The diagnostic impact of limited, screening obstetric ultrasound when performed by midwives in rural Uganda View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-07

AUTHORS

J O Swanson, M G Kawooya, D L Swanson, D S Hippe, P Dungu-Matovu, R Nathan

ABSTRACT

OBJECTIVE: To evaluate the diagnostic impact of limited obstetric ultrasound (US) in identifying high-risk pregnancies when used as a screening tool by midwives in rural Uganda. STUDY DESIGN: This was an institutional review board-approved prospective study of expecting mothers in rural Uganda who underwent clinical and US exams as part of their standard antenatal care visit in a local health center in the Isingiro district of Uganda. The midwives documented clinical impressions before performing a limited obstetric US on the same patient. The clinical findings were then compared with the subsequent US findings to determine the diagnostic impact. The midwives were US-naive before participating in the 6-week training course for limited obstetric US. RESULT: Midwife-performed screening obstetric US altered the clinical diagnosis in up to 12% clinical encounters. This diagnostic impact is less (6.7 to 7.4%) if the early third trimester diagnosis of malpresentation is excluded. The quality assurance review of midwives' imaging demonstrated 100% sensitivity and specificity in the diagnosing gestational number, and 90% sensitivity and 96% specificity in the diagnosis of fetal presentation. CONCLUSION: Limited, screening obstetric US performed by midwives with focused, obstetric US training demonstrates the diagnostic impact for identifying conditions associated with high-risk pregnancies in 6.7 to 12% of patients screened. The limited obstetric US improved diagnosis of early pregnancy complication as well as later gestation twins and malpresentation. Midwives who have undergone focused 6-week limited obstetric US training proved capable of diagnosing twins and fetal presentation with high sensitivity and specificity. More... »

PAGES

508

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/jp.2014.54

DOI

http://dx.doi.org/10.1038/jp.2014.54

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1021905102

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24699218


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