Routine ultrasound for pregnancy

Status: Decision completed

Policy context

Ultrasound involves transmission of high frequency sound waves and recording of the echoes created when reflected off of tissues of varying densities in the body. Images created by ultrasound are used to confirm a healthy pregnancy, assess the growth and health of the placenta and fetus. Ultrasound is considered safe as used for pregnancy imaging. Concerns about the efficacy and cost-effectiveness of multiple ultrasounds during non-high risk pregnancies remain.

Primary criteria ranking

  • Safety = Low
  • Efficacy = High
  • Cost = High

Assessment timeline

  • Draft report published: August 20, 2010
  • Public comment period: August 20 to September 3, 2010
  • Final report published: September 22, 2010
  • HTCC public meeting: October 22, 2010


Ultrasound is performed in a significant number of pregnancies (49% in 1989, 58% in 1992 and probably 70-80% currently). Ultrasound of the fetus can be used to estimate fetal age, detect multiple pregnancies, detect fetal malformations, detect intrauterine growth retardation, determine fetal presentation, and detect low-lying placenta. Many of these conditions may be associated with maternal or perinatal morbidity and mortality. However, the US Preventive Services Task Force (USPSTF) and other evidence states that neither early, late nor serial ultrasound has been proven to improve perinatal morbidity or mortality. Ultrasound does detect multiple pregnancies and congenital malformations earlier in pregnancy but there is not current evidence that early detection results in improved outcomes or increased rate of induced abortion. Information about when ultrasound is clinically indicated and what maternal or fetal health outcomes it improves is needed.