Sahel Medical Journal

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 20  |  Issue : 1  |  Page : 38--42

Awareness and perception of pregnant women about obstetrics ultrasound at Aminu Kano Teaching Hospital


AA Saleh1, G Idris1, A Dare1, MA Yahuza2, MA Suwaid2, SK Idris2,  
1 Department of Radiography, Bayero University Kano, Kano, Nigeria
2 Department of Radiology, Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria

Correspondence Address:
A A Saleh
Department of Radiography, Bayero University Kano
Nigeria

Abstract

Background: Ultrasonography is firmly embedded in antenatal maternity care around the world. It proves accuracy in calculation of gestational age, earlier identification of multiple pregnancies, and diagnosis of nonviable pregnancies and certain fetal malformations. Objective: The study is aimed to determine the awareness and perception of pregnant women towards obstetric scan, at Aminu Kano Teaching Hospital (AKTH). Materials and Methods: This was a prospective and cross-sectional study conducted among 400 pregnant women that attended antenatal ultrasound scan at AKTH. A pretested and structured questionnaire was used. Only women that agreed to participate were included in the study. Convenience sampling technique was employed for the data collection. Information collected from the participants was: Age, marital status, occupation, level of education, parity, level of awareness and level of perception. The collected data was analyzed using SPSS (16.0) software for windows (SPSS Inc., Chicago, IL, USA) to obtain frequency, mean and percentages. Results: A total of 400 women were included in the study, of which most of them were within the age range of 21–30 years. Almost all the participants (97%) had ultrasound before, and they believed it is safe. The majority (93.8%) believed that ultrasound is necessary during pregnancy. Ninety-seven percent believed it is done to determine fetal viability and wellbeing. Conclusion: The study established that most of the participants are aware of ultrasound scan. The subjects also believed that the procedure is safe, and the main purpose is for fetal wellbeing and viability.



How to cite this article:
Saleh A A, Idris G, Dare A, Yahuza M A, Suwaid M A, Idris S K. Awareness and perception of pregnant women about obstetrics ultrasound at Aminu Kano Teaching Hospital.Sahel Med J 2017;20:38-42


How to cite this URL:
Saleh A A, Idris G, Dare A, Yahuza M A, Suwaid M A, Idris S K. Awareness and perception of pregnant women about obstetrics ultrasound at Aminu Kano Teaching Hospital. Sahel Med J [serial online] 2017 [cited 2024 Mar 29 ];20:38-42
Available from: https://www.smjonline.org/text.asp?2017/20/1/38/204332


Full Text



 Introduction



Routine obstetric sonography is now globally recognized as one of the ways through which maternal mortality can be reduced.[1] Based on existing evidence, routine ultrasound in early pregnancy appears to enable better assessment of gestational age, early detection of multiple pregnancy and detection of clinically unsuspected fetal malformation at a point when early termination of pregnancy is still possible.[2] Increasingly, first trimester screening with biochemical and ultrasound markers is being proposed as advance on this, yielding higher detection rates of Down's syndrome at an earlier gestational age.[3]

Pregnancy occurs when a male sperm penetrates an egg and fertilizes it which usually happens in the woman's fallopian tube after ovulation (the matured egg was released from one of her ovaries)[4] and ending when a baby is born.[5] Pregnancy symptoms differ from woman to woman and pregnancy to pregnancy; however, one of the most significant pregnancy symptoms is a delayed or missed period.[6] A full-term pregnancy lasts 9 months (38–40 weeks) and is divided into trimesters: One (the embryo develops), two (the embryo turns into a fetus), and three (the fetus gains weight and gets ready for birth) and usually does not involve major health problems.[7]

Obstetrician Ian Donald from Scotland introduced the diagnostic use of ultrasound in clinical medicine.[8] American Pregnancy Association [5] defined obstetric ultrasound scan as a procedure (a safe, noninvasive, accurate and cost-effective means of imaging) that uses high-frequency sound waves to scan a woman's abdomen and pelvic cavity, using small transducer (probe) and ultrasound gel creating a picture (sonogram) of the baby, placenta as well as the mother's uterus, blood vessels and ovaries. Ultrasound scan in obstetrics is widely accepted to be the best and most accurate medical technique to assess pregnancy.[9] Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam.[5]

Regarding their knowledge about the use of obstetric sonography, all women expressed some level of knowledge about obstetric sonography.[1] The examination is usually carried out once, between the 16th and 20th week of the pregnancy.[10] Neilson [11] reported that diagnostic ultrasound examination may be employed in a number of specific circumstances during pregnancy such as after clinical complications (e.g. bleeding), or where the fetus is perceived to be at a particularly high risk of malformation or of being inappropriately growing. Transvaginal ultrasound scans may be used early in pregnancy to diagnose potential ectopic or molar pregnancies.[5] Routine obstetric sonography is now globally recognized as one of the ways through which maternal mortality can be reduced.[1]

It has been observed that in Aminu Kano Teaching Hospital (AKTH) a lot of pregnant women were referred for obstetric sonography from Obstetrics and Gynaecology Department either at their first, second or third trimester everyday for diagnosis. The perception of this procedure among pregnant women who present for the procedure has been scarcely described in this locality. Therefore, the study determined the awareness and perceptions of pregnant women towards obstetric scan at AKTH.

 Materials and Methods



This was a prospective and cross-sectional study design. Primary data was used for the study. The data were obtained using a prestructured questionnaire. The study population consists of all pregnant women who came for obstetric ultrasound scan at AKTH within the year 2014. A total of 400 subjects were included in the study. The sample was obtained using the Taylor's formula. Convenience sampling technique was employed for the data collection. The sampling technique was chosen because using a stringent sampling technique would make the data inaccessible. Only pregnant women that came for obstetric scan at AKTH were included in the study. Pregnant women that came for other scans such as abdominal or renal scans were excluded. The data was collected using a structured questionnaire. The questionnaire contains the following; age, marital status, level of education, occupation, level of awareness and level of perception. The data was organized using a cross-tabulation based on age, gender, occupation, level of awareness and perception. The data was analyzed using SPSS version (16.0) software (SPSS Inc., Chicago, IL, USA) for windows and excel spread sheet to determine the mean, frequency and percentage. Bar charts were also plotted. Ethical clearance to conduct the study was sought and obtained the hospital ethical committee. Each of the subjects filled an expressed consent form before participating in the study.

 Results



A total of 400 questionnaires were distributed to pregnant women, and all (100%) were returned and recorded. Their ages were classified based on age grouping. Those within 21–30 years age group were the predominant participants (63.7%) while age group 41 and above were less frequent (2.5%) [Figure 1].{Figure 1}

Most of the participants are married (99.2%), but 1 (0.2%) is divorced and 2 (0.5%) are singles as shown in [Table 1].{Table 1}

A majority of the participants are full-time homemakers 205 (51.2%) followed by civil servants 107 (26.8%) as shown in [Figure 2].{Figure 2}

Most of the participants, 58.5% had tertiary education, 31.8% had secondary education while only 3.2% had primary education [Figure 3].{Figure 3}

Seventy-three percent of the participants are multiparous, and the remaining (27%) are nulliparous [Table 2].{Table 2}

Two hundred and forty-seven of the participants (61.8%) had none of the listed history of previous pregnancy and only few of them (4.2%) had history of multiple gestations [Table 3] and [Figure 4].{Table 3}{Figure 4}

Participant's awareness

[Table 3] showed that almost all the subjects 97% had obstetric scan before. About 91.2% believed that the procedure is safe. The majority of the participants (93.8%) knew that the scanning is necessary for pregnant women. One hundred and sixty of the participants (41.0%) responded that ultrasound should be done twice in each pregnancy.

Participant's perception

With respect to the indications for this procedure, 95.8% of women thought that the main purpose for this test is to assess fetal growth. About 97.5% thought that ultrasound is also used to determine viability and helps in the prenatal diagnosis of congenital abnormalities [Table 4].{Table 4}

 Discussion



Ultrasound scanning or imaging is firmly embedded in antenatal maternity care around the world.[2] In particular, the 18–23 weeks - anomaly scan has become a vital part of antenatal care.[12] Clinical evidence suggests that such a practice improves the effectiveness of the clinical management.[13] There is a need to utilize clinical imaging on the basis of sound clinical reasons.[8]

Regarding their knowledge about the use of obstetric sonography, all women expressed some level of knowledge about obstetric sonography. This is partly due to the wide use of ultrasound in health care today as part of routine antenatal care as well as the unlimited access to information. However, the kind of knowledge these women have again varies mainly due to their level of education.[10]

In this study, majority of the participants (63.5%) fall within age group 21–30 years. This agrees with a work conducted by Ugwu et al.[8] It also showed that very few were found to be either divorced or single (0.5% and 0.2% respectively) but almost all were married (99.2%). The study has established 51.2% of the participants to be homemakers which is similar to Ugwu et al.[8] having 53.3%, but slightly lower than that of Ugwu et al.[9] that reported 49.1% of their participants to be traders followed by students (36.4%).

The study showed that 58.5% had formal education beyond secondary level. It is similar to Ugwu et al.[8] but contrary to Gonzaga et al.[1] report. Ugwu et al.[9] reported the same percentage (947%) among those that had secondary or tertiary level of education. Almost all the participants (73%) are multiparous, only 27% are found to be nulliparous which was contrary to a research carried out by Schmidt et al.[14] where 62% were reported to be nulliparous.

It has been observed that even though 61.8% had none of the listed history of pregnancies, a quite number 21.5% had stillbirth.

Almost all the participants (97%) had obstetric ultrasound scan before. This is similar to a study conducted in Syria [2] and another study in Nigeria [11] which revealed that 97.9% and 73% had been previously scanned respectively.

According to this study, 91.2% of the women believed obstetric scan to be safe which corresponds with Bashour et al.[2] and Ugwu et al.[8] and Ugwu et al.[9]

The study also shows similarity with findings by Munim et al.[13] in terms of scan frequency during pregnancy period in which some of the participants (41.0%) believed it should be done twice.

The majority of the women (95.8%) in our study population thought that ultrasound is performed mainly to predict fetal growth, which is consistent with those of the other studies Munim et al.[13] Whynes [15] and Heazell et al.[16]

It was found that 97.5% believed that the main purpose of the test is to determine fetal viability, which is similar to Munim et al.,[13] Whynes,[15] and Heazell et al.[16] reports. It also coincides with Firth et al.[17] study which stated that pregnancy and fetal viability verification were commonly stated reasons for wanting an ultrasound by participants in their study.

 Conclusion



The study established that most of the participants are aware of ultrasound scan. The subjects also believed that the procedure is safe and the main purpose for performing it is fetal wellbeing and viability.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Gonzaga MA, Kiguli-Malwadde E, Francis B, Rosemary B. Current knowledge, attitudes and practices of expectant women toward routine sonography in pregnancy at Naguru health centre, Uganda. Pan Afr Med J 2009;3:18.
2Bashour H, Hafez R, Abdulsalam A. Syrian women's perceptions and experiences of ultrasound screening in pregnancy: Implications for antenatal policy. Reprod Health Matters 2005;13:147-54.
3Williams C, Sandall J, Lewando-Hundt G, Heyman B, Spencer K, Grellier R. Women as moral pioneers? Experiences of first trimester antenatal screening. Soc Sci Med 2005;61:1983-92.
4Nordqvist C. What is an Ultrasound? 2012. Available from: http://www.medicalnewstoday.com. [Last accessed on 2014 Mar 4].
5American Pregnancy Association. Pregnancy Symptoms – Early Signs of Pregnancy; 2013. Available from: http://www.americanpregnacy.org/pregnancysymptoms/earlysignsofpregnancy.htm. [Last accessed on 2013 Aug 20].
6Raynor BD. Routine ultrasound in pregnancy. Clin Obstet Gynecol 2003;46:882-9.
7Caughey AB, Nicholson JM, Washington AE. First- vs second-trimester ultrasound: The effect on pregnancy dating and perinatal outcomes. Am J Obstet Gynecol 2008;198:703.e1-5.
8Ugwu AC, Idigo FU, Anakwue AC, Nwogu UB, Egwu OA. Patient satisfaction rating of obstetric sonography: A validation study. Afr J Midwifery Womens Health 2008;2:727-29.
9Ugwu AC, Udo BE, Eze JC, Erondu OF. Awareness of information, expectations and experiences among women for obstetric sonography in a South East Nigeria population. Am J Sci Ind Res 2011;2:478-81.
10Molander E, Alehagen S, Berterö CM. Routine ultrasound examination during pregnancy: A world of possibilities. Midwifery 2010;26:18-26.
11Neilson JP. Ultrasound for fetal assessment in early pregnancy. Cochrane Database of Syst Rev 1998;(4):CD000182.
12Levi S. Routine ultrasound screening of congenital anomalies. An overview of the European experience. Ann N Y Acad Sci 1998;847:86-98.
13Munim S, Khawaja NA, Qureshi R. Knowledge and awareness of pregnant women about ultrasound scanning and prenatal diagnosis. J Pak Med Assoc 2004;54:553-5.
14Schmidt W, Cseh I, Hara K, Kubli F. Maternal perception of fetal movements and real-time ultrasound findings. J Perinat Med 1984;12:313-8.
15Whynes DK. Receipt of information and women's attitudes towards ultrasound scanning during pregnancy. Ultrasound Obstet Gynecol 2002;19:7-12.
16Heazell A, North L S, Mahmoud S. A Prospective Study of Women's Expectations and Knowledge of the Mid Trimester Anomaly Scan. Ultrasound of Obstetrics and Gynaecology. Suppl 1:88.
17Firth ER, Mlay P, Walker R, Sill PR. Pregnant women's beliefs, expectations and experiences of antenatal ultrasound in Northern Tanzania. Afr J Reprod Health 2011;15:91-107.