Early ultrasound in routine pregnancy care

Routine early ultrasound at weeks 11 –13 of gestation may have the same objective as the current practice of ultrasound at weeks 17 – 19. Since nuchal translucency will be observed at weeks 11 - 1 3, it is likely that early ultrasound will reveal more foetuses with a risk of chromosomal anomalies. 

Health effects

• We did not find evidence on health benefits due routine early ultrasound scans
• Offering routine early ultrasound may lead to a reduction in the number of children born with trisomy 21 (Down syndrome)
• We did not find clinical evidence on harmful effects or risks due to ultrasound scans per se for the mother, foetus or child.
• Early ultrasound may increase the rate of women who are satisfied with prenatal care
• The significance of better diagnostic accuracy of monochorionic twins is unclear

The diagnosis of different conditions

• Early ultrasound may detect almost all monochorionic twins, which may be more difficult at later stages of pregnancy.
• There is substantially uncertainty regarding diagnostic accuracy of ultrasound in the detection of serious structural anomalies, such as congenital heart defects.
• Nuchal translucency measurement combined with a serum test has higher accuracy in detecting cases of trisomy 21 than nuchal translucency measurement alone.

Other consequences of early ultrasound

The results of our economic model analyses show that introduction of a public programme of early ultrasound in addition to ultrasound at weeks 17 – 19 of gestation, may lead to a doubling of running costs compared to the programme currently in place. The actual utilization of ultrasound and foetal diagnostic procedures is higher than the levels estimated by the model. Therefore, it is not granted that the running costs associated with ultrasound and foetal diagnostics in Norwegian prenatal care will increase upon introducing routine early ultrasound.  Routine early ultrasound and foetal diagnostics is ethically challenging whether one decides to introduce a routine early ultrasound, or to retain current practice.