Ibrahimi Janat, Mumtaz Zubia
School of Public Health, University of Alberta, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada.
Int J Gynaecol Obstet. 2024 Apr;165(1):76-93. doi: 10.1002/ijgo.15097. Epub 2023 Sep 25.
Obstetric ultrasound imaging is a relatively new, but rapidly expanding, technology in low- and middle-income countries (LMICs). Given that new technologies modify practices, the influence of ultrasound on pregnancy management in LMICs is not comprehensively understood.
To map how ultrasound technology may be modulating the culture of pregnancy management in LMICs.
A search of five databases up to November 18, 2022.
Original, peer-reviewed articles from LMICs, published in English from 2000 to 2022.
All articles were assessed for quality using the GRADE approach. Data were analyzed thematically to generate new interpretive constructs and explanations.
Forty articles involving 113 000 respondents suggests that obstetric ultrasound is becoming the preferred method of pregnancy surveillance, replacing clinically important components of prenatal care. Mothers overestimate ultrasound as an all-powerful diagnostic and "therapeutic" tool that can deliver the perfect baby. For-profit providers are driving medically unnecessary scans while the poor do not receive the recommended scans.
Ultrasound technology has modified the culture of pregnancy management in LMICs in unintended and possibly harmful ways. Private health services are pushing the detrimental trends. Limitations include generalizability of qualitative studies and insufficient attention to inequities.
产科超声成像在低收入和中等收入国家（LMICs）是一项相对较新但迅速发展的技术。鉴于新技术会改变医疗实践，超声对LMICs妊娠管理的影响尚未得到全面了解。
梳理超声技术如何可能正在改变LMICs妊娠管理的文化。
检索截至2022年11月18日的五个数据库。
来自LMICs的原创、经同行评审的文章，于2000年至2022年以英文发表。
所有文章均采用GRADE方法评估质量。对数据进行主题分析，以生成新的解释性结构和解释。
涉及113,000名受访者的40篇文章表明，产科超声正成为妊娠监测的首选方法，取代了产前护理中临床上重要的组成部分。母亲们高估了超声作为一种万能的诊断和“治疗”工具，认为它能生出完美的婴儿。营利性医疗服务提供者在推动进行医学上不必要的扫描，而穷人却没有接受推荐的扫描。
超声技术以意想不到且可能有害的方式改变了LMICs妊娠管理的文化。私人医疗服务正在推动这些有害趋势。局限性包括定性研究的可推广性以及对不平等问题的关注不足。
