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产前超声筛查的随机试验:对孕产妇管理及结局的影响。RADIUS(超声常规产前诊断成像)研究组。

A randomized trial of prenatal ultrasonographic screening: impact on maternal management and outcome. RADIUS (Routine Antenatal Diagnostic Imaging with Ultrasound) Study Group.

作者信息

LeFevre M L, Bain R P, Ewigman B G, Frigoletto F D, Crane J P, McNellis D

机构信息

Department of Family and Community Medicine, University of Missouri, Columbia 65212.

出版信息

Am J Obstet Gynecol. 1993 Sep;169(3):483-9. doi: 10.1016/0002-9378(93)90605-i.

Abstract

OBJECTIVES

This randomized clinical trial of 15,530 women was designed to test the hypothesis that screening ultrasonography in low-risk pregnancies would improve perinatal outcome. A secondary hypothesis addressed in this article was that screening ultrasonography would have a favorable impact on maternal management or outcome.

STUDY DESIGN

Pregnant women without a specific indication for ultrasonographic examination in early pregnancy were randomly assigned to have either two screening sonograms or conventional obstetric care. Pregnancy interventions and maternal outcomes were compared in the two groups.

RESULTS

No significant differences were found in maternal outcomes. Use of ultrasonography was markedly higher in the screened group. The rates of induced abortion, amniocentesis, tests of fetal well-being, external version, induction, and cesarean section and the distribution of total hospital days were similar in the two groups. Use of tocolytics and the rate of postdate pregnancy were both slightly lower in the screened group.

CONCLUSION

Screening ultrasonography resulted in no clinically significant benefit.

摘要

目的

这项针对15530名女性的随机临床试验旨在检验以下假设:对低风险妊娠进行超声筛查可改善围产期结局。本文探讨的次要假设是,超声筛查会对产妇管理或结局产生有利影响。

研究设计

在孕早期无超声检查特定指征的孕妇被随机分为两组,一组接受两次超声筛查,另一组接受常规产科护理。比较两组的妊娠干预措施和产妇结局。

结果

两组产妇结局无显著差异。筛查组的超声检查使用率明显更高。两组的人工流产率、羊膜穿刺术、胎儿健康检查、外倒转术、引产和剖宫产率以及总住院天数分布相似。筛查组的宫缩抑制剂使用率和过期妊娠率均略低。

结论

超声筛查未带来临床上的显著益处。

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