Use and misuse of ultrasound in obstetrics with reference to developing countries

Abstract

Maternal and neonatal health is one of the main global health challenges. Every day, approximately 800 women and 7,000 newborns die due to complications during pregnancy, delivery, and neonatal period. The leading causes of maternal death in sub-Saharan Africa are obstetric hemorrhage (28.8%), hypertensive disorders in pregnancy (22.1%), non-obstetric complications (18.8%), and pregnancy-related infections (11.5%). Diagnostic ultrasound examinations can be used in a variety of specific circumstances during pregnancy. Because adverse outcomes may also arise in low-risk pregnancies, it is assumed that routine ultrasound in all pregnancies will enable earlier detection and improved management of pregnancy complications. The World Health Organization (WHO) estimated in 1997 that 50% of developing countries had no access to ultrasound imaging, and available equipment was outdated or broken. Unfortunately, besides all the exceptional benefits of ultrasound in obstetrics, its inappropriate use and abuse are reported. Using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication can be considered ethically unjustifiable. Ultrasound assessment when indicated should be every woman’s right in the new era. However, it is still only a privilege in some parts of the world. Investment in both equipment and human resources has been clearly shown to be cost-effective and should be an obligatory step in the improvement of health care. Well-developed health systems should guide developing countries, creating principles for the organization of the health system with an accent on the correct, legal, and ethical use of diagnostic ultrasound in pregnancy to avoid its misuse. The aim of the article is to present the importance of correct and appropriate use of ultrasound in obstetrics and gynecology with reference to developing countries.

The abuse of ultrasonography: A critical review of the Nigerian situation

“…Studies have highlighted the presence of untrained individuals performing ultrasound scans without proper credentials, leading to inaccurate diagnoses and patient harm 3,17 . This phenomenon underscores the need for stringent regulatory measures to ensure that only qualified healthcare professionals are authorized to perform ultrasonography.…”

“…Ultrasonography, a non-invasive imaging technique, has revolutionized medical diagnosis and management worldwide, including in Nigeria [1,2] . However, alongside its widespread use comes a growing concern over its abuse, particularly within the Nigerian healthcare system [3] . The abuse of ultrasonography refers to the inappropriate or excessive use of ultrasound imaging technology in medical or non-medical contexts.…”

“…The availability of ultrasonography has expanded significantly in Nigeria, with ultrasound machines becoming commonplace in healthcare facilities across the country [6] . While this technology has undoubtedly enhanced diagnostic capabilities and improved patient care, there is mounting evidence to suggest that its misuse and abuse are becoming prevalent issues 3 . Several studies have shed light on the patterns and practices surrounding the use of ultrasonography in Nigeria [6,7] .…”