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Bukhari AA, Alhibshi DN, Alsayyad HM, Altaifi RI, Althakafi KA. Assessing the Quality of Antenatal Care in King Abdulaziz University Hospital: A Retrospective Study. Cureus 2023; 15:e37150. [PMID: 37153298 PMCID: PMC10161147 DOI: 10.7759/cureus.37150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Antenatal care is vital for pregnant women and fetuses. However, the coronavirus disease 2019 (COVID-19) pandemic has hindered access to care worldwide, resulting in missed appointments. Therefore, assessing the quality of antenatal care during the pandemic is crucial. This study evaluated the care provided at King Abdulaziz University Hospital in Saudi Arabia and suggested areas for improvement. METHODS This retrospective medical records review involved 400 pregnant patients who received antenatal care at King Abdulaziz University Hospital in the past two years. A checklist was used to collect patient data, including demographics, antenatal care visits, ultrasounds, gestational age at first visit and ultrasound, prior cesarean section and preterm delivery, and virtual clinic attendance during the COVID-19 pandemic. Statistical analyses were performed using SPSS version 25 (Armonk, NY: IBM Corp.). RESULTS The sample had a mean age of 30±6 years, and most participants (87.8%) were Saudi women. Over half of the participants did not attend any antenatal follow-up visits, and the majority had only one ultrasound. Only a small proportion of mothers attended virtual clinics during the pandemic. Having a prior cesarean section and a parity of 1-3 were positively associated with ultrasound attendance, while prior preterm delivery was positively associated with antenatal visits and virtual clinic attendance. CONCLUSION This study highlighted the importance of improving antenatal care quality at King Abdulaziz University Hospital, especially during COVID-19. To achieve this, strategies such as increasing visits, ultrasound attendance, and virtual clinic access should be considered. By implementing these recommendations, the hospital can enhance care and promote maternal and fetal health.
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Brawley AM, Schaefer EW, Lucarelli E, Ural SH, Chuang CH, Hwang W, Paul IM, Daymont C. Differing prevalence of microcephaly and macrocephaly in male and female fetuses. Front Glob Womens Health 2023; 4:1080175. [PMID: 36911049 PMCID: PMC9998507 DOI: 10.3389/fgwh.2023.1080175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/01/2023] [Indexed: 03/14/2023] Open
Abstract
Objective To compare the proportion of female and male fetuses classified as microcephalic (head circumference [HC] < 3rd percentile) and macrocephalic (>97th percentile) by commonly used sex-neutral growth curves. Methods For fetuses evaluated at a single center, we retrospectively determined the percentile of the first fetal HC measurement between 16 and 0/7 and 21-6/7 weeks using the Hadlock, Intergrowth-21st, and NICHD growth curves. The association between sex and the likelihood of being classified as microcephalic or macrocephalic was evaluated with logistic regression. Results Female fetuses (n = 3,006) were more likely than male fetuses (n = 3,186) to be classified as microcephalic using the Hadlock (0.4% male, 1.4% female; odds ratio female vs. male 3.7, 95% CI [1.9, 7.0], p < 0.001), Intergrowth-21st (0.5% male, 1.6% female; odds ratio female vs. male 3.4, 95% CI [1.9, 6.1], p < 0.001), and NICHD (0.3% male, 1.6% female; odds ratio female vs. male 5.6, 95% CI [2.7, 11.5], p < 0.001) curves. Male fetuses were more likely than female fetuses to be classified as macrocephalic using the Intergrowth-21st (6.0% male, 1.5% female; odds ratio male vs. female 4.3, 95% CI [3.1, 6.0], p < 0.001) and NICHD (4.7% male, 1.0% female; odds ratio male vs. female 5.1, 95% CI [3.4, 7.6], p < 0.001) curves. Very low proportions of fetuses were classified as macrocephalic using the Hadlock curves (0.2% male, < 0.1% female; odds ratio male vs. female 6.6, 95% CI [0.8, 52.6]). Conclusion Female fetuses were more likely to be classified as microcephalic, and male fetuses were more likely to be classified as macrocephalic. Sex-specific fetal head circumference growth curves could improve interpretation of fetal head circumference measurements, potentially decreasing over- and under-diagnosis of microcephaly and macrocephaly based on sex, therefore improving guidance for clinical decisions. Additionally, the overall prevalence of atypical head size varied using three growth curves, with the NICHD and Intergrowth-21st curves fitting our population better than the Hadlock curves. The choice of fetal head circumference growth curves may substantially impact clinical care.
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Affiliation(s)
- Amalia M Brawley
- Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA, United States
| | - Eric W Schaefer
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Elizabeth Lucarelli
- Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA, United States
| | - Serdar H Ural
- Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA, United States
| | - Cynthia H Chuang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States.,Department of Medicine, Penn State College of Medicine, Hershey, PA, United States
| | - Wenke Hwang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Ian M Paul
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States.,Department of Pediatrics, Penn State College of Medicine, Hershey, PA, United States
| | - Carrie Daymont
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States.,Department of Pediatrics, Penn State College of Medicine, Hershey, PA, United States
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Di Giacomo M, Piacenza M, Siciliani L, Turati G. The effect of co-payments on the take-up of prenatal tests. J Health Econ 2022; 81:102553. [PMID: 34808492 DOI: 10.1016/j.jhealeco.2021.102553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 06/13/2023]
Abstract
Noninvasive prenatal screening tests help identify genetic disorders in a fetus, but their take-up remains low in several countries. Using a regression discontinuity design, we test the causal effect of a policy that eliminated co-payments for noninvasive screening tests in Italy. We identify the treatment effects by a discontinuity in women's eligibility for a free test based on their conception date. We find that the policy increases the probability of women's undergoing noninvasive screening tests by 5.5 percentage points, and the effect varies by socioeconomic status. We do not find evidence of substitution effects with more expensive and riskier invasive diagnostic tests. In addition, the increase in take-up does not affect pregnancy termination or newborn health. We find some evidence of positive effects on mothers' health behaviors during pregnancy as measured by reductions in mothers' weight gain and hospital admissions during pregnancy, but these are statistically significant only at the 10 percent level.
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Affiliation(s)
- Marina Di Giacomo
- University of Torino, Department of Economics, Social Sciences, Applied Mathematics and Statistics (ESOMAS).
| | - Massimiliano Piacenza
- University of Piemonte Orientale, Department of Economics and Business (DISEI), Novara, Italy.
| | - Luigi Siciliani
- University of York, Department of Economics and Related Studies, York, United Kingdom.
| | - Gilberto Turati
- Università Cattolica del Sacro Cuore, Department of Economics and Finance, Rome, Italy.
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Howard S. The rise of the souvenir scanners: ultrasonography on the high street. BMJ 2020; 370:m1321. [PMID: 32703763 DOI: 10.1136/bmj.m1321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Akca E, Gokyildiz Surucu S, Sanberk I. Validity and reliability of the Turkish version of the PEER-U scale. J Reprod Infant Psychol 2019; 37:499-512. [PMID: 30836012 DOI: 10.1080/02646838.2019.1584667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Antenatal care is necessary for mother and infant by reducing or eliminating the risks which may occur in the antenatal and postnatal period. Ultrasound is one of the most commonly used examination methods in antenatal monitoring. Evaluating the expectations, experiences and reactions of both parents during routine ultrasound examinations is essential to provide the best antenatal care. Objective: This study aims to test the validity and reliability of the PEER-U scale developed for Sweden by Ekelin et al. Method: The PEER-U scale consists of before and after ultrasound scales. Four hundred and thirty-six parents participated in the study. Interviews were conducted with all participating parents in a private room 15 minutes before and five minutes after the ultrasound. Researchers analysed the PEER-U scale for language, content, construct, criterion-referenced validity and internal consistency reliability. Results: The Turkish version of PEER-U has 21 items in the before ultrasound scale and 21 items in the after ultrasound scale. Cronbach's alpha was 0.65 for the before ultrasound scale and 0.89 for the after ultrasound scale. Conclusion: The study determined that the Turkish version of the PEER-U scale is a valid and reliable scale for Turkish society.
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Affiliation(s)
- Emine Akca
- Inonu University, Faculty of Health Sciences, Midwifery Department , Malatya , Turkey
| | - Sule Gokyildiz Surucu
- Cukurova University, Faculty of Health Sciences, Midwifery Department , Adana , Turkey
| | - Ismail Sanberk
- Cukurova University, Faculty of Education, Department of Educational Sciences , Adana , Turkey
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King K, Foo J, Hazelton K, Henry A. Selective versus universal third trimester ultrasound: Time for a rethink? An audit of current practices at a metropolitan Sydney hospital. Australas J Ultrasound Med 2018; 21:96-103. [PMID: 34760509 PMCID: PMC8411926 DOI: 10.1002/ajum.12082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Routine third-trimester ultrasound (T3US) is not recommended in evidence-based clinical guidelines despite occurring frequently. This study investigated the incidence, indication for, results and follow-up needs of T3US performed at a Sydney metropolitan teaching hospital. METHODS Audit of T3US amongst singleton pregnancies at St George Hospital, Sydney: retrospective review October-December 2012, prospective cohort with clinician survey February-April 2013. Data included are as follows: maternal demographics, aneuploidy screening results, T3US ordering patterns, results, follow-up management and pregnancy outcomes. Comparison of demographic characteristics and pregnancy outcomes was performed for women undergoing T3US vs. no T3US. RESULTS One thousand and thirty-five women (623 retrospective, 412 prospective) were included, of whom 560 (54%) received at least one T3US. Characteristics of retrospective and prospective cohorts were similar, so combined data are presented. Most initial T3USs were for valid indications (463 of 560; 83%), most frequently low-lying placenta at morphology (19%), reduced fundal height (10%) and to follow-up fetal concerns at morphology ultrasound (9%). One hundred and sixty-two out of 560 (29%) of initial T3US were not normal, predominantly related to accelerated or reduced fetal growth. Detection of SGA babies was significantly higher in the T3US group (32% SGA babies detected vs. 0% if no T3US, P < 0.001). However, overall detection rates remained low, with 5.2% and 3.0% of babies who had a T3US unexpectedly <10th and <3rd centile birthweight, respectively. DISCUSSION/CONCLUSION The majority of women received at least one, usually indicated, T3US in routine practice at our metropolitan Sydney hospital. This may impact obstetric care, resource allocation and patient well-being. Detection of small for gestational age fetuses was poor.
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Affiliation(s)
- Kristina King
- Department of Women's and Children's HealthSt George Hospital28 Gray StKogarah2217New South WalesAustralia
| | - Jinny Foo
- Department of Women's and Children's HealthSt George Hospital28 Gray StKogarah2217New South WalesAustralia
| | - Kirsty Hazelton
- University of Aberdeen College of Life Sciences and MedicineKings CollegeAberdeen AB24 3FXUK
| | - Amanda Henry
- School of Women's and Children's HealthUniversity of New South WalesLevel 1, Royal Hospital for Women Barker St, RandwickSydneyNew South WalesAustralia
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Oscarsson M, Gottvall T, Swahnberg K. When fetal hydronephrosis is suspected antenatally--a qualitative study. BMC Pregnancy Childbirth 2015; 15:349. [PMID: 26694546 PMCID: PMC4689046 DOI: 10.1186/s12884-015-0791-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 12/11/2015] [Indexed: 12/28/2022] Open
Abstract
Background The information about fetal malformation findings during the ultrasound examination often comes unexpectedly, and the women and their partners may not necessarily receive any conclusive statement on the prognosis. A finding such as fetal hydronephrosis range from being a soft markers or mild anomaly, to a serious condition associated with neonatal morbidity and mortality. The aim of this study was to explore women’s reactions to the discovery of fetal hydronephrosis in the context of uncertainty regarding the prognosis. Methods Ten women were interviewed and the interviews were conducted six to twelve months after the women gave birth. They had experience of suspected fetal hydronephrosis in gestational week 18–20. The interviews were recorded, transcribed verbatim and analysed using constant comparative analysis. Results The core category, ‘Going through crisis by knowing that you are doing the right thing’ illustrates the meaning of women’s reactions and feelings. It illuminates the four categories: ‘When the unexpected happens’– on the one hand, women had positive views that the suspicious malformation could be discovered; however, on the other hand, women questioned the screening. ‘To live in suspense during pregnancy’ – the suspicious malformation caused anxiety and was a stressful situation. ‘Difficulties in understanding information’ – the women thought they had limited knowledge and had difficulties in understanding the information. ‘Suppress feelings and hope for the best’ – the women tried to postpone the problem and thought they should deal with it after delivery. Conclusions Women are worried irrespective of suspicious or severe malformations, and in need of information and counselling tailored to their individual needs. Other sources of support could be: written information, links to reliable sources on the Internet and possibilities for ongoing follow-ups.
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Affiliation(s)
- Marie Oscarsson
- Department of Health and Caring Sciences, Linnaeus University, Stagneliusgatan, 14, 391 82, Kalmar, Sweden.
| | - Tomas Gottvall
- Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 581 83, Linköping, Sweden.
| | - Katarina Swahnberg
- Department of Health and Caring Sciences, Linnaeus University, Stagneliusgatan, 14, 391 82, Kalmar, Sweden. .,Division of Gender and Medicine, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
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Perez-Botella M, Downe S, Meier Magistretti C, Lindstrom B, Berg M. The use of salutogenesis theory in empirical studies of maternity care for healthy mothers and babies. Sexual & Reproductive Healthcare 2015; 6:33-9. [DOI: 10.1016/j.srhc.2014.09.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 08/22/2014] [Accepted: 09/01/2014] [Indexed: 10/24/2022]
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Aite L, Zaccara A, Cuttini M, Mirante N, Nahom A, Bagolan P. Lack of institutional pathways for referral: results of a survey among pediatric surgeons on prenatal consultation for congenital anomalies. Prenat Diagn 2013; 33:904-7. [PMID: 23703679 DOI: 10.1002/pd.4165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Revised: 03/25/2013] [Accepted: 05/18/2013] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This paper aimed to assess pathways through which pediatric surgeons receive couples for prenatal consultation after prenatal diagnosis. METHOD A questionnaire was mailed to pediatric surgical centers to assess the following: (1) surgical caseload per year; (2) number of centers in which prenatal consultation is offered; (3) presence of a 'structured' prenatal consultation clinic; (4) number of consultations per year; (5) pathways for referral to the pediatric surgeon; and (6) the availability of psychological counseling. RESULTS Response rate was 81%, (42/52 centers). Thirty-eight centers (93%) offered prenatal consultation. Seven centers (18%) reported to have a 'structured' clinic in terms of time and location. In 13 centers (34%), 1-9 consultations were carried out, from 10 to 19 in 18 centers (47%), from 20 to over 50 in 7 centers (18%). In 34 centers, internal referrals from the obstetric departments were counseled, and in 28 centers, there were also external referrals. Eleven centers reported that couples were self-referred. Information regarding prenatal counseling was available on the institutional website in 10/38 (26%) centers. Psychological counseling was available in 36 centers. CONCLUSION Despite the fact that the majority of pediatric surgical centers provides prenatal consultation, caseloads are very variable as are referral modalities.
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Affiliation(s)
- Lucia Aite
- Medical and Surgical Neonatal Department, Bambino Gesù Children's Hospital, P.zza S. Onofrio, 4, Rome, 00165, Italy.
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Harris JM, Franck L, Michie S. Assessing the psychological effects of prenatal screening tests for maternal and foetal conditions: a systematic review. J Reprod Infant Psychol 2012. [DOI: 10.1080/02646838.2012.710834] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- James Matthew Harris
- a Department of Clinical, Educational and Health Psychology , University College London , London , UK
| | - Linda Franck
- b University of California–San Francisco, Family Health Care Nursing , San Francisco , CA , USA
| | - Susan Michie
- a Department of Clinical, Educational and Health Psychology , University College London , London , UK
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Rijken MJ, Gilder ME, Thwin MM, Ladda Kajeechewa HM, Wiladphaingern J, Lwin KM, Jones C, Nosten F, McGready R. Refugee and migrant women's views of antenatal ultrasound on the Thai Burmese border: a mixed methods study. PLoS One 2012; 7:e34018. [PMID: 22514615 PMCID: PMC3325974 DOI: 10.1371/journal.pone.0034018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 02/20/2012] [Indexed: 11/23/2022] Open
Abstract
Background Antenatal 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 Findings Qualitative (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/Significance The 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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Affiliation(s)
| | | | - May Myo Thwin
- Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand
| | | | | | | | - Caroline Jones
- Kenyan Medical Research Institute – Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Public Health & Primary Care, University of Oxford, Oxford, United Kingdom
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - François Nosten
- Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Rose McGready
- Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Huang K, Tao F, Raven J, Liu L, Wu X, Tang S. Utilization of antenatal ultrasound scan and implications for caesarean section: a cross-sectional study in rural Eastern China. BMC Health Serv Res 2012; 12:93. [PMID: 22494358 PMCID: PMC3350450 DOI: 10.1186/1472-6963-12-93] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 04/12/2012] [Indexed: 11/30/2022] Open
Abstract
Background Antenatal ultrasound scan is a widely accepted component of antenatal care. Studies have looked at the relationship between ultrasound scanning and caesarean section (CS) in certain groups of women in China. However, there are limited data on the utilization of antenatal ultrasound scanning in the general population, including its association with CS. The purpose of this study is to describe the utilization of antenatal ultrasound screening in rural Eastern China and to explore the association between antenatal ultrasound scan and uptake of CS. Methods Based on a cluster randomized sample, a total of 2326 women with childbirth participated in the study. A household survey was conducted to collect socio-economic information, obstetric history and utilization of maternal health services. Results Coverage of antenatal care was 96.8% (2251/2326). During antenatal care, 96.1% (2164/2251) women received ultrasound screening and the reported average number was 2.55. 46.8% women received at least 3 ultrasound scans and the maximum number reached 11. The CS rate was found to be 54.8% (1275/2326). After adjusting for socio-demographic and clinical variables, it showed a statistically significant association between antenatal ultrasound scans and uptake of CS by multivariate logistic regression model. High husband education level, high maternal age, having previous adverse pregnant outcome and pregnancy complications during the index pregnancy were also found to be risk factors of choosing a CS. Conclusions A high use of antenatal ultrasound scan in rural Eastern China is found and is influenced by socio-demographic and clinical factors. Evidence-based guidelines for antenatal ultrasound scans need to be developed and disseminated to clinicians including physicians, nurses and sonographers. Guidance about the appropriate use of ultrasound scans should also be shared with women in order to discourage unreasonable expectations and demands. It is important to monitor the use of antenatal ultrasound scan as well as the indications for caesarean section in rural China.
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Affiliation(s)
- Kun Huang
- School of Public Health, Anhui Medical University, Hefei city, Anhui Province, People's Republic of China
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Abstract
Prenatal ultrasonography has become a critical and integral component of the obstetric care of women worldwide. As a result, a number of congenital anomalies are now routinely being detected prior to birth. Anomalies affecting the genitourinary system are among those most commonly detected, and thus pediatric urologists are increasingly being asked to provide parental counseling in such situations. However, much of the data needed to enhance these discussions and provide informed consent are absent from the literature. In this review, we hope to address the published literature describing the rapidly expanding role of ultrasound in prenatal care. More importantly, however, we hope to provide some insight into the manner in which prenatal ultrasound and subsequent urologic anomaly diagnosis has affected the practice of pediatric urology.
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Affiliation(s)
- J S Carvalho
- Fetal & Paediatric Cardiology, Royal Brompton & St George's Hospitals and Fetal Cardiology, St George's University of London, London, UK.
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Ranji A, Dykes AK. Ultrasound screening during pregnancy in Iran: womens' expectations, experiences and number of scans. Midwifery 2010; 28:24-9. [PMID: 21041007 DOI: 10.1016/j.midw.2010.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 07/31/2010] [Accepted: 10/03/2010] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the number of ultrasound scans received by Iranian mothers during pregnancy and the relationship between scanning and background factors, and to describe the mothers' expectations and experiences of ultrasound scanning. DESIGN Descriptive survey. SETTING A hospital related to the Social Security Organisation of Urmia City in Iran. PARTICIPANTS Over a six-month period, all mothers attending postpartum care and who met the inclusion criteria (n=654) were interviewed two to three days post partum, and asked to complete a questionnaire containing defined closed- and open-ended questions. FINDINGS The mean number of ultrasound scans received by each woman during her latest pregnancy was 5.9. None of the participants received written information about the scanning procedure. For 91.1% (n=596) of the women, the most important reason for undergoing the scan was to be assured of their infant's health. However, the majority of women were not shown the monitor screen during any of their scans. The main reasons given for feeling happy after a scan were discovering the infant's gender and assurance about the infant's health. Most women overestimated the diagnostic power of ultrasound scanning. Few mothers reported negative feelings towards scanning, but more than half of the mothers indicated that they would like to see changes in the scanning procedure. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The quality of the information offered prior to scanning and the communication between staff and mothers should be improved. The number of scans should be decreased to be in accordance with the official Iranian public health-care guidelines. Although most women viewed ultrasound as being beneficial, it is essential to offer women appropriate information about the limitations of ultrasound in order to discourage unreasonable expectations and demands.
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Affiliation(s)
- Azar Ranji
- Islamic Azad University, Urmia Branch, Faculty of Medical Sciences, Urmia, Iran.
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Larsson AK, Svalenius EC, Lundqvist A, Dykes AK. Parents' experiences of an abnormal ultrasound examination - vacillating between emotional confusion and sense of reality. Reprod Health 2010; 7:10. [PMID: 20546610 PMCID: PMC2904723 DOI: 10.1186/1742-4755-7-10] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 06/14/2010] [Indexed: 11/15/2022] Open
Abstract
Background An ultrasound examination is an important confirmation of the pregnancy and is accepted without reflection to any prenatal diagnostic aspects. An abnormal finding often comes unexpectedly and is a shock for the parents. The aim was to generate a theoretical understanding of parents' experiences of the situation when their fetus is found to have an abnormality at a routine ultrasound examination. Methods Sixteen parents, mothers and fathers, whose fetus had been diagnosed with an abnormality during an ultrasound scan in the second or third trimester, were interviewed. The study employed a grounded theory approach. Results The core category vacillating between the emotional confusion and sense of reality is related to the main concern assessment of the diagnosis impact on the well-being of the fetus. Two other categories Entering uncertainty and Involved in an ongoing change and adaptation have each five sub-categories. Conclusions Parents are aware of that ultrasound examination is a tool for identifying abnormalities prenatally. The information about the abnormality initially results in broken expectations and anxiety. Parents become involved in ongoing change and adaptation. They need information about the ultrasound findings and the treatment without prolonged delay and in a suitable environment. The examiner who performs the ultrasound examination must be aware of how anxiety can be intensified by environmental factors. All parents should to be offered a professional person to give them support as a part of the routine management of this situation.
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Affiliation(s)
- Anna-Karin Larsson
- Faculty of Medicine, Department of Health Sciences, Division of Nursing, Lund University, PO Box 157, SE-221 00 Lund, Sweden.
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