Accuracy sonogram dating

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Cost-benefit ratios of routine ultrasound use have still not been completely resolved in every practice setting, with one study suggesting that community-based hospitals would actually lose money if routine ultrasound screening is performed.further states that ultrasound sensitivity in detecting fetal anomalies remains controversial, with higher detection rates reported at tertiary centers and higher sensitivity rates overall for central nervous system and urinary tract versus cardiac anomalies.When one also considers the costs of postterm surveillance, which typically includes twice weekly nonstress tests and weekly amniotic fluid measurements, there are potential cost savings with accurate dating by early ultrasound assessment -- not to mention the costs of fetal fibronectin cultures or the clinical and legal implications of inappropriately managing preterm labor.Does it not then behoove all obstetric providers to discuss and offer routine ultrasound screening to every pregnant woman, even in the absence of medical indications?This is an interesting sidebar that provides some latitude in an otherwise firm stance echoing the RADIUS trial findings.In spite of this ongoing debate as to the feasibility and efficacy of routine ultrasound evaluation in pregnancy, one thing remains clear: ultrasound examination of the fetus provides the most precise assessment of gestational age, especially in the first trimester.

Practicing what is commonly referred to as the "ALARA" principle (As Low As Reasonably Achievable), there have been no studies to date that have reported any adverse bioeffects on human fetuses as a result of exposure to the low levels of ultrasound energy in use today.

They further concluded that the costs associated with routine screening were too prohibitive to justify its use in the absence of clear medical indications.

states that obstetricians are under no obligation to perform routine ultrasounds in low-risk women; however, it is reasonable to honor a patient's request for one.

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