Effectiveness of antenatal care: a population based study
Abstract
OBJECTIVE: To analyse the effectiveness of antenatal care as a screening for nonsymptomatic disease and obstetrical risk conditions. DESIGN: Programme evaluation of antenatal care in a geographically based cohort. SETTING: Routine clinical practice in primary and specialist level of health care without intervention. SUBJECTS: One thousand nine hundred and eight women residing in one Norwegian county giving birth during a 12 month period, 1988 to 1989. OUTCOME MEASURES: The detection rates at the time of delivery, for women with five conditions: twin pregnancies, placenta praevia, breech presentation, small for gestational age (SGA) and pre-eclampsia. RESULTS: Two hundred and ninety-two women had one or more of the actual conditions, 124 (42%) had been diagnosed at the time of the delivery. The detection rate for SGA was remarkably low (14%). The detection rates for pre-eclampsia (75%), breech presentation (69%), placenta praevia (57%) and twin pregnancies (94%) were in the same range as results reported in the literature. The number of false positive antenatal diagnosis was insignificant. CONCLUSIONS: Assessing the effectiveness of antenatal diagnosis of growth retardation is connected with major unsolved methodological problems. Clinical management of such cases may be better than indicated by the results based on the ultimate SGA classification. For important obstetrical conditions this study describes an applicable method for practical evaluation of the effectiveness of antenatal care. Areas where care could be improved are demonstrated.
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Symphysio-fundal height measurement performs poorly, with detection rates as low as 14% in some studies.
“This technique performs poorly, with detection rates as low as only 14% in some studies [14].”
From Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta (2019) · cites this paper as [14]
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Intrauterine growth restriction: new concepts in antenatal surveillance, diagnosis, and management
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Volume and vascularity: Using ultrasound to unlock the secrets of the first trimester placenta
Mathewlynn, S., & Collins, S. L. (2019) · Placenta · doi:10.1016/j.placenta.2019.06.379 · Cited by 30 · see citing works
- Authors
- Backe, B., & Consultant, J. N.
- Affiliations
- Lillehammer Municipality (NO)
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 1993-08
- Volume
- 100
- Issue
- 8
- Pages
- 727-732
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2043146664
- Cited by
- 103
- References
- 19
- Citations by year
- 2025: 1 · 2023: 2 · 2022: 15 · 2021: 3 · 2020: 3 · 2019: 7 · 2018: 8 · 2017: 2 · 2016: 5 · 2015: 4 · 2014: 4 · 2013: 6 · 2012: 1
- FWCI
- 10.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Norges Forskningsråd
- Topics
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- prenatal care, effectiveness evaluation, prenatal screening, twin pregnancy, placenta previa, breech presentation, small for gestational age, preeclampsia, detection rate, false-positive diagnosis
- MeSH terms
- Adolescent, Adult, Breech Presentation, Female, Humans, Infant, Newborn, Infant, Small for Gestational Age, Middle Aged, Norway, Placenta Previa, Pre-Eclampsia, Predictive Value of Tests, Pregnancy, Pregnancy Complications, Prenatal Care, Prenatal Diagnosis, Sensitivity and Specificity, Twins, Cohort Studies, Program Evaluation
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