Vale of Clwyd MP Dr James Davies has welcomed research into a third scan for expectant mothers beyond the 20-week scan, after questioning medical experts on the matter in Parliament last week.
At last week’s Health and Social Care Select Committee, Professor Gordon Smith, Head of Department of Obstetrics and Gynaecology, University of Cambridge, told members that they are “thinking about a scan at 36 weeks to try to stratify women for risk as they are making plans around location and type of birth.”
He said a third scan at 36 weeks would be particularly helpful in detecting breech pregnancies.
He said:
“One open goal at the moment is the presentation of the baby. Midwives routinely perform palpation to determine whether the baby is head first or otherwise, but we know from research that anybody doing palpation detects about 50% to 70% of non-cephalic presentation and misses the remainder. In cases where the diagnosis is not made, the woman loses the opportunity to have interventions.
“You can attempt to turn the baby using external cephalic version, or have a discussion around a planned caesarean section or a planned vaginal breech birth. You really want to know the information before you go into that situation, but what happens is that quite large numbers of women go into labour with a non-head-first presentation and the diagnosis is made at some point during the labour. Often, those women end up with an emergency caesarean section or take the risks of an unplanned breech, which can sometimes lead to the death of the baby.”
James asked whether for breech presentation alone there is sufficient evidence to warrant a third scan at 36 weeks or so, and was told by Professor Smith “My assessment would be that there isn’t a research question left, other than the best way to implement it.”
James also asked whether there would be the manpower to implement it and was told every junior doctor in a delivery unit can be taught how to do it, avoiding pressure on radiographers.
Speaking after the meeting, James said:
“From what I heard, it seems that introducing a third scan would be a beneficial move which would be very much welcomed by expectant mothers.
“What they are suggesting is an additional basic ultrasound scan to look at the presentation of the baby, as opposed to a more complex scan that is looking for abnormalities.
“As the Professor stressed, you have to set the cost of time in making the diagnosis versus the cost of failing to make it.”
