Third pregnancy scan at 36 weeks could be ‘game-changing’ | UK News

A third scan at the end of pregnancy could be a “game changer”, according to a study.

Women had scans at 12 and 20 weeks, but were referred for another scan only if a potential risk was identified.

Researchers believe that having a baby in the third trimester can reduce unplanned breech deliveries by 70 percent, as well as the chances of the baby being born with serious health complications.

About 4 percent of babies end up in an unexpected breech position at the end of pregnancy, the data shows – with the child’s feet or buttocks first.

This puts them at higher risk of needing to go to the neonatal unit, brain injury or even death.

Study leader Asma Khalil, professor of obstetrics and maternal-fetal medicine at St George’s, University of London, said: “Knowing how the baby lies in the third trimester is crucial because we want to avoid breech deliveries as much as possible.”

“These two routine scans are too early to tell us where the baby is at delivery, which is why a third scan at 36-37 weeks could be a game-changer for pregnancy and delivery care.”

The study compared unplanned breech deliveries and infant health after two hospitals adopted different third-trimester scanning policies.

Some 7,351 or more than 24,000 women attending St George’s University Hospital NHS Foundation Trust underwent an additional ultrasound at 36 weeks.

At Norfolk and Norwich University Hospital NHS Foundation Trust, 5,119 of almost 9,700 women underwent two standard ultrasounds, while the remainder also underwent hand-held scanning at 36 weeks.

“Safer, Healthier Childbirth”

The study found that both third-trimester scanning methods significantly reduced unplanned breech deliveries.

The reduction was 71% for standard ultrasonography and 69% for handheld scanning.

Babies whose mothers had a third scan were also 16% less likely to be admitted to the neonatal unit and 40-77% less likely to have a low Apgar score after birth.

Apgar assesses heart rate, appearance and colour, muscle function, reflexes and breathing ability.

Mothers who underwent the third scan were also less likely to need an emergency C-section.

Professor Khalil said: “We have shown for the first time that just one extra scan can save expectant mothers from trauma, emergency c-sections and their babies from serious health complications that would otherwise be avoidable.”

“Our research comes at a time when safety in maternity services is a concern and provides the NHS with a clear solution to help maternity units better prepare for safer, healthier births.”

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She hopes more midwives can be trained to use the handheld device so women can have a third scan at home or in hospital, and that national guidelines will change.

A spokesman for the National Institute for Health and Care Excellence said it already had guidance on “recognition and management of breech presentations” but it would review the research to see if it needed to be updated.

It says it currently recommends that “midwives examine a woman’s abdomen by palpation at all appointments after 36 weeks to determine possible breech position in a woman carrying a baby.

“If a breech presentation is suspected, an ultrasound scan is used to confirm that is the case.”

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