Celebrating 190 Years

There is no evidence at all that this is beneficial to women and babies. WHO does not recommend a third trimester scan based on lack of evidence of effect. If the issue is ‘large baby’ fetal weight estimation by scan is inaccurate and anyway it is the interaction between mother and baby in labour that matters and not the size of the baby alone. If it is ‘small baby’ it should already be clear by this gestation if the baby is below the 3^rd centile, or if it has severe tailing off of growth (which are the main, but not, of course, the only) indicators of pathologically small babies) I don’t know what the amount of amniotic fluid is supposed to indicate at that gestation but anyway it wont tell anyone much about fetal wellbeing alone. In the uk, the only time a full workup is done at this gestation (including scan) is if women report being concerned about reduced fetal movements. Also dating of pregnancies is inaccurate by several days when womens cycle (and therefore the probable time of ovulation) is taken into account, and so 40+3 days is a relatively meaningless degree of accuracy.

Just my thoughts anyway Rainhild! Id be inclined to ask the insurance companies for the evidence that this policy reduces risk, and, indeed to demonstrate that it does not cause harm due to increased levels of unnecessary induction and/or CS based on inaccurate scan estimations.

All the best

Soo

From: A forum for discussion on midwifery and reproductive health research. <[log in to unmask]> On Behalf Of Rainhild Schäfers
Sent: 01 April 2019 12:08
To: [log in to unmask]
Subject: Question monitoring prolonged pregnancy

Dear colleagues

I have a question for you and hope for your support. In Germany, experts recommend to have an ultrasound examination when the estimated date of birth is reached. In addition, health insurance companies in Germany require pregnant women to have an ultrasound performed at 40+3 weeks of pregnancy. The aim is to estimate the fetal weight and determine the amount of amniotic fluid.

Now my question to you: How do you handle this in your country? How does the monitoring of a pregnant woman work when the estimated date is reached? Apart from the great NICE Guidelines, are there any national guidelines you can send me? It would be great if I could get answers especially from the Netherlands, Belgium, France and Scandinavia.

All best wishes

Rainhild

Prof’in. Dr. Rainhild Schäfers