Additional benefits of first trimester screening

Achieving universal access to obstetric ultrasound in resource constrained settings: A narrative review

OBJECTIVES

The potential benefits and challenges of achieving universal access to obstetric ultrasound services in resource constrained settings were reviewed, with a view to making some recommendations to address the huge burden of avoidable maternal and child morbidity and mortality.

KEY FINDINGS

In most resource-poor settings of the world, antenatal ultrasound is available only to a privileged few in urban centres, while the majority of the population living in rural areas have little or no access to diagnostic imaging services. There is also the extreme shortage of sonographers and doctors with specialist training in sonography. A comprehensive regulation must be put in place to achieve maximum benefits and to ensure quality assurance; appropriate use and application of ethics and training must be comprehensive.

CONCLUSION

Ultrasound service provision, in resource-scarce settings, has the potential to improve access and quality of health care services in areas like the point of care ultrasound service provision and in the fields of obstetrics and gynaecology. A comprehensive regulation must be put in place to achieve maximum benefits and to ensure quality assurance.

IMPLICATIONS FOR PRACTICE

Making ultrasound technology available and affordable in resource scare settings has the potential to improve access to diagnostic imaging services and reduce avoidable maternal and child death in resource constrained settings.

Issues in pregnancy dating: revisiting the evidence

As the end point date in pregnancy, the estimated date of delivery provides guidance for the timing of specific prenatal tests, gauges fetal growth, and informs critical decision making for specific obstetric complications. It is prudent to use the most evidenced-based methods available to accurately determine gestational age. This article explores the accuracy of both menstrual and ultrasound dating techniques and discusses some of the issues and limitations for each method. In addition, a simple formula called the rule of eights can be used to determine a final estimated date of delivery when a discrepancy between menstrual and ultrasound dating occurs.