A community-based obstetric ultrasound service

Geerts, L; Theron, A.M; Grové, D.; Theron, Gerhard; Odendaal, Hein J.

doi:10.1016/s0020-7292(03)00310-2

Cited by 25 publications

(27 citation statements)

References 17 publications

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“…This work showed that ultrasound can be an important diagnostic tool in reducing the number of referrals to higher-end facilities; as with the other work described above, the device was operated by cardiologists, not a health worker with abbreviated training. Additionally, researchers in South Africa showed that ultrasound scans reduced the number of referrals to a regional center by studying 3009 women in an economically disadvantaged urban area who sought antenatal care at two Midwife Obstetric Units [10]. While this work was done in an urban setting, the fact that ultrasound improved accuracy of referrals shows that our approach is viable.…”

Section: Related Workmentioning

confidence: 96%

Portable antenatal ultrasound platform for village midwives

Brunette

Gerard

Hicks

et al. 2010

Proceedings of the First ACM Symposium on Computing for Development

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Ultrasound imaging is an effective tool for identifying maternal mortality risk factors. Unfortunately, ultrasound is nearly absent in many rural healthcare facilities in developing regions due to the high costs of both equipment and required training. To leverage existing healthcare systems commonly found in these contexts, we have focused our efforts on increasing the diagnostic capabilities of midwives -often central medical figures in rural and lowincome communities. We have designed and built a low-cost portable ultrasound device consisting of a USB ultrasound probe and a touchscreen netbook for a total cost of around USD3500. Compared to currently available ultrasound devices, we simplified the user interface while maintaining functionality to allow midwives to detect three common obstetrical conditions: placenta previa, multiple gestations, and breech presentation. To evaluate our solution, we tested the accuracy of ultrasound measurements, image quality, and whether midwives could use ultrasound. Testing performed by nine clinicians indicated our device would be appropriate for identifying the three conditions. Our modular design approach allows for easy modification, and the device is designed to utilize existing local healthcare resources in order to create a sustainable solution that does not depend on continuous foreign assistance.

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Section: Related Workmentioning

confidence: 96%

Portable antenatal ultrasound platform for village midwives

Brunette

Gerard

Hicks

et al. 2010

Proceedings of the First ACM Symposium on Computing for Development

View full text Add to dashboard Cite

show abstract

“…While the utility of ultrasound for prenatal screening and diagnosis has been debated, 15 ultrasound has additional benefits, including accurate pregnancy dating and early detection of unexpected problems. 16,17 Fetal ultrasound also appears to be popular with parents and primary health care providers, which will probably improve the link between primary and tertiary care. Fetal ultrasound services are therefore increasingly used and, in metropolitan areas, fetal medicine is increasingly important.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of prenatal screening for Down syndrome on the basis of maternal age in Cape Town

et al. 2011

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Down syndrome (DS) is the most common genetic cause of intellectual disability. Evidence suggests that live-birth prevalence of DS is high in South Africa: 1.33 -1.8 per 1 000 live births in two urban areas, 1,2 and 2.1 per 1 000 in a rural area. 3 Prenatal screening for DS was established in the 1970s using advanced maternal age (AMA) as a risk factor, and this remains the standard of care in the public health sector of South Africa. National policy provides for free amniocentesis to be offered to AMA women, whereas biochemical screening is not offered and access to fetal ultrasound is limited.Cape Town's public health services are among the best developed in South Africa. Although access to fetal ultrasound has increased in recent years, AMA remains a frequent indication for prenatal genetic counselling. The study focused on the Cape Town Metropole West health district (CT West) to obtain evidence regarding the effectiveness of age-based screening for the prevention of DS, and preliminary evidence regarding factors affecting utilisation of prenatal diagnosis. We assessed (i) laboratory trends in prenatal diagnostic testing over a 30-year period, (ii) trends in uptake of prenatal diagnostic testing among women receiving genetic counselling and (iii) the referral pathway from primary care to tertiary care. MethodsStudy population. Women attending state antenatal health care services in CT West, which comprises a large and diverse urban population, with a majority coloured population, and minorities of whites and blacks. The district has experienced rapid urbanisation and considerable demographic changes. In 2005, there were approximately 34 000 deliveries in the district (Patel, unpublished data).Study sites and services. The antenatal health service and cytogenetic laboratory service in CT West have been stable since the 1970s. The health service includes several primary and secondary level facilities, and tertiary level fetal medicine and pregnancy counselling services at Groote Schuur Hospital (GSH). The University of Cape Town (UCT) Cytogenetic Laboratory (CL) has provided prenatal and postnatal diagnostic laboratory services to CT West throughout the period. Prenatal diagnostic testing is almost exclusively by amniocentesis, and indications have included increased risk of DS (most commonly AMA, but more recently also based on ultrasound markers (first trimester nuchal translucency thickness and second trimester soft markers) and fetal anomalies detected on ultrasound. The age cut-off for AMA counselling has varied over the years.UCT CL database. The laboratory has maintained a database of samples received since the early 1970s. Initially this was a written record but all records were transferred to Microsoft Access in the mid-1990s, and a parallel written and computerised database was maintained. To improve data quality, the database was cleaned by cross-referencing blank or unclear computer data fields with the written records -the remaining missing data represented less than 5% of data points per category...

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“…A lack of screening was the main reason for the postnatal diagnoses, but the reasons for this lack were not investigated. Along with many additional benefits, a wider availability of obstetric ultrasound services would facilitate aneuploidy detection by providing accurate dating and better case selection for referral [17]. A detailed cost analysis is needed.…”

Section: Discussionmentioning

confidence: 99%

“…The indications for ultrasound assessment were the following: a high obstetric risk necessitating prenatal care at the hospital (2 scans, in weeks 11-14 and 18-24); genetic counseling because of age (N 36 years at conception) or because of a fetal risk of abnormality (1 or 2 scans, in weeks 11-14 and/or [16][17][18][19][20][21][22][23][24]; or an emergency referral because of an abnormal clinical course or abnormal findings on a basic scan offered before the 24th week at the primary care level.…”

Section: Methodsmentioning

confidence: 99%