Dopplerundersøgelse af højrisiko gravide [Umbilical artery Doppler ultrasonography in high risk pregnancies]
Danish Centre for Evaluation and Health Technology Assessment (formerly DIHTA)
Record Status
This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database.
Citation
Danish Centre for Evaluation and Health Technology Assessment (formerly DIHTA). Dopplerundersøgelse af højrisiko gravide. [Umbilical artery Doppler ultrasonography in high risk pregnancies] Copenhagen: Danish Centre for Evaluation and Health Technology Assessment (DACEHTA). 2002
Authors' objectives
The purpose of the present study is to evaluate the use of umbilical artery Doppler ultrasonography in high-risk pregnancies.
Authors' conclusions
The reanalysis of RCTs on umbilical artery Doppler ultrasonography in high-risk pregnancies showed that only in pregnancies with suspected IUGR and/or hypertensive disease, there was a reduction in the number of perinatal deaths and unnecessary obstetric interventions. The annual number of women referred for assessment by Doppler ultrasonography because of SGA in Denmark was 1500 and they had a total of 5000 Doppler examinations. The organization of obstetric Doppler ultrasonography was established through the nineties, and almost all obstetrical units in Denmark had at least one piece of Doppler ultrasonography device in 2000. There was a substantial variation in the local organization of the technology. The obstetrical units reported a total of 20.000 Doppler examinations on pregnant women and all had wide indications for the use of Doppler ultrasonography. The majority of examinations were performed in groups of pregnant women without documented effect. Choosing a more centralized organization of Doppler ultrasonography will increase the costs for the patient but reduce the overall costs for the society in the long term. In Denmark the use of Doppler ultrasonography in high-risk pregnancies with suspected IUGR seems cost-effective, as the life of one saved SGA-infant will cost around 1 mill DKK. However, the analysis has shown that these calculations are very sensitive to assumptions of the cost and odds ratio. The women-s perspective on Doppler ultrasonography is orientated towards their life-world and therefore different from the professional's system- and result- orientated perspective. The knowledge on the pregnant women's perspective can contribute to an improved future use of Doppler ultrasonography.