Impact of Introducing Routine Antenatal Ultrasound Services on Reproductive Health Indicators in Mpigi District, Central Uganda
Impact of Introducing Routine Antenatal Ultrasound Services on Reproductive Health Indicators in Mpigi District, Central Uganda
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DOI：
10.1097/ruq.0000000000000142
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发表时间：
2015-12-01
影响因子：
1.3
通讯作者：
Ddungu-Matovu, Peter
中科院分区：
文献类型：
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作者：
Kawooya, Michael G.;Nathan, Robert O.;Ddungu-Matovu, Peter
全球孕产妇和新生儿死亡主要发生在资源匮乏的国家。导致这些死亡的风险因素通常可以通过超声（US）检测到，并且可能可以预防。我们评估了在乌干达农村地区产前保健（ANC）期间进行US扫描对生殖健康服务利用的影响。这项务实的比较研究在乌干达Mpigi区的两个选区进行。在位于Mawokota North选区的5个干预点，设施助产士接受了有限的产科超声扫描培训。他们配备了太阳能便携式US机器，并重新部署，以提供US扫描作为ANC的一个组成部分。Mawokota South选区的5个控制点提供相同的ANC服务，但没有US扫描。我们比较了在引入US之前和之后，干预和对照地点的第一次和第四次ANC出席率、设施分娩和产科并发症转诊的差异。干预组第一次接受ANC的人数增加了32%，而对照组增加了7.4%（P < 0.001）。干预组第四次产前检查率提高了147%，而对照组下降了0.6%（P < 0.001）。干预地点的高危妊娠转诊率增加了40.7%，而对照地点为25%。干预地点的出生人数增加了34.1%，而对照地点的出生人数增加了29.5%。将有限的产科US纳入常规ANC访视与ANC就诊率的增加相关。
The preponderance of global maternal and neonatal deaths occurs in low-resource countries. The risk factors that lead to these deaths are often detectable with ultrasound (US) and potentially preventable. We assessed the impact of performing US scanning during antenatal care (ANC) on reproductive health service utilization in a rural Ugandan district. This pragmatic comparative study was conducted in 2 constituencies of Mpigi district in Uganda. In the 5 intervention sites located in the Mawokota North constituency, facility midwives were trained in limited obstetric US scanning. They were equipped with solar-powered portable US machines and redeployed to offer US scanning as an integral component of ANC. The 5 control sites in the Mawokota South constituency offered the same ANC services without US scanning. We compared the difference in the first and fourth ANC attendance, facility deliveries, and referral of obstetric complications in the intervention and the control sites before and after the introduction of US. There was a 32% increase in the first ANC attendance at the intervention sites compared with 7.4% in the controls sites (P < 0.001). In the intervention sites, the fourth antenatal attendance increased by 147% compared with 0.6% decline in the control sites (P < 0.001). Referrals of high-risk pregnancies increased by 40.7% in the intervention sites compared with 25% in the control site. The number of births at the interventional sites increased by 34.1% compared with 29.5% in the control sites. Integration of limited obstetric US into routine ANC visits is associated with an increase in ANC attendance.