan). My midwife wouldn't consider seeing me anymore if I refused ultrasounds.

I couldn't imagine anyone thinking that it was a good idea to skip the anatomy scan . Life threatening or fatal fetal abnormalities can be detected, and I sure would want to be in the hospital for one of those cases. Personally, I think there is too much risk in avoiding all ultrasounds for a pregnancy. At least have one, to make sure everything is progressing correctly and to rule out and placental issues as well. While many claim an experienced midwife can hear a case of placenta previa with a stethoscope, I would want to KNOW without a doubt that it was safe.
Reply With Quote Quick reply to this message
 
Old 01-12-2011, 09:43 AM
 
Location: Chicago's burbs
1,013 posts, read 3,136,807 times
Reputation: 883
Quote:
Originally Posted by StephM View Post
See, I have had both models of care, OBs and home birth midwives. And both insisted I get at least one ultrasound (the 20 week anatomy scan). My midwife wouldn't consider seeing me anymore if I refused ultrasounds.

I couldn't imagine anyone thinking that it was a good idea to skip the anatomy scan . Life threatening or fatal fetal abnormalities can be detected, and I sure would want to be in the hospital for one of those cases. Personally, I think there is too much risk in avoiding all ultrasounds for a pregnancy. At least have one, to make sure everything is progressing correctly and to rule out and placental issues as well. While many claim an experienced midwife can hear a case of placenta previa with a stethoscope, I would want to KNOW without a doubt that it was safe.
I totally agree with this.
Reply With Quote Quick reply to this message
 
Old 01-28-2011, 03:37 PM
 
Location: Georgia, USA
10,328 posts, read 9,877,160 times
Reputation: 10237
Default ACOG policy on home birth update

http://www.idahoperinatal.org/docume...OGstandard.pdf
Reply With Quote Quick reply to this message
 
Old 02-21-2011, 10:47 PM
 
210 posts, read 196,111 times
Reputation: 300
Quote:
Originally Posted by sbd78 View Post
Even if the ACOG does not formally recommend routine scans, I would love to see the percentage of OB/GYN's that do routinely scan all their patients. I suspect the number of docs that do is overwhelming. I've honestly never heard of any OB/GYN not recommending at least 1 scan on all pregnant women.
And why would they not? I would want to know beforehand if there any issues I might need to prepare for. The anatomy scan is really important and if it's just for that reason.
Reply With Quote Quick reply to this message
 
Old 02-22-2011, 09:42 AM
 
Location: Manhattan, Ks
1,276 posts, read 3,654,567 times
Reputation: 1671
Quote:
Originally Posted by Akama13 View Post
And why would they not? I would want to know beforehand if there any issues I might need to prepare for. The anatomy scan is really important and if it's just for that reason.
This. I just had my anatomy scan last Thursday. There were some concerns that prompted a referral to a perinatalolgist next week. I'm holding out hope that everything is fine. But if there is a problem, it looks like delivering in a hospital with a the appropriate level NICU could be important to us. From where I'm sitting it's much better to know ahead of time and be prepared. Even if it's not necessary for 99% of pregnancies, if I'm that 1% that's all that matters to me, kwim?
Reply With Quote Quick reply to this message
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.

Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.


Reply
Please update this thread with any new information or opinions. This open thread is still read by thousands of people, so we encourage all additional points of view.

Quick Reply
Message:

Over $84,000 in prizes was already given out to active posters on our forum and additional giveaways are planned!

Go Back   City-Data Forum > General Forums > Parenting > Pregnancy
Similar Threads

All times are GMT -6.

2005-2014, Advameg, Inc.

City-Data.com - Archive 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 - Top