Routine pregnancy exams to check a baby is in a good position before birth are not sensitive enough, experts warn. They say simply feeling the mother's bump or palpation - misses about 24 in 100 cases of abnormal lie, where a baby is not in the normal head-down position.
Knowing the lie of a baby is important because some positions, like foot-first or breech, make vaginal delivery difficult or impossible.
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Routine ultrasound tests may be needed, says the British Medical Journal, as ultrasound scans can show the baby's exact position
A team at the University of Sydney studied 1,633 women in their 35th to 37th week of pregnancy who were attending an antenatal clinic at a local obstetric hospital. Each woman was examined in the usual way by a doctor to assess the position of their baby. Afterwards the women also underwent an ultrasound scan to confirm the position.
Simple palpation detected 70% of the babies who were not in the head-down position but missed the other 30%. The researchers reason that if this figure is applied to a general maternity population of 1,000 women, clinical examination would identify 101 women as having an abnormal lie but in only 56 would this be correct and 24 women with abnormal lie would be missed altogether.
They suggested routine ultrasound scans for women late in pregnancy might help spot more babies with abnormal lie, but stressed that the cost effectiveness of such screening would have to be assessed before any services could be rolled out.
August 2006 |
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