{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:17:07Z","timestamp":1761513427902},"reference-count":13,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,3,5]],"date-time":"2014-03-05T00:00:00Z","timestamp":1393977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Clintec, Karolinska Institute, Stockholm"},{"name":"SLL, Stockholm county council"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To study whether a routine with a routine ultrasound examination (routine scan) at 41 gestational weeks as compared with ultrasound on clinical indication (indicated scan), lowered the risk of severe adverse fetal outcome in post\u2010term period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>arolinska <jats:styled-content style=\"fixed-case\">U<\/jats:styled-content>niversity <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>ospital, <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>tockholm, <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>weden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Eight years of deliveries, 2002\u20132009.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>One of the two delivery units at <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>arolinska <jats:styled-content style=\"fixed-case\">U<\/jats:styled-content>niversity <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>ospital used a routine scan at 41\u00a0week of gestation and the other unit used an indicated scan. Severe adverse fetal outcome were defined: severe asphyxia, death or cerebral damage. The study was analysed using logistic regression with adjustment for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Differences in post\u2010term severe adverse fetal outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No increased risk of post\u2010term severe adverse fetal outcome was seen at the unit using a routine scan; conversely, a 48% significantly increased risk was seen at the unit using an indicated scan (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.89, 95% confidence interval, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.5\u20131.5 and <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.48, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.06\u20132.1, respectively). Comparing post\u2010term periods, there was no significantly increased risk at the unit using indicated scans (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.6, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.9\u20133.0). There was a 60% increased prevalence of small\u2010for\u2010gestational age (<jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>) newborns in the post\u2010term period at the unit using indicated scans (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.6, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.1\u20132.4), but no differences in operative delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A policy to use routine scans at 41\u00a0weeks of gestation seems to normalise an increased post\u2010term risk of severe adverse fetal outcome, possible due to increased awareness of <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content> and\/or oligohydramniosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12654","type":"journal-article","created":{"date-parts":[[2014,3,5]],"date-time":"2014-03-05T07:26:42Z","timestamp":1394004402000},"page":"1108-1116","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Routine ultrasound examination at 41\u00a0weeks of gestation and risk of post\u2010term severe adverse fetal outcome: a retrospective evaluation of two units, within the same hospital, with different guidelines"],"prefix":"10.1111","volume":"121","author":[{"given":"PG","family":"Lindqvist","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Clintec Karolinska Institute Karolinska University Hospital, Huddinge Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Pettersson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Clintec Karolinska Institute Karolinska University Hospital, Huddinge Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Mor\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Clintec Karolinska Institute Karolinska University Hospital, Huddinge Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Kublickas","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Clintec Karolinska Institute Karolinska University Hospital, Huddinge Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Nordstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Mothers and Childrens Health Karolinska University Hospital, Solna Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,3,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1996.tb14164.x"},{"key":"e_1_2_6_3_1","first-page":"615","article-title":"Obstetric characteristics and neonatal performance in a four\u2010year small for gestational age population","volume":"72","author":"Wennergren M","year":"1988","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1996.08030160.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1996.08030152.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1806"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70482-X"},{"key":"e_1_2_6_8_1","first-page":"197","article-title":"Scoring of uterine artery flow velocity waveforms in the assessment of fetal growth restriction and\/or pregnancy\u2010induced hypertension","volume":"7","author":"Sekizuka N","year":"1997","journal-title":"J Matern Fetal Investig"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)92818-Z"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2003.00203.x"},{"key":"e_1_2_6_11_1","first-page":"424","article-title":"Reports from the Swedish Council on Technology Assessment in Health Care (SBU)","volume":"15","year":"1999","journal-title":"Int J Technol Assess Health Care"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2002.810909.x"},{"key":"e_1_2_6_13_1","first-page":"CD001451","article-title":"Routine ultrasound in late pregnancy (after 24\u00a0weeks' gestation)","author":"Bricker L","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(02)03122-8"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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