Women’s perception of accuracy of ultrasound dating in late pregnancy: a challenge to prevention of prolonged pregnancy in a resource-poor Nigerian setting

Abstract

BackgroundExpected date of delivery (EDD) is estimated from the last menstrual period (LMP) or ultrasound scan. Conflicts between these estimates especially on the part of the physician and his/her patient could pose a challenge to prevention of prolonged pregnancy. The objective of this study was to determine the perception and acceptability of menstrual dating (EDD derived from LMP) with regard to timing of labor induction for postdatism by pregnant women who have a late pregnancy (≥23 weeks’ gestation) ultrasound scan.MethodsThis cross-sectional study included 443 consecutive pregnant women receiving antenatal care at two tertiary health institutions in Enugu, Nigeria, from January 1, 2013 to March 31, 2013.ResultsThe mean age of the women was 27.9±2.41 (range 17–45) years. Most ultrasound scans (90.8%, 357/389) were carried out in late pregnancy, and 41.9% (167/389) were self-referred. The majority of the respondents (51.7%, 229/443) did not accept induction of labor for postdatism at a certain menstrual dating-derived gestational age of 40 weeks plus 10 days if the late pregnancy ultrasound scan dating was less. Predictors of this poor attitude to timing of induction of labor for postdatism included low educational level, low social class, and poor knowledge of the limitations of ultrasound scan dating in late pregnancy (P<0.05).ConclusionThe worrisome confidence in ultrasound scan dating is a challenge to the prevention of prolonged pregnancy and its complications in our environment. Antenatal health education should discourage self-referral for ultrasound scan dating and emphasize its limitations in late pregnancy as well as the perinatal effects of prolonged pregnancy.

Interprofessional Obstetric Ultrasound Education: Successful Development of Online Learning Modules; Case‐Based Seminars; and Skills Labs for Registered and Advanced Practice Nurses, Midwives, Physicians, and Trainees

“…In addition to questions regarding optimal course formats and mix of participants, the development of obstetric ultrasound education is challenged by ethical concerns inherent in the use of pregnant women as standardized patients in training exercises. Questions arise about how to best obtain informed consent for participation and support volunteers if an abnormal finding is noted during a nondiagnostic scan or more generally; very little is known about women's perceptions and experience of ultrasound examination . These and other considerations warrant further exploration as faculty navigate uncertainties with the aim to provide high‐quality interprofessional education in response to perinatal health care and workforce needs.…”

Fetal Ultrasound Anatomy and Morphometric Parameters of the Humerus in Fetuses at 19-22 Weeks of Gestation

“…Accurate fetal biometry is of paramount importance to the obstetrician, who will make clinical decisions about pregnancy management based on the measurements made by the ultrasound providers. When fetal biometry is not performed accurately, it can lead to over-or underestimation of fetal development, which in turn can lead to subsequent inappropriate pregnancy management 15,16 .…”

Intrauterine Growth Charts for Fetal Biparietal Diameter Between 12 and 40 Weeks of Pregnancy and Its Correlation With Gestational Age

“…It is a standard practice to estimate the duration of pregnancy using patient's recalled 1 st day of last menstrual period (LMP) [1]. LMP itself is subjected to poor recall and is influenced by several factors such as irregular cycles, lactational amenorrhea, usage of oral contraceptive pills, and implantation bleeding [2]. In the modern era, measurement of fetal biometric parameters can be helpful in the determination of gestational age (GA) and the error can be minimized when ultrasound is performed in early in pregnancy.…”