Effects of institutionalizing limited obstetric ultrasound services on utilization of maternal and neonatal health services: a pre-post study

Abstract

Background A minimum of one ultrasound scan is recommended for all pregnant women before the 24th week of gestation. In Ethiopia, there is a shortage of skilled manpower to provide these services. Currently, trained mid-level providers are providing the services at the primary healthcare level. Methods A pre and post intervention observational study was conducted to understand maternal health service utilization rates before and after institutionalizing Vscan access limited obstetric ultrasound services between 2017 and 2020. Results The observed monthly increase on the mean rank of first ANC visits after the introduction of Vscan limited obstetric ultrasound services shows a statistically significant difference at KW-ANOVA H (3) =17.09, P=0.001. The mean rank of fourth ANC utilization increment shows statistically significant difference at KW- ANOVA H (3) =16.24, P=0.001. The observed mean rank in skilled birth attendance shows a statistically significant positive difference using KW-ANOVA H (3) =23.6, P<0.001. The mean rank of increased utilization in postnatal care shows a statistically significant difference using KW-ANOVA H (3) =17.79, P<0.001. Conclusion The introduction of limited obstetric ultrasound services by trained mid-level providers at primary healthcare levels was found to have improved the utilization of antenatal care, skilled birth attendance, and postnatal care services. It is recommended that limited obstetric ultrasound services be scaled up, and a further comparative study between facilities with and without ultrasound services be conducted to assess the effect of the introduction of the services on maternal and perinatal outcomes.

Inovação tecnológica ultrassom na prática profissional da enfermeira obstétrica: protocolo de revisão de escopo

“…In order to reduce the alarming rate of maternal and neonatal mortality (5) . During prenatal care, ultrasound is essential for screening and stratification of gestational risk, allowing early follow-up and interventions, in addition to determining gestational age, number of fetuses and their position, uterine cervix length, possible amniotic fluid abnormalities, congenital anomalies and placenta location and growth (6) . WHO recommends that a routine ultrasound be performed before 24 weeks of gestation for all pregnant women, including those at low risk, and the International Federation of Gynecology and Obstetrics (Figo) recommends performing at least two ultrasound examinations on all pregnancies (6) .…”

“…During prenatal care, ultrasound is essential for screening and stratification of gestational risk, allowing early follow-up and interventions, in addition to determining gestational age, number of fetuses and their position, uterine cervix length, possible amniotic fluid abnormalities, congenital anomalies and placenta location and growth (6) . WHO recommends that a routine ultrasound be performed before 24 weeks of gestation for all pregnant women, including those at low risk, and the International Federation of Gynecology and Obstetrics (Figo) recommends performing at least two ultrasound examinations on all pregnancies (6) . Some research suggests that counting with nurse midwives trained to use ultrasound, with the ability to make immediate decisions based on the findings of the images, enables women to be offered better quality prenatal care at the care site (1) .…”