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ultrasound in EU ( was Holland )From: Malcolm Griffiths (Malcolm@mgriff22.demon.co.uk)Thu May 30 14:16:04 1996
In message <9605301033.AA14665@?>, "T-H Bui, Clinical Genetics, Karolinska Hospital" <bui@gen.ks.se> writes >At 01.07 1996-05-29 -0500, gerard.miranda@bcn.servicom.es wrote: >>Hi listers: can somebody tell me which is the ultrasound situation in >>Holland? How many ultrasound test do You make in a normal pregnancy? This >>afternoon a women said me that the ultrasound are restrict in Holland? Is >>that true ? >> >>Gerard Miranda M.D >>J.V Foix, 18. S.Joan de Vilatorrada. Barcelona. Spain >>Gerard Miranda M.D >>J.V Foix, 18. S.Joan de Vilatorrada.08250 >>Barcelona-Spain >> > >At the 'Eucromic workshop on prenatal diagnosis' - a EU concerted action on >prenatal diagnosis - last week the Dutch delegates (NJ Leschot and MD >Kloosterman) mentioned that routine ultrasound screening is not standard >practice in their country. However, level III U/S are targeted at women who >are at increased risk of fetal structural anomalies. This was in constrast >with some other EU countries where, now, three U/S scans (one for each >trimester) were standard and paid for by the insurers/national health service... > In fact the UK ( which is still part of the EU, but to the annoyance of some conservatives ;-) ) the pattern of routine scans varies from none, through one to two. 0 Certainly in some parts of Scotland, there is great scepticism that routine anomaly scans achieve anything, indeed the data can be interpreted to indicate that scans simply convert early neonatal deaths and stillbirths to second trimester induced abortions. Similarly in both parts of Ireland where availability of termination ( even for abnormality ) is not freely available, the logic is not to scan either. 1 Even the most optimistic interpretation of the data would only support a single second trimester scan ( @ 18 - 20 weeks ), this is all that's offered in many units in the UK. 2 In additon to the above many units see advantages in a later first/early second trimester scan. This has two functions: a) recognises non-viable pregnancies earlier than a 20 week scan would ( this means, empty sacs, no FH, etc. ) allowing earlier evacuation; b) provides reliable data for interpeting serum screening, some reports show dates by LMP inaccurate in more than 30% of cases. 3 Nowhere in the UK ( as far as I am aware ) routinely does three scans. I am aware of some purchasers ( these are local public bodies that buy health-care from providers [ eg, hospitals ] ) who have withdrawn funding for routine scans which they believe to be of no value. They've simply looked at "Guide to Effective Care ...", which effectively says it not of proven value, and concluded they shouldn't waste money on it !
--
Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt
Obstetrician & Gynaecologist Luton & Dunstable Hosp.,UK.
Tel: 01582-497459 (office)
01525-222849 (home)
Fax: 01582-497424
email: Malcolm@mgriff22.demon.co.uk
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