Trial reportBJOG : an international journal of obstetrics and gynaecology2018
Routine antenatal ultrasound in low- and middle-income countries: first look - a cluster randomised trial.
Trial report in BJOG : an international journal of obstetrics and gynaecology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
56 citing papers in PubMed, 3 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- Routine ultrasound for fetal assessment before 24 weeks' gestation.The Cochrane database of systematic reviews · 2021Pooled it
- Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review.Journal of global health · 2021Pooled it
- Investigating the use of ultrasonography for the antenatal diagnosis of structural congenital anomalies in low-income and middle-income countries: a systematic review.BMJ paediatrics open · 2020Pooled it
- Cost estimation alongside a multi-regional, multi-country randomized trial of antenatal ultrasound in five low-and-middle-income countries.BMC public health · 2021Trial
- Oligohydramnios: a prospective study of fetal, neonatal and maternal outcomes in low-middle income countries.Reproductive health · 2020Trial
- Polyhydramnios among women in a cluster-randomized trial of ultrasound during prenatal care within five low and low-middle income countries: a secondary analysis of the first look study.BMC pregnancy and childbirth · 2019Trial
- Article
- Quality of antenatal care and maternal mortality: a mixed-methods study in Purwakarta District, Indonesia.BMC public health · 2026Article
- Factors influencing antenatal care utilisation in Madang Province, Papua New Guinea: a qualitative study.BMC pregnancy and childbirth · 2026Article
- Patient and public involvement (PPI) reporting in maternal and neonatal clinical trials: an exploratory review.Trials · 2026Review
- Implementation strategies and economic considerations for point-of-care ultrasound in Low- and Middle-Income Countries: A scoping review.PLOS global public health · 2026Article
- Quality of first antenatal care visits and perinatal outcomes: Evidence from a cohort study in Ethiopia, Kenya, South Africa, and India.PLOS global public health · 2026Article
- Barriers to Timely Referral of Children Born with Myelomeningocele in Zambia.Journal of clinical medicine · 2025Article
- AI-enabled obstetric point-of-care ultrasound as an emerging technology in low- and middle-income countries: provider and health system perspectives.BMC pregnancy and childbirth · 2025Article
- Routine antenatal ultrasound by nurse-midwives in rural Kenya: a pragmatic trial assessing feasibility and effects of theFrontiers in global women's health · 2025Article
- Perspectives of health care providers on obstetric point-of-care ultrasound in lower-level health facilities in Kenya.Midwifery · 2025Article
- The best healthcare (commodity) available (for purchase): provider-induced demand for obstetric ultrasonography among ethnic minority women in rural northern Vietnam.AJOG global reports · 2024Article
- Implementation and evaluation of a pilot antenatal ultrasound imaging programme using tele-ultrasound in Ethiopia.Journal of telemedicine and telecare · 2024Article
- Fetal neuroimaging applications for diagnosis and counseling of brain anomalies: Current practice and future diagnostic strategies.Seminars in fetal & neonatal medicine · 2024Review
- Cost-effectiveness of low-dose aspirin for the prevention of preterm birth: a prospective study of the Global Network for Women's and Children's Health Research.The Lancet. Global health · 2023Article
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Authors and funding
33 authors at 14 institutions in 6 countries.
Funding
Abstract
objectiveUltrasound is widely regarded as an important adjunct to antenatal care (ANC) to guide practice and reduce perinatal mortality. We assessed the impact of ANC ultrasound use at health centres in resource-limited countries.
designCluster randomised trial.
settingClusters within five countries (Democratic Republic of Congo, Guatemala, Kenya, Pakistan, and Zambia)
methodsClusters were randomised to standard ANC or standard care plus two ultrasounds and referral for complications. The study trained providers in intervention clusters to perform basic obstetric ultrasounds.
main outcome measuresThe primary outcome was a composite of maternal mortality, maternal near-miss mortality, stillbirth, and neonatal mortality.
resultsDuring the 24-month trial, 28 intervention and 28 control clusters had 24 263 and 23 160 births, respectively; 78% in the intervention clusters received at least one study ultrasound; 60% received two. The prevalence of conditions noted including twins, placenta previa, and abnormal lie was within expected ranges. 9% were referred for an ultrasound-diagnosed condition, and 71% attended the referral. The ANC (RR 1.0 95% CI 1.00, 1.01) and hospital delivery rates for complicated pregnancies (RR 1.03 95% CI 0.89, 1.20) did not differ between intervention and control clusters nor did the composite outcome (RR 1.09 95% CI 0.97, 1.23) or its individual components.
conclusionsDespite availability of ultrasound at ANC in the intervention clusters, neither ANC nor hospital delivery for complicated pregnancies increased. The composite outcome and the individual components were not reduced. TWEETABLE ABSTRACT: Antenatal care ultrasound did not improve a composite outcome that included maternal, fetal, and neonatal mortality.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.