Prenatal ultrasound gathering momentum in disease management

For more than three decades, clinicians have routinely conducted prenatal ultrasound screenings to detect congenital anomalies, multiple-gestation pregnancies, fetal growth disorders, placental abnormalities and errors in the estimation of gestational age. When managed care was born, executives realized the importance of providing benefit coverage for this test because they recognized early prenatal ultrasound is one of the tools in the disease management arsenal to promote fetal, neonatal and maternal health. In an era where medical costs are surging, and in response, healthcare premiums of employers and their workers have climbed twice as fast as wages and inflation in 2006, the evidence-based benefits of prenatal ultrasound is gaining momentum and medical community recognition as a disease management tool.

Disease management programs focus on the bottom line to tame the rising costs of medical costs. Behind cost savings is an even more important goal-the goal of creating better health and healthy lifestyles for plan members. Although disease management programs are commonly equated with taming diseases-like asthma, diabetes and heart disease-solid research suggests the importance of preventing diseases. Prenatal ultrasound can prevent a litany of short- and long-term health issues for the unborn, the newborn and the mother.

Psychosocial benefits of ultrasounds

New studies demonstrate that diagnostic prenatal ultrasounds provide a unique psychosocial benefit for expecting women that often results in a variety of notable benefits. These include compliance with keeping doctor visits, reduced blood pressure because of reduced maternal anxiety, smoking modifications, less post-natal depression and better eating habits to prevent the onset and management of gestational diabetes and diabetes risk to newborn.

One reason that prenatal ultrasounds are being heralded is the influence they have on the mother's lifestyle and behaviors. Studies demonstrate that prenatal ultrasounds increase maternal-fetal bonding, resulting in improvements to the baby's heath and size at birth.

Pregnancy and smoking cessation

A 1996 study, "Maternal smoking habit modification via fetal visualization," conducted by the University of California tobacco-related disease research program and presented to the California State Legislature, noted that quitting smoking improves fetal, neonatal and maternal health.

"The economic costs to society, both human and medical, for both the child and the mother are immense. Fetal complications of maternal smoking include increased mortality, prematurity, placental previa and abruption, low birth weight, spontaneous abortion, learning deficits, impaired cognitive development and congenital abnormalities," the report stated.

Healthcare executives with the responsibility to hold down rising healthcare costs can quickly calculate the significant cost savings for their respective plans by averting these costly and life-threatening outcomes.

Prenatal ultrasounds also have proven to reap emotional benefits for mom, dad and the unborn baby. A common focus in many studies has been the issue of maternal anxiety, the negative effects of such on the fetus and the use of ultrasound to reduce anxiety. One study reported a consistent decrease not only in anxiety but also in depression, somatic symptoms and hostility. This is attributed, in part, to compassionate and comprehensive feedback and explanation provided during the ultrasound that produced measurable reassurance. Several studies also have reported significant reductions in paternal stress when fathers view an ultrasound of their unborn child. This benefit also can be applied to other family members, creating greater understanding in those closest to the mother and a stronger support system for the mother and child. This can be especially important if the unborn child is diagnosed with a healthcare issue.

With so much emphasis these days on the comprehensive benefits of disease management programs and tools to help control rising healthcare costs, managed care can take pride in knowing that diagnostic prenatal ultrasound is considered one of the forerunners to today's growing list of disease management programs and continues to be important player on every plan's disease management scorecard.

Darlene Ginnett, RDMS, is CEO of Pacific Coast Ultrasound, a certified independent diagnostic facility that specializes in prenatal ultrasound offering full diagnostics as well as 3D/4D limited diagnostic/elective ultrasounds.