Department of Clinical Sciences, Obstetrics and Gynaecology, Umeå University, Umeå, Sweden.
Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania.
Womens Health (Lond). 2024 Jan-Dec;20:17455057241273675. doi: 10.1177/17455057241273675.
Obstetric ultrasound is considered important for determining gestational age, identifying single or multiple pregnancies, locating the placenta and fetal anomalies and monitoring fetal growth and pregnancy-related complications in order to improve patient management.
To explore health professionals' perspectives on different aspects of obstetric ultrasound in Tanzania regarding self-reported skills in performing ultrasound examinations and what could improve access to and utilization of obstetric ultrasound in the clinical setting.
Cross-sectional study.
Data was collected between November and December 2017 using a questionnaire based on previous qualitative research results from the CROss Country UltraSound Study (CROCUS Study). Seventeen healthcare facilities in 5 urban and semiurban municipalities in the Dar-es-Salaam region were included, with 636 health professionals participating (physicians, = 307 and midwives/nurses, = 329).
Most health professionals (82% physicians, 81% midwives/nurses) believed that obstetric ultrasound was decisive in the clinical management of pregnancy. Results indicate proficiency gaps across disciplines: 51% of physicians and 48.8% of midwives/nurses reported no or low-level skills in assessing cervical length. Similarly, deficiencies were observed in evaluating the four-chamber view of the fetal heart (physicians: 51%, midwives/nurses: 61%), aorta, pulmonary artery (physicians: 60.5%, midwives/nurses: 65%) and Doppler assessments (umbilical artery: physicians 60.6%, midwives/nurses 56.1%). Compared to midwives/nurses, physicians were significantly more likely to agree or strongly agree that utilization would improve with more ultrasound machines (odds ratio (OR) 2.13; 95% confidence intervals (CI) 1.26-3.61), better quality of ultrasound machines (OR 2.27; 95% CI 1.10-4.69), more training for health professionals currently performing ultrasound (OR 2.11; 95% CI 1.08-4.17) and more physicians trained in ultrasound (OR 2.51; 95% CI 1.30-4.87).
Improving the provision of obstetric ultrasound examinations in Tanzania requires more and better-quality ultrasound machines, enhanced training for health professionals and an increased number of physicians trained in ultrasound use. To further increase the accessibility and utilization of obstetric ultrasound in maternity care in Tanzania, it is essential to provide training for midwives in basic obstetric ultrasound techniques.
产科超声检查被认为对于确定孕周、识别单胎或多胎妊娠、定位胎盘和胎儿异常、监测胎儿生长以及妊娠相关并发症以改善患者管理非常重要。
本研究旨在探索坦桑尼亚卫生专业人员对产科超声的不同方面的看法，包括自我报告的超声检查技能以及哪些因素可以改善产科超声在临床环境中的可及性和利用。
横断面研究。
2017 年 11 月至 12 月期间，采用基于 CROss Country UltraSound Study (CROCUS Study) 先前定性研究结果的问卷收集数据。该研究纳入了达累斯萨拉姆地区 5 个城市和半城市行政区的 17 家医疗机构，共有 636 名卫生专业人员参与（医生 307 人，助产士/护士 329 人）。
大多数卫生专业人员（82%的医生和 81%的助产士/护士）认为产科超声对妊娠的临床管理具有决定性作用。结果表明，各学科之间存在技能差距：51%的医生和 48.8%的助产士/护士报告在评估宫颈长度方面没有或只有低水平的技能。同样，在评估胎儿心脏的四腔心视图（医生：51%，助产士/护士：61%）、主动脉、肺动脉（医生：60.5%，助产士/护士：65%）和多普勒评估（脐动脉：医生 60.6%，助产士/护士 56.1%）方面也存在缺陷。与助产士/护士相比，医生更有可能同意或强烈同意增加超声机（比值比（OR）2.13；95%置信区间（CI）1.26-3.61）、提高超声机质量（OR 2.27；95%CI 1.10-4.69）、增加当前从事超声检查的卫生专业人员的培训（OR 2.11；95%CI 1.08-4.17）以及增加接受过超声培训的医生人数（OR 2.51；95%CI 1.30-4.87）可以提高产科超声的利用率。
要提高坦桑尼亚产科超声检查的提供水平，需要更多和更高质量的超声机、加强卫生专业人员的培训以及增加接受过超声使用培训的医生人数。为了进一步提高产科超声在坦桑尼亚产科护理中的可及性和利用率，必须为助产士提供基本产科超声技术培训。
