OVERVIEW OF ROUTINE ULTRASONOGRAPHY IN DETECTING FETAL ANOMALIES IN A SUBURBAN SETTING IN NIGERIA
Main Article Content
Abstract
Introduction: Fetal structural abnormalities significantly impact the health and well-being of both the fetus and the expectant mother, ranking among the leading causes of perinatal mortality and morbidity worldwide. This study aimed to evaluate the effectiveness of routine prenatal ultrasound scans in detecting fetal anomalies in a suburban setting in Nigeria.
Methods: This retrospective study was conducted at a major diagnostic center in southwestern Nigeria from June 2022 to April 2023. Routine prenatal ultrasound scans were evaluated for pregnant women referred predominantly by Traditional Birth Attendants (TBAs).
Results: A total of 2,392 pregnant women, including 43 with twin pregnancies, underwent routine prenatal scans during the study period. Among these, 41 anomalies (1.7%) were detected in the scanned low-risk population. However, 45 fetuses were confirmed to have anomalies at delivery or termination, with 7 cases (15.5%) resulting in stillbirths. Most abnormalities (n=37) were identified before 24 weeks of gestation, yielding a sensitivity of 90.2%. The genitourinary tract was the most frequently affected system (39.1%), followed by the central nervous system (21.2%). The specificity of the scans was 99.1%, with one false positive reported. Six anomalies (13.3%) were classified as lethal.
Conclusion:
Routine prenatal ultrasound scans in suburban settings are effective in detecting fetal anomalies but pose challenges in counseling. The establishment of standardized fetal anomaly detection protocols could help reduce perinatal mortality and morbidity in such settings. Lack of awareness and inadequate funding, particularly among TBAs, remain significant barriers to effective implementation.
Keyword: Ultrasound, Prenatal, Fetal Anomaly, Traditional Birth Attendants
Downloads
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles in JRRS are published under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
How to Cite
References
1. kinmoladun, J. A., Ogbole, G. I., Lawal, T. A., & Adesina, O. A. (2015). Routine prenatal ultrasound anomaly screening program in a Nigerian university hospital: Redefining obstetrics practice in a developing African country. Nigerian Medical Journal, 56(4), 263-267.
2. Taye, M., Afework, M., Fantaye, W., Diro, E., & Worku, A. (2018). Factors associated with congenital anomalies in Addis Ababa and the Amhara Region, Ethiopia: a case-control study. BMC pediatrics, 18, 1-11.
3. Ahmed, A. M., El-Kader, S. A., El-Hamid, A. A. A., & Gaafar, H. M. (2011). Assessment of risk factors for fetal congenital anomalies among pregnant women at Cairo University Hospitals.
4. Goley, S. M., Sakula-Barry, S., Adofo-Ansong, N., Ntawunga, L. I., Botchway, M. T., Kelly, A. H., & Wright, N. (2020). Investigating the use of ultrasonography for the antenatal diagnosis of structural congenital anomalies in low-income and middle-income countries: a systematic review. BMJ Paediatrics Open, 4(1).
5. World Health Organization;(2014). World Health Organization/US-Center for Disease Control and Prevention/International Clearance House on Birth Defects Surveillance and Research.
6. Birth defects surveillance: a manual for programme managers. Geneva.
7. Kurinczuk, J. J., Hollowell, J., Boyd, P. A., Oakley, L., Brocklehurst, P., & Gray, R. (2010). The contribution of congenital anomalies to infant mortality. National Perinatal Epidemiology Unit, University of Oxford.
8. Chitty, L. S., Hunt, G. H., Moore, J., & Lobb, M. O. (1991). Effectiveness of routine ultrasonography in detecting fetal structural abnormalities in a low risk population. British Medical Journal, 303(6811), 1165-1169.
9. Bashour, H., Hafez, R., & Abdulsalam, A. (2005). Syrian women's perceptions and experiences of ultrasound screening in pregnancy: implications for antenatal policy. Reproductive health matters, 13(25), 147-154.
10. Edzie, E. K. M., Dzefi-Tettey, K., Gorleku, P. N., Ampofo, J. W., Piersson, A. D., Asemah, A. R., ... & Edzie, R. A. (2020). Perception of Ghanaian Primigravidas undergoing their first antenatal ultrasonography in Cape Coast. Radiology Research and Practice, 2020(1), 4589120.
11. Pathak, S., & Lees, C. (2009). Ultrasound structural fetal anomaly screening: an update. Archives of Disease in Childhood-Fetal and Neonatal Edition, 94(5), F384-F390.
12. Amutah-Onukagha, N., Rodriguez, M., Opara, I., Gardner, M., Assan, M. A., Hammond, R., ... & Farag, E. (2017). Progresses and challenges of utilizing traditional birth attendants in maternal and child health in Nigeria. International Journal of MCH and AIDS, 6(2), 130.
13. Esan, D. T., Ayenioye, O. H., Ajayi, P. O., & Sokan-Adeaga, A. A. (2023). Traditional birth attendants’ knowledge, preventive and management practices for postpartum haemorrhage in Osun State, Southwestern Nigeria. Scientific Reports, 13(1), 12314.
14. Saluja, S., Rudolfson, N., Massenburg, B. B., Meara, J. G., & Shrime, M. G. (2020). The impact of physician migration on mortality in low and middle-income countries: an economic modelling study. BMJ global health, 5(1), e001535.
15. World Health Organization. Traditional birth attendants: a joint WHO/UNFPA/UNICEF statement. Geneva: WHO; 1992. p. 18. Retrieved from: http://apps.who.int/iris/bitstream/10665/38994/1/9241561505.pdf.
16. World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland World Health Organization; 2012. https:// apps. who.int/ iris/ bitst ream/ handle/ 10665/ 75411/ 97892 41548 502_ eng. Pdf
17. Ogunyemi, A. O., Odeyemi, K. A., Okusanya, B. O., Olorunfemi, G., Simon, M., Balogun, M. R., & Akanmu, A. S. (2024). Impact of training and case manager support for traditional birth attendants in the linkage of care among HIV-positive pregnant women in Southwest Nigeria: a 3-arm cluster randomized control trial. BMC Pregnancy and Childbirth, 24(1), 153.
18. Sacca, L., Zerrouki, Y., Burgoa, S., Okwaraji, G., Li, A., Arshad, S., ... & Retrouvey, M. (2024). Exploring measurement tools used to assess knowledge, attitudes, and perceptions of pregnant women toward prenatal screening: A systematic review. Women's Health, 20, 17455057241273557.
19. Romosan, G., Henriksson, E., Rylander, A., & Valentin, L. (2009). Diagnostic performance of routine ultrasound screening for fetal abnormalities in an unselected Swedish population in 2000–2005. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 34(5), 526-533.
20. Garne, E., Stoll, C., & Clementi, M. (2001). Evaluation of prenatal diagnosis of congenital heart diseases by ultrasound: experience from 20 European registries. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 17(5), 386-391.
21. Shirley, I. M., Bottomley, F., & Robinson, V. P. (1992). Routine radiographer screening for fetal abnormalities by ultrasound in an unselected low risk population. The British Journal of Radiology, 65(775), 564-569.