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December 05-06, 2019 | Dubai, UAE
29
th
International Conference on
14
th
International Conference on
Nursing Education and Research
Cancer and Cancer Therapy
Joint Event
&
Journal of Intensive and Critical Care Nursing | Volume 2
The use of handheld ultrasound by general physicians, midwives and Nurses to
avert maternal deaths in 2 regions of the Philippines.@ ibuntis
Godofreda Vergeire-Dalmacion
Asian Hospital and Medical center, Philippines
Background andObjectives:
One of themajor reasons for the
Philippines’ high maternal ratio of 209 per 100,000 livebirths
is the lack of primary health care and low contraceptive
coverage. Thus, the functions of nurses, midwives and general
physicians manning our health facilities must be expanded
and optimized to the fullest. Using a cross sectional design
we chose 2 municipalities from 2 regions of the Philippines,
one rural and one urban with similar maternal mortality ratio.
Our objectives were to train their health workers on the use
of handheld ultrasound to identify 5 obstetrical conditions
of women in their 20th to 24th weeks age of gestation
which may lead to catastrophic pregnancy outcomes. The
ultrasound readings of the trainees were compared with
those made by an obstetrician- perinatologist, acting as gold
standard. Training activities used lectures, modules, return
demos and small group discussions.
Results:
Four hundred sixty pregnant women were scanned.
Thirty two percent of images were abnormal, namely, fetal
malpresentation (27%) abnormal placentation (3.7%), twin
pregnancy, ( 1.3%) and amniotic fluid volume abnormalities
(1.3%). All women with abnormal scans were subsequently
referred to their health facilities and advised closer prenatal
followups. Early ultrasound imaging will potentially avert
6.3%of maternal deaths and 28.0%of neonatal deaths. In our
study, we had 3 cases of neonatal deaths, 2 from congenital
anomalies and 1 from dysfunctional labor secondary to
neglected breech. The latter was actually diagnosed by the
team but patient opted for home delivery. The agreement
between the health workers readings with the gold standard
was 100% for the number of fetuses, 99% for placental
localization and amniotic fluid volume and 95% for fetal
presentation specifically breech versus cephalic.
Conclusion:
Screening ultrasound between 20th to 24th
weeks AOG can detect a high number of abnormal ultrasound
images and can potentially avert maternal and neonatal
deaths. Community health workers are trainable and
reliable in the use of handheld ultrasound on five important
obstetrical parameters. However, knowledge alone is not
enough to improve health seeking behavior
e
:
jody.dalmacion@gmail.comJ Intensive Crit Care Nurs | Volume 2