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Wiley InterScience

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 113 Issue 2, Pages 171 - 176

Published Online: 13 Jan 2006

Journal compilation © 2010 RCOG



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General obstetrics
Does a first trimester dating scan using crown rump length measurement reduce the rate of induction of labour for prolonged pregnancy? An uncompleted randomised controlled trial of 463 women
DJ Harrington, a IZ MacKenzie, a K Thompson, a M Fleminger, b C Greenwood a
  a Department of Obstetrics and Gynaecology, The Women's Centre, John Radcliffe Hospital, Oxford, UK and  b Hollow Way Medical Centre, Oxford, UK
Correspondence to  Dr C Greenwood, Department of Obstetrics and Gynaecology, Level 4, The Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK. Email catherine.greenwood@orh.nhs.uk
Copyright RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology
KEYWORDS
Induction of labour • Labour • pregnancy • ultrasound

ABSTRACT

Objective To evaluate the effect of a first trimester ultrasound dating scan on the rate of induction of labour for prolonged pregnancy.

Design Randomised controlled trial to include 400 women in each arm of the trial.

Setting Participating general practices and a district general teaching hospital.

Population Women attending their general practitioner in the first trimester to confirm pregnancy, in whom a first trimester ultrasound scan was not indicated.

Methods Women randomised to the study group (scan group) underwent an ultrasound dating scan between 8 and 12 weeks, measuring crown-rump length. The estimated date of delivery (EDD) was changed if there was a discrepancy of more than 5 days from the gestation, calculated from the last menstrual period (LMP). For the remaining women (no-scan group), gestation was determined using the LMP.

Main outcome measures The rate of induction of labour for prolonged pregnancy.

Results Due to circumstances beyond the researchers' control, recruitment was abandoned when 463 women had been enrolled. The EDD was adjusted in 13 (5.7%) women in the scan group and in 2 (0.9%) in the no-scan group. There was no difference in the rate of induction for prolonged pregnancy between the scan (19 [8.2%]) and the no-scan (17 [7.4%]) groups (relative risk 1.10; 95% CI 0.59–2.07).

Conclusions Acknowledging the reduced numbers recruited for study, it is concluded that there is no evidence that a first trimester ultrasound dating scan reduces the rate of induction of labour for prolonged pregnancy and may result in a more expensive healthcare strategy.


Accepted 9 November 2005.

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1471-0528.2005.00833.x About DOI

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