‘Women think pregnancy management means obstetric ultrasound’: Vietnamese obstetricians’ views on the use of ultrasound during pregnancy

Abstract

ObjectiveTo explore Vietnamese obstetricians’ experiences and views on the role of obstetric ultrasound in clinical management of complicated pregnancy and in situations where maternal and fetal health interests conflict.DesignSeventeen obstetricians in northern Vietnam were interviewed as part of the CROss-Country Ultrasound Study (CROCUS) project in 2013. Data were analysed using qualitative content analysis.ResultsThe participants described ultrasound as a central tool in prenatal care, although they called for increased training and resources to prevent inappropriate management. A prevailing overuse driven by women's request and increased commercialisation was described. Other clinical examinations were seen as being disregarded by women in favour of ultrasound, resulting in missed opportunities for identifying potential pregnancy complications. The use of ultrasound for sex selection purposes raised concern among participants. Visualisation of human features or heartbeat during ultrasound was commonly described as the point where the fetus became regarded as a ‘person’. Women were said to prioritise fetal health interests over their own health, particularly if a woman had difficulties becoming pregnant or had undergone assisted fertilisation. The woman's husband and his family were described as having an important role in decision-making in situations of maternal and fetal health conflicts.ConclusionsThis study provides insight into issues surrounding ultrasound use in contemporary Vietnam, some of which may be specific to this low-income context. It is clear that ultrasound has become a central tool in prenatal care in Vietnam and that it has also been embraced by women. However, there seems to be a need to balance women's demands for obstetric ultrasound with better recognition of the valuable contribution to be made by the full range of clinical examinations in pregnancy, along with a more strategic allocation of resources, that is, use of obstetric ultrasound based on clinical indications. Better regulation of private obstetric practice also appears to be needed. While the root causes of sex selection need to be addressed at societal level, efforts are also required more immediately to find ways to combat the inappropriate use of ultrasound for the purpose of sex selection.

Physicians' experiences and views on the role of obstetric ultrasound in rural and urban Rwanda: a qualitative study

“…Another important finding of this study is that if these physicians’ perceptions are correct, women may perceive ultrasound as superior to other examinations during pregnancy. This result is comparable to our previous findings from Vietnam, where physicians felt that women at times perceived the obstetric ultrasound to be a ‘complete check’ of the pregnancy, resulting in less participation in clinical examinations in antenatal care . A tendency for both healthcare professionals and pregnant women to treat or regard ultrasound as superior to other fundamental examinations in pregnancy has also been reported in other studies from Vietnam , Botswana and Syria .…”

Health professionals’ experiences and views on obstetric ultrasound in Vietnam: a regional, cross-sectional study

“…The study questionnaire was developed based on the results from the earlier qualitative studies performed in the CROCUS study 7 19–27. Sociodemographic characteristics, evaluation of self-reported skills in performing ultrasound, and questions about access to obstetric ultrasound and health professionals’ views on what may improve utilisation of ultrasound in Vietnam were included, among other items.…”

“…Low education, poverty, ethnic minority status6 and living in rural areas are factors associated with decreased access to reproductive health services 5. Ultrasound has become a central tool in ANC services in Vietnam 7. Currently the Ministry of Health in Vietnam recommends at least four ANC visits,8 in accordance with the previous recommendation by WHO 9.…”

Satisfaction with the gender of the baby and related factors

“…Ultrasound is the most commonly used technic in the prenatal period, and it is more often used to determine the gender of the fetus . This study found that the number of ultrasound scans was lower for those who had a baby desired gender.…”

“…Ultrasound is the most commonly used technic in the prenatal period, and it is more often used to determine the gender of the fetus. 20,22 This study found that the number of ultrasound scans was lower for those who had a baby desired gender. The logistic regression analysis revealed that an increase in the number of ultrasound scans meant a 1.09 times greater risk factor associated with having a baby of the desired gender.…”