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Expectant Mothers' Perception of Prenatal Sonography in a South Original Article Expectant mothers’ perception of prenatal sonography in a South‑Eastern population in Nigeria A. C. Ugwu, H. C. Elugwu, O. A. Onyegbule1 Department of Radiography and Radiological Sciences, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria, 1Obstetrics and Gynaecology Department, Federal Medical Centre, Owerri, Imo State, Nigeria ABSTRACT Background: Prenatal sonography is very important for quality patient management and effective service delivery in diagnostic radiology during the antenatal period. Aim: The study was conducted to assess the perception of pregnant women to prenatal sonography and to investigate the factors affecting maternal satisfaction to prenatal sonography in some tertiary institutions in south‑eastern Nigeria. Materials and Methods: The study was a cross‑sectional study that involved 150 patients. It was conducted by administering semi‑structured questionnaires. The questionnaire contained a total of 17 questions consisting of 16 close‑ended questions and 1 open‑ended question. The respondents were pregnant women who presented for obstetric sonography in Federal Teaching Hospitals and Federal Medical Centers in south‑eastern Nigeria. The data were analyzed descriptively using frequency tables and percentages. Results: There was a high indication of clinical use of obstetric ultrasound such as the health and well‑being of the foetus (35.3%), foetal age determination, and the expected date of delivery (24.7%). Most respondents (84.6%) perceived prenatal sonography as being necessary, and 66.7% of the patients considered the result of obstetric sonography to be reliable. Majority of the respondents (88.7%) considered the services rendered during their sonographic scan to be satisfactory. Conclusion: Most of the women perceived prenatal sonography as necessary and reliable. The services rendered during sonography were also considered satisfactory by most women; however, most pregnant women did not know about diagnostic ultrasound safety during the prenatal period. Key words: Maternal; perception; prenatal; sonography. Introduction suggesting the need for guidelines regarding the appropriate use of obstetric ultrasound in antenatal care.[1] The recommendation of obstetric ultrasound as an indispensable part of modern antenatal care has resulted in its Prenatal sonography could represent an important area dramatic overuse mainly because of its over commercialization of conflict between patient autonomy and the clinical for monetary gains in both public and private health facilities. This was shown in a survey carried out in Vietnam; 400 Address for correspondence: Dr. O. A. Onyegbule, woman had an average of 6.6 scans during their pregnancy Obstetrics and Gynaecology Department, Federal Medical Centre, Owerri, Imo State, Nigeria. and one‑fifth had 10 or more scans. The study concluded by E‑mail: [email protected] Access this article online This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, Quick Response Code and build upon the work non-commercially, as long as the author is credited and the new Website: creations are licensed under the identical terms. www.tjogonline.com For reprints contact: [email protected] DOI: How to cite this article: Ugwu AC, Elugwu HC, Onyegbule OA. Expectant 10.4103/0189-5117.192222 mothers' perception of prenatal sonography in a South‑Eastern population in Nigeria. Trop J Obstet Gynaecol 2016;33:190‑5. 190 © 2016 Tropical Journal of Obstetrics and Gynaecology | Published by Wolters Kluwer - Medknow Ugwu, et al.: Expectant mothers’ perception of prenatal sonography decision‑making process, however, reviewed literature ultrasound has been found to be associated not only with has shown that most women did not view ultrasound in the clinical results but also with the clarity of the image, pregnancy as a screening tool for abnormalities.[2] the quality of the explanation given and the attitude of the scanning operator.[8] Sonography has become a routine and indispensable tool in the care of pregnant woman during their antenatal period. It This reveals that the effectiveness of ultrasound depends has grown in popularity over the last 20 years and is widely considerably on the quality of the equipment used and the adopted as a standard tool for the management of expectant skill of the sonographer or sonologist. Therefore, ultrasound women in the developed world.[3] By virtue of its versatility, imaging is highly operator dependent. Cost effectiveness of safety and cost‑effectiveness, this imaging technology equally obstetric ultrasound scan is a measure to ascertain if the suits developing countries such as Nigeria.[4] benefit and services rendered to the expectant mother are really worth the monetary value, reflecting the degree of Prenatal sonography also known as obstetric sonography is reliability on obstetrics ultrasound during pregnancy. The the use of diagnostic medical ultrasound in visualization of cost‑effectiveness of an obstetric sonography is influenced by the embryo or foetus in its mother’s uterus. This procedure patient perception, awareness, expectations and experiences yields a variety of information regarding the health of the regarding obstetric ultrasound. Therefore, this study was mother and of the foetus, the progress of the pregnancy conducted to evaluate the perception of pregnant women to and further information on the baby. The increasing spread prenatal sonography and to investigate the factors affecting of obstetric ultrasound technology around the world and the maternal satisfaction to prenatal sonography in some tertiary conflation of its use with creating a safe pregnancy, as well as institutions in south‑eastern Nigeria. the ability to see and determine features such as the sex of the foetus impact the way in which pregnancy is experienced and Patients and Methods conceptualized. The views and perception of these pregnant women toward prenatal sonography affects its utilization.[1] Study setting The study sites were tertiary institutions in south‑east Bricker et al. reported that most expectant women initiate Nigeria. The study was carried out at three Federal a request for ultrasound for both medical and non‑medical Teaching Hospitals [University of Nigeria Teaching reasons.[5] These reveal that, while pregnant women seek Hospital Enugu (UNTH), Nnamdi Azikiwe Teaching much of the medical information that is of interest to health Hospital Anambra (NAUTH) and Federal Teaching Hospitals professionals, they also want additional information that is Abakaliki (FETHA)] and two Federal Medical Centres (Imo not typically encompassed by clinical decisions. It is reported and Umuahia) in south‑eastern Nigeria. These places served that well‑educated women are more likely to appreciate as referral centres, and were attended by many patients on the limits of ultrasound whereas the lesser educated ones a daily basis. These places were chosen because of different are more likely to rely more on the impression created perceptions of pregnant women to sonography in the region. outside sonography procedure whether right or wrong.[6] Patients from surrounding states also presented to these Encouragement of maternal interaction and the basic training centres. of sonographers or sonologists, obstetricians and others in the counseling session could be beneficial in obstetric Study design sonography. These benefits include increased maternal– The research was carried out prospectively using a descriptive foetal attachment, reduced maternal complaints, knowledge research design to assess the maternal perception of prenatal of foetal development, positive behaviour towards the sonography in south‑eastern Nigeria. clinicians and increased maternal investment in health during pregnancy. Sample population and sample size Pregnant women presenting for obstetric scan who were The diagnostic capability of obstetric sonography has willing to participate in the research within the period important psychological benefits in reducing anxiety in of the study, from June to July 2014, formed the target pregnant women, which helps to stimulate a parental bond population. Taro yamani formula: n = N/[1+ (Ne2)] was used with the foetus and contribute to positive health behaviour. to calculate a sample size of 150 pregnant women,[9] where Moreover, scan results that revealed foetal anomalies n was the sample size, N was the population size, I was a significantly increase the maternal anxiety level. Larsen constant and e was the error limit or margin of error of level et al stated that most pregnant women feel more secure of significance (accepted error at 5%, i.e., 0.05). Statistical after obstetric sonography[7] the subjective experience of significance was set at P < 0.05. Tropical Journal of Obstetrics and Gynaecology / May-Aug 2016 / Volume 33 / Issue 2 191 Ugwu, et al.: Expectant mothers’ perception of prenatal sonography Sampling method Ethics Committee of Nnamdi Azikiwe University Teaching This was a cross‑sectional study. Convenience sampling was Hospital, Nnewi. used to select the respondents (pregnant women) who presented for prenatal ultrasound based on the ease of access Results and availability. Thirty pregnant women were chosen from each of the centres. Table 1 below shows the distribution of respondents according to age. It was shown that most of the respondents
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