Experiences of Midwives on Vscan Limited Obstetric Ultrasound Use: A Qualitative Exploratory Study

Background Ethiopia is a low-income country located in the horn of Africa’s sub-Saharan region, with very high incidences of maternal and neonatal mortality. Quality antenatal care improves perinatal health outcomes. The USAID funded Transform: Primary Health Care Activity in collaboration with the Ministry of Health and GE Healthcare introduced Vscan limited obstetric ultrasound services in 120 health centers in Ethiopia. So far, the experiences and opinions of midwives on their use have not been explored and described within the local context. This study therefore aims to explore and describe the experiences and opinions of midwives on Vscan limited obstetric ultrasound services at health centers within Ethiopia. Methods An exploratory and descriptive qualitative study was conducted in Amhara, Oromia, and Southern Nations, Nationalities and Peoples’ (SNNP) regions of Ethiopia. Twenty-four participants were selected through a purposeful sampling technique. In-depth individual interviews with trained midwives with practical hands-on limited obstetric ultrasound service provision experience were conducted. The thematic analysis was conducted manually. Results The qualitative data analysis on the experiences and opinions of midwives revealed three themes, namely: individual perception of self-efficacy, facilitators, and barriers of limited obstetric ultrasound services. The basic ultrasound training, which was unique in its organization and arrangement, prepared and built the self-efficacy of trainees in executing their expected competencies. Support of health systems and health managers in dedicating space, availing essential supplies, and assigning human resources emerged as facilitators of the initiated limited obstetric ultrasound services, whereas high workload on one or two ultrasound trained midwives, interruption of essential supplies like paper towels, gel, and alternative power sources were identified as barriers for limited ultrasound services. Conclusion This study explored the experiences and opinions of midwives who were trained on the provision of limited obstetric ultrasound services and served the community in health centers in rural parts of Ethiopia. The results of this study revealed the positive impacts of the intervention on the perceived self-efficacy, facilitation, and breaking-down of barriers to obstetric ultrasound services. Before scaling-up limited obstetric ultrasound interventions, health managers should ensure and commit to availing essential supplies (e.g., paper towels, ultrasound gel, and large memory hard discs), arranging private rooms, and training other mid-level health professionals. In addition, improving pregnant women’s literacy on the national schedule for ultrasound scanning services is recommended.

Fetal Echocardiogram and Detailed First Trimester Obstetric Ultrasound: ICD-10 Indications

The American Institute of Ultrasound in Medicine and multiple national organizations have published the indications for fetal echocardiogram and for the detailed first trimester obstetric ultrasound. We present the corresponding International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for those indications. Key Points

Knowledge, Attitudes and Practices of Pregnant Women towards Obstetric Ultrasound at Mulago Hospital: A Cross-sectional Survey

Introduction: Obstetric ultrasonography in antenatal care (ANC) is globally recognized as one of the ways through which maternal mortality can be reduced. Pregnant women’s knowledge, perceptions, and attitudes are thought to influence their response towards obstetric ultrasonography. This study was conducted to assess the knowledge, attitudes, and practices of pregnant women towards obstetric sonography at Mulago hospital.Methods: This was a descriptive cross-sectional study that involved 300 pregnant women who reported for obstetric sonography at Mulago hospital in Kampala, Uganda. Consecutive sampling technique was used to recruit participants into the study. The data was collected using interviewer-administered questionnaires and was analyzed quantitatively into descriptive statistical tables, percentages and graphs using Statistical Package for Social Scientists (SPSS) version 25.0 software.Results: The study had a response rate of 100%. Most participants had good knowledge of obstetric ultrasound scan. However, there was a misconception that ultrasound has harmful effects. Generally, participants had a positive attitude but poor practices towards obstetric ultrasound scan. Long waiting time and lack of privacy were reported by most participants as leading factors that contributed to the poor practices. Conclusion: This study shows that the knowledge and attitude of pregnant women towards obstetric ultrasound in Mulago hospital were good. However, their practices were poor. The concerns that need to be addressed in order to improve their practices include patient’s privacy, waiting time and the misconception regarding the safety of ultrasound that it can cause cancer.

Utilization of obstetric ultrasonography and findings in a cottage hospital in Nigeria

Objectives: The integration of ultrasound into routine obstetric workup has transformed antenatal care in resource-poor and remote communities in Africa. The present study aims to investigate the utilization of obstetric ultrasound at a cottage hospital in suburban Nigeria. Material and Methods: This retrospective study was conducted at Obio Cottage Hospital, Port Harcourt, Rivers State, South-South Nigeria. Ethical approval was obtained before commencement of the study from the Health Research Ethics Committee of University of Calabar Teaching Hospital with reference number UCTH/HREC/33/533. Reports were retrieved from the records of the radiology unit of the study facility, and data including biometric data and radiological diagnosis were transferred to Microsoft Excel spreadsheet for data analysis. Simple proportions and percentages were used to analyze the data. All statistical analyses were conducted using Statistical Package for the Social Science version 21.0, IBM Inc., Chicago, Illinois, USA. Statistical significance was set at P ≤ 0.05. Results: The total ANC visits at Obio Cottage Hospital was 28,072, with 27% (7689) utilization of ultrasound scan. The mean age and range of parity of attendees were 32 ± 2.3 and 1–5, respectively. Of the total scans performed, 99.93% was routine, while 0.07% (5) was clinical-based (targeted). Normal findings were 7520 (97.8%) of antenatal scans recorded, while abnormal cases, multiple gestation, and uncertain diagnosis accounted for 121 (1.57%), 44 (0.57%), and 4 (0.06%), respectively. Conclusion: The present study has shown a considerable volume of obstetric ultrasound scan in this cottage hospital, albeit, with low utilization compared to the number of antenatal registration. Findings were mainly normal with minimal need for referral for advance care.