Krätzig Franziska, Mei Jie, Rebaliha Mahery, Rampanjato Zavaniarivo, Ranaivoson Rinja, Razafinjato Jenia, De Neve Jan-Walter, Franke Mara Anna, Muller Nadine, Emmrich Julius Valentin
Charité - Universitätsmedizin Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany.
Western Institute for Neuroscience, University of Western Ontario, London, Ontario, Canada.
PLoS One. 2024 Dec 31;19(12):e0311918. doi: 10.1371/journal.pone.0311918. eCollection 2024.
Like other countries in sub-Saharan Africa, Madagascar has a high burden of maternal and neonatal mortality. However, as the proportion of foetal and placental abnormalities among the Malagasy population is unknown, strategies aimed at reducing maternal and neonatal mortality are challenging to define and implement.
We conducted a multi-year, cross-sectional study using secondary NGO data on obstetric ultrasound, including patient records of all pregnant women who received an obstetric ultrasound screening between July 1st, 2017, and September 30th, 2020, at 62 public-sector primary care facilities in urban and rural regions of Madagascar. We analysed demographic characteristics and determined the prevalence of foetal and placental abnormalities.
The dataset included 38,688 ultrasound screening reports from 35,919 women, where 2,587/35,919 (7.20%) women had more than one ultrasound exam. Most women (68.63%, 26,550/38,688) received their first ultrasound during the third trimester of pregnancy. Foetal malpresentation at 36 weeks of gestation or later was diagnosed in 5.48% (176/3,211) of women with the breech presentation being most common (breech 3.99%, 128/3,211; transverse 0.84%, 27/3,211; mobile 0.5%, 16/3,211; oblique 0.16%, 5/3,211). Placenta previa was found in 2.31% (875/38,755) and multiple gestations in 1.03% (370/35,919) cases. Around one in every 150 women (0.66%, 234/38,702) had amniotic fluid disorders.
The proportion of foetal and placental abnormalities detected by obstetric ultrasound is consistent with findings from other countries in sub-Saharan Africa. In contrast to current WHO recommendations, pregnant women, particularly those from rural, resource-constrained settings attend obstetric ultrasound screenings most commonly during their third trimester of pregnancy.
与撒哈拉以南非洲的其他国家一样，马达加斯加的孕产妇和新生儿死亡率负担很重。然而，由于马达加斯加人群中胎儿和胎盘异常的比例尚不清楚，旨在降低孕产妇和新生儿死亡率的策略难以确定和实施。
我们利用非政府组织关于产科超声的二手数据进行了一项多年横断面研究，包括2017年7月1日至2020年9月30日期间在马达加斯加城乡地区62个公共部门初级保健机构接受产科超声筛查的所有孕妇的病历。我们分析了人口统计学特征，并确定了胎儿和胎盘异常的患病率。
该数据集包括来自35919名女性的38688份超声筛查报告，其中2587/35919（7.20%）名女性接受了不止一次超声检查。大多数女性（68.63%，26550/38688）在妊娠晚期接受了第一次超声检查。妊娠36周及以后诊断出胎位异常的女性占5.48%（176/3211），臀位最常见（臀位3.99%，128/3211；横位0.84%，27/3211；活动胎位0.5%，16/3211；斜位0.16%，5/3211）。前置胎盘的发生率为2.31%（875/38755），多胎妊娠的发生率为1.03%（370/35919）。每150名女性中约有1名（0.66%，234/38702）患有羊水异常。
产科超声检测到的胎儿和胎盘异常比例与撒哈拉以南非洲其他国家的研究结果一致。与世界卫生组织目前的建议相反，孕妇，尤其是来自农村、资源有限地区的孕妇，最常在妊娠晚期接受产科超声筛查。
