Obstetric Ultrasonography in Low-income Countries

Seffah, J.D.; Adanu, Richard

doi:10.1097/grf.0b013e3181a4c2d5

Cited by 32 publications

(30 citation statements)

References 17 publications

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“…Ultrasound may contribute to timely diagnosis and intervention that can result in the reduction of foetal morbidity and mortality [9]. In low-income countries, ultrasound during pregnancy is generally provided by obstetricians, radiologists and medical officers [10], but a lack of trained healthcare providers and a shortage of ultrasound equipment are often barriers to its utilisation [11,12]. Many pregnant women have a strong desire for ultrasound examinations to obtain information on foetal well-being and images of the foetus [13].…”

Section: Introductionmentioning

confidence: 99%

Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives’ experiences and views of obstetric ultrasound

Holmlund

Ntaganira

Edvardsson

et al. 2017

Global Health Action

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Background: Obstetric ultrasound has become an indispensable part of antenatal care worldwide. Although the use of ultrasound has shown benefits in the reduction of maternal and foetal morbidity and mortality, it has also raised many ethical challenges. Because of insufficient numbers of midwives in Rwanda, uncomplicated pregnancy care is usually provided by nurses in local health centres. Obstetric ultrasound is generally performed by physicians at higher levels of healthcare, where midwives are also more likely to be employed. Objectives: To explore Rwandan midwives’ experiences and views of the role of obstetric ultrasound in relation to clinical management, including ethical aspects. Methods: A qualitative study design was employed. Six focus group discussions were held in 2015 with 23 midwives working in maternity care in rural and urban areas of Rwanda, as part of the CROss Country Ultrasound Study (CROCUS). Results: Obstetric ultrasound was experienced as playing a very important role in clinical management of pregnant women, but participants emphasised that it should not overshadow other clinical examinations. The unequal distribution of ultrasound services throughout Rwanda was considered a challenge, and access was described as low, especially in rural areas. To increase the quality of maternity care, some advocated strongly for midwives to be trained in ultrasound and for physicians to receive additional training. In general, pregnant women were perceived both as requesting more ultrasound examinations than they received, and as not being satisfied with an antenatal consultation if ultrasound was not performed. Conclusions: Obstetric ultrasound plays a significant role in maternity care in Rwanda. Increasing demand for ultrasound examinations from pregnant women needs to be balanced with medical indication and health benefits. Training of midwives to perform obstetric ultrasound and further training for physicians would help to address access to ultrasound for greater numbers of women across Rwanda. RESPONSIBLE EDITOR Virgilio Mariano Salazar Torres, Karolinska Institute, Sweden

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Section: Introductionmentioning

confidence: 99%

Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives’ experiences and views of obstetric ultrasound

Holmlund

Ntaganira

Edvardsson

et al. 2017

Global Health Action

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“…Emergency ultrasound training in the developed world emphasizes abdominal and cardiac ultrasound, but ultrasound training in low‐ and middle‐income countries must be tailored to the local setting 7 . Since emergency obstetric ultrasound may be the most used indication for point‐of‐care ultrasound in low‐ and middle‐income countries, guidelines for obstetric ultrasound in low‐income countries have been proposed 8 …”

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confidence: 99%

Evaluation of an Obstetric Ultrasound Curriculum for Midwives in Liberia

Bentley

Hexom

Nelson

2015

J of Ultrasound Medicine

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“…Yet it is not known how this technology is viewed by pregnant women, or by the local providers implementing the system. Recent literature highlights the usefulness of antenatal ultrasound in developing country settings[2], [6]–[8], but at the same time over-and misuse of ultrasound have been reported[9], [10].…”

Section: Introductionmentioning

confidence: 99%

Refugee and Migrant Women's Views of Antenatal Ultrasound on the Thai Burmese Border: A Mixed Methods Study

et al. 2012

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BackgroundAntenatal ultrasound suits developing countries by virtue of its versatility, relatively low cost and safety, but little is known about women’s or local provider’s perspectives of this upcoming technology in such settings. This study was undertaken to better understand how routine obstetric ultrasound is experienced in a displaced Burmese population and identify barriers to its acceptance by local patients and providers.Methodology/Principal FindingsQualitative (30 observations, 19 interviews, seven focus group discussions) and quantitative methods (questionnaire survey with 644 pregnant women) were used to provide a comprehensive understanding along four major themes: safety, emotions, information and communication, and unintended consequences of antenatal ultrasound in refugee and migrant clinics on the Thai Burmese border. One of the main concerns expressed by women was the danger of childbirth which they mainly attributed to fetal malposition. Both providers and patients recognized ultrasound as a technology improving the safety of pregnancy and delivery. A minority of patients experienced transitory shyness or anxiety before the ultrasound, but reported that these feelings could be ameliorated with improved patient information and staff communication. Unintended consequences of overuse and gender selective abortions in this population were not common.Conclusions/SignificanceThe results of this study are being used to improve local practice and allow development of explanatory materials for this population with low literacy. We strongly encourage facilities introducing new technology in resource poor settings to assess acceptability through similar inquiry.

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Obstetric Ultrasonography in Low-income Countries

Cited by 32 publications

References 17 publications

Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives’ experiences and views of obstetric ultrasound

Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives’ experiences and views of obstetric ultrasound

Evaluation of an Obstetric Ultrasound Curriculum for Midwives in Liberia

Refugee and Migrant Women's Views of Antenatal Ultrasound on the Thai Burmese Border: A Mixed Methods Study

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