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Review
. 2021 Aug 26;8(8):CD014698.
doi: 10.1002/14651858.CD014698.

Routine ultrasound for fetal assessment before 24 weeks' gestation

Andrea Kaelin Agten  1 , Jun Xia  2 , Juliette A Servante  1 , Jim G Thornton  3 , Nia W Jones  3
Affiliations
Review

Routine ultrasound for fetal assessment before 24 weeks' gestation

Andrea Kaelin Agten et al. Cochrane Database Syst Rev. .

Abstract

Background: Ultrasound examination of pregnancy before 24 weeks gestation may lead to more accurate dating and earlier diagnosis of pathology, but may also give false reassurance. It can be used to monitor development or diagnose conditions of an unborn baby. This review compares the effect of routine or universal, ultrasound examination, performed before 24 completed weeks' gestation, with selective or no ultrasound examination. OBJECTIVES: To assess the effect of routine pregnancy ultrasound before 24 weeks as part of a screening programme, compared to selective ultrasound or no ultrasound, on the early diagnosis of abnormal pregnancy location, termination for fetal congenital abnormality, multiple pregnancy, maternal outcomes and later fetal compromise. To assess the effect of first trimester (before 14 weeks) and second trimester (14 to 24 weeks) ultrasound, separately.

Search methods: We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, and the World Health Organization's International Clinical Trials Registry Platform (ICTRP) on 11 August 2020. We also examined the reference lists of retrieved studies.

Selection criteria: We included randomised controlled trials (RCTs), quasi-RCTs, cluster-RCTs and RCTs published in abstract form. We included all trials with pregnant women who had routine or revealed ultrasound versus selective ultrasound, no ultrasound, or concealed ultrasound, before 24 weeks' gestation. All eligible studies were screened for scientific integrity and trustworthiness.

Data collection and analysis: Two review authors independently assessed trials for eligibility and risk of bias, extracted data and checked extracted data for accuracy. Two review authors independently used the GRADE approach to assess the certainty of evidence for each outcome MAIN RESULTS: Our review included data from 13 RCTs including 85,265 women. The review included four comparisons. Four trials were assessed to be at low risk of bias for both sequence generation and allocation concealment and two as high risk. The nature of the intervention made it impossible to blind women and staff providing care to treatment allocation. Sample attrition was low in the majority of trials and outcome data were available for most women. Many trials were conducted before it was customary for trials to be registered and protocols published. First trimester routine versus selective ultrasound: four studies, 1791 women, from Australia, Canada, the United Kingdom (UK) and the United States (US). First trimester scans probably reduce short-term maternal anxiety about pregnancy (risk ratio (RR) 0.80, 95% confidence interval (CI) 0.65 to 0.99; moderate-certainty evidence). We do not have information on whether the reduction was sustained. The evidence is very uncertain about the effect of first trimester scans on perinatal loss (RR 0.97, 95% CI 0.55 to 1.73; 648 participants; one study; low-certainty evidence) or induction of labour for post-maturity (RR 0.83, 95% CI 0.50 to 1.37; 1474 participants; three studies; low-certainty evidence). The effect of routine first trimester ultrasound on birth before 34 weeks or termination of pregnancy for fetal abnormality was not reported. Second trimester routine versus selective ultrasound: seven studies, 36,053 women, from Finland, Norway, South Africa, Sweden and the US. Second trimester scans probably make little difference to perinatal loss (RR 0.98, 95% CI 0.81 to 1.20; 17,918 participants, three studies; moderate-certainty evidence) or intrauterine fetal death (RR 0.97, 95% CI 0.66 to 1.42; 29,584 participants, three studies; low-certainty evidence). Second trimester scans may reduce induction of labour for post-maturity (RR 0.48, 95% CI 0.31 to 0.73; 24,174 participants, six studies; low-certainty evidence), presumably by more accurate dating. Routine second trimester ultrasound may improve detection of multiple pregnancy (RR 0.05, 95% CI 0.02 to 0.16; 274 participants, five studies; low-certainty evidence). Routine second trimester ultrasound may increase detection of major fetal abnormality before 24 weeks (RR 3.45, 95% CI 1.67 to 7.12; 387 participants, two studies; low-certainty evidence) and probably increases the number of women terminating pregnancy for major anomaly (RR 2.36, 95% CI 1.13 to 4.93; 26,893 participants, four studies; moderate-certainty evidence). Long-term follow-up of children exposed to scans before birth did not indicate harm to children's physical or intellectual development (RR 0.77, 95% CI 0.44 to 1.34; 603 participants, one study; low-certainty evidence). The effect of routine second trimester ultrasound on birth before 34 weeks or maternal anxiety was not reported. Standard care plus two ultrasounds and referral for complications versus standard care: one cluster-RCT, 47,431 women, from Democratic Republic of Congo, Guatemala, Kenya, Pakistan and Zambia. This trial included a co-intervention, training of healthcare workers and referral for complications and was, therefore, assessed separately. Standard pregnancy care plus two scans, and training and referral for complications, versus standard care probably makes little difference to whether women with complications give birth in a risk appropriate setting with facilities for caesarean section (RR 1.03, 95% CI 0.89 to 1.19; 11,680 participants; moderate-certainty evidence). The intervention also probably makes little to no difference to low birthweight (< 2500 g) (RR 1.01, 95% CI 0.90 to 1.13; 47,312 participants; moderate-certainty evidence). The evidence is very uncertain about whether the community intervention (including ultrasound) makes any difference to maternal mortality (RR 0.92, 95% CI 0.55 to 1.55; 46,768 participants; low-certainty evidence). Revealed ultrasound results (communicated to both patient and doctor) versus concealed ultrasound results (blinded to both patient and doctor at any time before 24 weeks): one study, 1095 women, from the UK. The evidence was very uncertain for all results relating to revealed versus concealed ultrasound scan (very low-certainty evidence).

Authors' conclusions: Early scans probably reduce short term maternal anxiety. Later scans may reduce labour induction for post-maturity. They may improve detection of major fetal abnormalities and increase the number of women who choose termination of pregnancy for this reason. They may also reduce the number of undetected twin pregnancies. All these findings accord with observational data. Neither type of scan appears to alter other important maternal or fetal outcomes, but our review may underestimate the effect in modern practice because trials were mostly from relatively early in the development of the technology, and many control participants also had scans. The trials were also underpowered to show an effect on other important maternal or fetal outcomes.

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Conflict of interest statement

The authors have nothing to declare.

AK: no conflict of interest.

NJ: no conflict of interest.

JX: no conflict of interest.

JT: no conflict of interest.

JS: no conflict of interest.

Figures

1
1
Figure 1 ‐ process for using the Cochrane Pregnancy and Childbirth criteria for assessing the trustworthiness of a study
2
2
Study flow diagram.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 1: Maternal anxiety (mother worried about pregnancy)
1.2
1.2. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 2: Perinatal loss
1.3
1.3. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 3: Perinatal death
1.4
1.4. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 4: Perinatal death (excluding lethal malformations)
1.5
1.5. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 5: Miscarriage (fetal loss before 20 weeks)
1.6
1.6. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 6: IUFD
1.7
1.7. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 7: Detection of multiple pregnancy by 24 to 26 weeks' gestation (number NOT detected)
1.8
1.8. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 8: Detection of multiple pregnancy before labour (number NOT detected)
1.9
1.9. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 9: Ectopic pregnancy before clinical presentation
1.10
1.10. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 10: Caesarean section rate
1.11
1.11. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 11: Induction of labour for post maturity
1.12
1.12. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 12: Induction of labour for any cause
1.13
1.13. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 13: Termination of pregnancy for any cause
1.14
1.14. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 14: Appropriately timed serum screening tests (number having repeat screening)
1.15
1.15. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 15: Appropriately timed anomaly scan (18 to 22 weeks)(number NOT appropriately timed)
1.16
1.16. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 16: Serious neonatal morbidity (admission to neonatal intensive care unit)
1.17
1.17. Analysis
Comparison 1: First trimester routine versus selective ultrasound, Outcome 17: Low birthweight (less than 2500 g)
2.1
2.1. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 1: Perinatal loss
2.2
2.2. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 2: Perinatal death (all babies)
2.3
2.3. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 3: Perinatal death (excluding lethal malformations)
2.4
2.4. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 4: Miscarriage (fetal loss before 20 weeks)
2.5
2.5. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 5: IUFD
2.6
2.6. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 6: Detection of multiple pregnancy by 24 to 26 weeks' gestation (number NOT detected)
2.7
2.7. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 7: Detection of multiple pregnancy before labour (number NOT detected)
2.8
2.8. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 8: Number of fetal ultrasound scans
2.9
2.9. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 9: Number of antenatal visits
2.10
2.10. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 10: Antenatal hospital admission
2.11
2.11. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 11: Caesarean section rate
2.12
2.12. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 12: Induction of labour for post maturity
2.13
2.13. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 13: Induction of labour for any cause
2.14
2.14. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 14: Termination of pregnancy for any cause
2.15
2.15. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 15: Detection of fetal abnormality before 24 weeks' gestation
2.16
2.16. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 16: Termination of pregnancy for fetal abnormality
2.17
2.17. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 17: Serious neonatal morbidity
2.18
2.18. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 18: Neonatal death
2.19
2.19. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 19: Admission to neonatal intensive care unit
2.20
2.20. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 20: Mean birthweight (g)
2.21
2.21. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 21: Low birthweight (less than 2500 g)
2.22
2.22. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 22: Very low birthweight (< 1500 g)
2.23
2.23. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 23: Small‐for‐gestational age
2.24
2.24. Analysis
Comparison 2: Second trimester routine versus selective ultrasound, Outcome 24: Dyslexia
3.1
3.1. Analysis
Comparison 3: Standard care plus two ultrasounds and referral for complications vs standard care, Outcome 1: IUFD
3.2
3.2. Analysis
Comparison 3: Standard care plus two ultrasounds and referral for complications vs standard care, Outcome 2: Birth in a risk‐appropriate setting
3.3
3.3. Analysis
Comparison 3: Standard care plus two ultrasounds and referral for complications vs standard care, Outcome 3: Antenatal care utilisation (4 or more visits)
3.4
3.4. Analysis
Comparison 3: Standard care plus two ultrasounds and referral for complications vs standard care, Outcome 4: Caesarean section rate (unadjusted)
3.5
3.5. Analysis
Comparison 3: Standard care plus two ultrasounds and referral for complications vs standard care, Outcome 5: Maternal mortality (unadjusted)
3.6
3.6. Analysis
Comparison 3: Standard care plus two ultrasounds and referral for complications vs standard care, Outcome 6: Neonatal death
3.7
3.7. Analysis
Comparison 3: Standard care plus two ultrasounds and referral for complications vs standard care, Outcome 7: Low birthweight (< 2500 g)
4.1
4.1. Analysis
Comparison 4: Revealed (ultrasound results communicated to both patient and doctor) versus concealed (ultrasound results blinded to both doctor and patient) at any time before 24 weeks, Outcome 1: Perinatal loss
4.2
4.2. Analysis
Comparison 4: Revealed (ultrasound results communicated to both patient and doctor) versus concealed (ultrasound results blinded to both doctor and patient) at any time before 24 weeks, Outcome 2: Perinatal death (all babies)
4.3
4.3. Analysis
Comparison 4: Revealed (ultrasound results communicated to both patient and doctor) versus concealed (ultrasound results blinded to both doctor and patient) at any time before 24 weeks, Outcome 3: Perinatal death (excluding lethal malformations)
4.4
4.4. Analysis
Comparison 4: Revealed (ultrasound results communicated to both patient and doctor) versus concealed (ultrasound results blinded to both doctor and patient) at any time before 24 weeks, Outcome 4: IUFD
4.5
4.5. Analysis
Comparison 4: Revealed (ultrasound results communicated to both patient and doctor) versus concealed (ultrasound results blinded to both doctor and patient) at any time before 24 weeks, Outcome 5: Detection of multiple pregnancy by 24 to 26 weeks' gestation (number NOT detected)
4.6
4.6. Analysis
Comparison 4: Revealed (ultrasound results communicated to both patient and doctor) versus concealed (ultrasound results blinded to both doctor and patient) at any time before 24 weeks, Outcome 6: Induction of labour for any cause
4.7
4.7. Analysis
Comparison 4: Revealed (ultrasound results communicated to both patient and doctor) versus concealed (ultrasound results blinded to both doctor and patient) at any time before 24 weeks, Outcome 7: Termination of pregnancy for any cause
4.8
4.8. Analysis
Comparison 4: Revealed (ultrasound results communicated to both patient and doctor) versus concealed (ultrasound results blinded to both doctor and patient) at any time before 24 weeks, Outcome 8: Neonatal death
4.9
4.9. Analysis
Comparison 4: Revealed (ultrasound results communicated to both patient and doctor) versus concealed (ultrasound results blinded to both doctor and patient) at any time before 24 weeks, Outcome 9: Low birthweight (less than 2500 g)
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References

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References to studies excluded from this review

Chen 2008 {published data only}
    1. Chen M, Lee CP, Lam YH, Tang RY, Chan BC, Wong SF, et al. Comparison of nuchal and detailed morphology ultrasound examinations in early pregnancy for fetal structural abnormality screening: a randomized controlled trial. Ultrasound in Obstetrics & Gynecology 2008;31(2):136-46. - PubMed
Duff 1993 {published data only}
    1. Duff G. A randomised controlled trial in a hospital population of ultrasound measurement screening for the small for dates baby. In: Proceedings of 2nd International Scientific Meeting of the Royal College of Obstetricians and Gynaecologists; 1993 Sept 7-10; Hong Kong. 1993:90. [CENTRAL: CN-00231440]
    1. Duff GB. A randomized controlled trial in a hospital population of ultrasound measurement screening for the small for dates baby. Australian & New Zealand Journal of Obstetrics & Gynaecology 1993;33(4):374-8. [CENTRAL: CN-00101196] [PMID: ] - PubMed
Hoglund Carlsson 2016 {published data only}
    1. Hoglund Carlsson L, Saltvedt S, Anderlid BM, Westerlund J, Gillberg C, Westgren M, et al. Ultrasound in the first and second trimester and autism; a prospective randomized study. Ultrasound in Obstetrics & Gynecology 2016;48(3):285-8. [PMID: ] - PubMed
Larsen 1992 {published data only}
    1. Larsen T, Larsen JK, Petersen S, Greisen G. Detection of small-for-gestational-age fetuses by ultrasound screening in a high risk population: a randomized controlled study. British Journal of Obstetrics and Gynaecology 1992;99(6):469-74. [CENTRAL: CN-00085901] [PMID: ] - PubMed
Leung 2006 {published data only}
    1. Leung KY, Ngai CS, Lee A, Chan HY, Leung WC, Lee CP, et al. The effects on maternal anxiety of two-dimensional versus two- plus three-/four-dimensional ultrasound in pregnancies at risk of fetal abnormalities: A randomized study. Ultrasound in Obstetrics & Gynecology 2006;28(3):249-54. [CENTRAL: CN-00585837] [EMBASE: 2006458544] [PMID: ] - PubMed
Nelson 2017 {published data only}
    1. Nelson T, Patwardhan S, Wineland R, Sullivan S, Lobaugh K, Willan K, et al. A prospective randomized pilot study of handheld ultrasound assessment of abdominal circumference (HHUS/AC) to detect growth abnormalities. American Journal of Obstetrics and Gynecology 2017;216(1 Suppl):S133, Abstract no: 208.
Owen 1994 {published data only}
    1. Owen P, Donnet L, Ogston S, Christie A, Patel N, Howie P. A study of fetal growth velocity. British Journal of Obstetrics and Gynaecology 1994;101:270. [CENTRAL: CN-00233804] - PubMed
Rustico 2005 {published data only}
    1. Righetti PL, Dell'Avanzo M, Grigio M, Nicolini U. Maternal/paternal antenatal attachment and fourth-dimensional ultrasound technique: a preliminary report. British Journal of Psychology 2005;96(Pt 1):129-37. [CENTRAL: CN-00514337] [PMID: ] - PubMed
    1. Rustico MA, Mastromatteo C, Grigio M, Maggioni C, Gregori D, Nicolini U. Two-dimensional vs. two- plus four-dimensional ultrasound in pregnancy and the effect on maternal emotional status: a randomized study. Ultrasound in Obstetrics & Gynecology 2005;25(5):468-72. [CENTRAL: CN-00521612] [PMID: ] - PubMed
Saltvedt 2006 {published data only}
    1. Georgsson Ohman S, Saltvedt S, Grunewald C, Waldenstrom U. Does fetal screening affect the women's worries about the health of their baby? A randomized controlled trial of ultrasound screening for Down's syndrome versus routine ultrasound screening. Acta Obstetricia et Gynecologica Scandinavica 2004;83:634-40. [CENTRAL: CN-00520169] - PubMed
    1. Georgsson Ohman S, Waldenstrom U, Georgsson Ohman S, Waldenstrom U. Effect of first-trimester ultrasound screening for Down syndrome on maternal-fetal attachment--a randomized controlled trial. Sexual & Reproductive Healthcare 2010;1(3):85-90. [CENTRAL: CN-00786979] [PMID: ] - PubMed
    1. Saltvedt S, Almstrom H, Kublickas M, Reilly M, Valentin L, Grunewald C. Ultrasound dating at 12-14 or 15-20 weeks of gestation? A prospective cross-validation of established dating formulae in a population of in-vitro fertilized pregnancies randomized to early or late dating scan. Ultrasound in Obstetrics & Gynecology 2004;24(1):42-50. [CENTRAL: CN-00481268] [PMID: ] - PubMed
    1. Saltvedt S, Almstrom H, Kublickas M, Valentin L, Bottinga R, Bui TH, et al. Screening for Down syndrome based on maternal age or fetal nuchal translucency: a randomized controlled trial in 39,572 pregnancies. Ultrasound in Obstetrics & Gynecology 2005;25(6):537-45. [CENTRAL: CN-00522089] [EMBASE: 2005271576] [PMID: ] - PubMed
    1. Saltvedt S, Almstrom H, Kublickas M, Valentin L, Grunewald C. Detection of malformations in chromosomally normal fetuses by routine ultrasound at 12 or 18 weeks of gestation-a randomised controlled trial in 39,572 pregnancies. BJOG: an international journal of obstetrics and gynaecology 2006;113(6):664-74. [CENTRAL: CN-00556441] [EMBASE: 2006250815] [PMID: ] - PubMed
Schifano 2010 {published data only}
    1. Schifano M, Luchi C, Sceusa F, Nanini C, Pepe A, Mannella P, et al. Women's attitude towards ultrasound scanning in the first trimester of pregnancy: two-dimensional versus two-plus four-dimensional ultrasound effects on maternal emotional status. Journal of Psychosomatic Obstetrics and Gynaecology 2010;31(s1):65. [CENTRAL: CN-00776956]
Schwarzler 1999 {published data only}
    1. Schwarzler P, Senat MV, Holden D, Bernard JP, Masroor T, Ville Y. Feasibility of the second-trimester ultrasound examination in an unselected population at 18, 20 or 22 weeks of pregnancy: a randomised trial. Ultrasound in Obstetrics & Gynecology 1999;14:92-7. [CENTRAL: CN-00272375] - PubMed
Votino 2012 {published data only}
    1. Votino C, Kacem Y, Dobrescu O, Dessy H, Cos T, Foulon W, et al. Use of a high-frequency linear transducer and MTI filtered color flow mapping in the assessment of fetal heart anatomy at the routine 11 to 13 + 6-week scan: a randomized trial. Ultrasound in Obstetrics & Gynecology 2012;39(2):145-51. [CENTRAL: CN-00896348] [EMBASE: 21465608] [PMID: ] - PubMed
Zhang 2018 {published data only}
    1. Zhang C, Hediger ML, Albert PS, Grewal J, Sciscione A, Grobman WA, et al. Association of maternal obesity with longitudinal ultrasonographic measures of fetal growth: findings from the nichd fetal growth studies-singletons. JAMA Pediatrics 2018;172(1):24-31. [CENTRAL: CN-02113669] [EMBASE: 620071393] - PMC - PubMed

References to studies awaiting assessment

Belanger 1996 {published data only}
    1. Belanger K, Hobbins JC, Muller JP, Howard S. Neurological testing in ultrasound exposed infants. American Journal of Obstetrics and Gynecology 1996;174(1 Pt 2):413. [CENTRAL: CN-00230458]
Snaith 2004 {published data only}
    1. Deverill M, Snaith V, Howel D, Hewison J, Sturgiss S, Robson S. The Newcastle randomised controlled trial of early screening for fetal abnormality - women's preferences for early information on fetal status and cost-effectiveness analysis [abstract]. Journal of Obstetrics and Gynaecology 2004;24(Suppl 1):S20. [CENTRAL: CN-00498555]
    1. Snaith V, Howel D, Deverill M, Hewison J, Sturgiss S, Robson S. The Newcastle randomised controlled trial of early ultrasound screening for fetal abnormality (FA) - termination of pregnancy for FA and psychological consequences [abstract]. Journal of Obstetrics and Gynaecology 2004;24(Suppl 1):S19. [CENTRAL: CN-00498624]
    1. Snaith VJ, Howel D, Chadwick T, Deverill M, Hewison J, Sturgiss SN, et al. First trimester ultrasound screening - the psychological consequences of termination of pregnancy for foetal abnormality. Journal of Reproductive and Infant Psychology 2004;22(3):239. [CENTRAL: CN-00677270]
    1. Sturgiss S, Howel D, Snaith V, Deverill M, Hewison J, Robson S. The Newcastle randomized controlled trial of early ultrasound screening for fetal abnormality: impact on gestation at diagnosis [abstract]. Journal of Obstetrics and Gynaecology 2005;25 Suppl 1:S20. [CENTRAL: CN-00550226]
Wald 1988 {published data only}
    1. Wald NJ. Randomised controlled trial of routine dating ultrasound in pregnancy. Personal Communication (first received 1988).

References to ongoing studies

Figueras 2017 {published data only}
    1. Correction. revealed versus concealed criteria for placental insufficiency in an unselected obstetric population in late pregnancy (RATIO37): randomised controlled trial study protocol. BMJ Open 2019;19;9(2):e014835corr1. - PMC - PubMed
    1. Figueras F, Gratacos E, Rial M, Gull I, Krofta L, Lubusky M, et al. Revealed versus concealed criteria for placental insufficiency in an unselected obstetric population in late pregnancy (RATIO37): randomised controlled trial study protocol. BMJ Open 2017;7(6):e014835. - PMC - PubMed
    1. NCT02907242. Revealed versus concealed cerebroplacental ratio [Revealed versus concealed criteria for placental insufficiency in unselected obstetric population in late pregnancy: a multicenter randomized controlled trial]. Https://clinicaltrials.gov/show/NCT02907242 2016 Aug 1. [CENTRAL: CN-02033067]
Pietersma 2018 {published data only}
    1. Pietersma C, Mulders A, Steegers EA, Rousian M. P05.09: virtual reality and feasibility and efficacy of first trimester ultrasound: a randomised controlled trial (VR FETUS study). Ultrasound in Obstetrics & Gynecology 2018;52(S1):154-5.
Richter 2020 {published data only}
    1. PACTR201808107241133. Testing the added benefits of promoting early child development during pregnancy ultrasound. Http://www.who.int/trialsearch/Trial2.aspx?TrialID=PACTR201808107241133 2018. [CENTRAL: CN-01906468]
    1. Richter L, Slemming W, Norris SA, Stein A, Poston L, Pasupathy D. Health Pregnancy, Healthy Baby: testing the added benefits of pregnancy ultrasound scan for child development in a randomised control trial. Trials 2020;21(1):25. [CENTRAL: CN-02073143] [EMBASE: 630520638] [PMID: ] - PMC - PubMed

Additional references

Barnett 2002
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Begg 1996
    1. Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA 1996 Aug;28(276(8)):637-9. - PubMed
Bricker 2015
    1. Bricker L, Medley N, Pratt JJ. Routine ultrasound in late pregnancy (after 24 weeks' gestation). Cochrane Database of Systematic Reviews 1025, Issue 6. Art. No: CD001451. [DOI: 10.1002/14651858.CD001451.pub4] - DOI - PMC - PubMed
Carlisle 2017
    1. Carlisle B. Data fabrication and other reasons for non‐random sampling in 5087 randomised, controlled trials in anaesthetic and general medical journals. Anaesthesia 2017;72:944–52. - PubMed
Chen 2019
    1. Chen FC, Bacovsky A, Entezami M, Henrich W. Nearly half of all severe fetal anomalies can be detected by first-trimester screening in experts' hands. Journal Perinatal Medicine 2019;47:619-24. - PubMed
Garcia 2002
    1. Garcia J, Bricker L, Henderson J, Martin M, Mugford M, Nielson J, Roberts T. Women's Views of Pregnancy Ultrasound: A Systematic Review. Birth Issues in perinatal care 04.12.2002;29(4):225-250. - PubMed
García Fernández 2019
    1. García Fernández S, Arenas Ramirez J, Otero Chouza MT, Rodriguez-Vijande Alonso B, Llaneza Coto ÁP. Early fetal ultrasound screening for major congenital heart defects without Doppler. European Journal of Obstetrics & Gynecology and Reproductive Biology 2019;233:93-7. - PubMed
Glanc 2018
    1. Glanc P, D'Souza R, Parrish J, Tomlinson G, Maxwell C. Should an early anatomy ultrasound scan be offered routinely to obese pregnant women? Journal of Obstetrics and Gynaecology Canada 2018;40:1288-94. - PubMed
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Hofmeyr 2009
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Panaiotova 2019
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Peek 1994
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References to other published versions of this review

Whitworth 2015
    1. Whitworth M, Bricker L, Mullan C. Ultrasound for fetal assessment in early pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 7. Art. No: CD007058. [DOI: 10.1002/14651858.CD007058.pub3] - DOI - PMC - PubMed