KNOWLEDGE, ATTITUDE AND PRACTICES OF PREGNANT WOMEN TOWARDS ROUTINE ULTRASONOGRAPHY IN ENUGU URBAN USING UNTH AND PARKLANE HOSPITAL

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ABSTRACT
 This study aimed at finding out the knowledge, attitudes and practices of pregnant women towards routine sonography. 
      A prospective cross sectional Survey method was adopted. The data was collected through self-administered among 180 respondents and 176 were returned duly completed. The data collected was analysed using descriptive statistics. 
      The present study shows that most of the women who present for antenatal care have general knowledge of ultrasound scan (95.5%:4.5%) especially those with high level of education which is 35.2% compared to 9.7% of those with low level of education. There is limitation of knowledge on the reasons and benefit of ultrasound with only 1.7% knowing that it can be used to check for any sign of bleeding. There is poor knowledge on when best to undergo ultrasound scanning examination, 50% of the respondent indicating 7th-9th month of pregnancy (3rd trimester) and Some of the women present for ultrasound scanning on their own volition without doctor’s referral. it also shows that majority of the women (94.3%) will like to see their baby during the scan as this will help to alleviate their fears (59.7%).  
This led to the conclusion that there is need for increase awareness and Education on the importance and benefit of routine practice of Ultrasound scanning during antenatal care.

TABLE OF CONTENT
TITLE PAGE………………………………………………………………..
CERTIFICATION……………………………………………………………
DEDICATION……………………………………………………………….
ACKNOWLEDGEMENT………………………………………………….
 
CHAPTER ONE
INTRODUCTION…………………………………………………………
1.1 Statement of problem……………………………………………………
1.2 Objective of study………………………………………………………..
1.3 Significance of the study………………………………………………
1.4 Scope of study………………………………………………………….
1.5 Literature review……………………………………………………….
 
CHAPTER TWO
THEORITCAL BACKGROUND
2.1 What is ultrasound................................................................................
2.2 Ultrasound machines……………………………………………………
2.2.1 What does the ultrasound equipment look like………………………..
2.2.2 Components of an Ultrasound Machine…………………………….
2.2.3 How Ultrasound Machines Work…………………………………
2.2.4 Different areas of the body where Ultrasound can be used to scan…………………………………………………………………………...
2.2.5 The Best Person to Perform Your Ultrasound Exam……………
2.2.6 The limitations of Ultrasound Imaging…………………………..
2.2.7 What are the benefits vs. risks?....................................................
2.3 Prenatal/pregnancy ultrasound…………………………………….
2.3.1 How to Prepare for the Test……………………………………..
2.3.2 How the test is performed……………………………………..
2.3.3 How the Test Will Feel…………………………………………
2.3.4 Common uses of the Procedure………………………………….
2.3.5 Why the Test is performed………………………………………
2.3.6 Normal Results……………………………………………………
2.3.7 What Abnormal Results Mean………………………………….
 2.4 Safety of prenatal ultrasound……………………………………
2.5 The limitations of obstetric ultrasound imaging…………………..
2.5 Recommendations on ultrasound…………………………………
 
CHAPTER THREE
 RESEARCH METHODOLOGY
3.1 Research design……………………………………………………
3.2 Area of study……………………………………………………..
3.3 Target population…………………………………………………
3.4 Determination of sample size……………………………………..
3.5 Sample technique…………………………………………………..
3.7 Method of data collection…………………………………………..
3.8 Data analysis…………………………………………………………

CHAPTER FOUR
DATA PRESENTATION AND DISCUSSION
4.1  Data presentation……………………………………………….. 
4.2  Discussion of data………………………………………………..

CHAPTER FIVE
SUMMARY OF FINDINGS, RECOMMENDATION AND CONCLUSION
5.1 Summary of findings……………………………………………...
5.2  Recommendation…………………………………………………
5.3  Limitation of studies………………………………………………
CONCLUSION………………………………………………………..
APPROVAL PAGES
QUESTIONNAIRE
REFERENCES
                                        
INTRODUCTION
     Ultrasonography (sonography) involves the use of ultrasound to produce images of structures in the human body4. The ultrasound probe send out a short pulse of high frequency sound and detects the waves (echoes) occurring at interfaces within the organs. The direction of the pulse can then be moved across the area of interest with each pulse to build up a comp1lete image. Sound is emitted by a transducer source and when this sound interacts with tissues and organs echoes are created.  The echoes can be used to identify how far away the tissue or organ is, how large it is, its shape and its internal consistency (fluid, solid or mixed), and how uniform it is. 
         The ultrasound transducer functions as both a loudspeaker (to create the sound) and a microphone (to record the returning echoes). When the ultrasound transducer is pressed against the skin, it directs a stream of inaudible, high-frequency sound into the body. As the sound waves echo from the body's fluids and tissues, the sensitive microphone in the transducer records the characteristics of the reflected sound. There are two major components of the ultrasound examination: a) returning sound waves are instantly measured and displayed by a computer, which in turn creates a video picture on the ultrasound monitor (real-time images); b) images frozen by the ultrasound machine and stored as representative images of the real-time findings.  Both the real-time images and the frozen images of the examination can be recorded on videotape, on film, or on computer disk.
         Doppler ultrasonography is the application of diagnostic ultrasound to detect moving blood cells and measure their direction and speed of movement. 
         The real-time element of ultrasound allows for the detection of movement i.e. foetal movements, heart valve function, and blood vessel pulsation.  This component is an integral part of the examination and the technologist and the radiologist must be very familiar with what normal real-time functions of various organs and tissues as to complete a thorough assessment of each patient. Conventional ultrasound displays the images as thin sections (like looking at single slices of bread in a loaf). 3-D ultrasound is the result of modern computer technology that can reformat data into three-dimensional images (like looking at the entire loaf of bread in various projections). 4-D ultrasound is 3-D ultrasound in motion. As far as is known, there are no adverse effects from the use of ultrasound used at diagnostic energies.
       Ultrasound was originally developed in early days to detect enemy submarine during warfare. After the war in 1955, surgeon in Glasgow named Ian Donald began to experiment with it for medical uses. Using beef steaks as “control” subjects, he scanned the abdominal tumours he had removed from his patients and found that different tissues gave different patterns of sound wave echo. He quickly realized the potential of ultrasound for examining a growing baby in uterus and this brought about prenatal sonography.
        Prenatal sonography is the use of ultrasound in the management of pregnancy. Since its introduction in the 1950’s, ultrasonography has become a very useful diagnostic tool in obstetrics. It has dramatically changed the practice of obstetrics by enabling visualisation of the fetus and intrauterine environment4.
        Prenatal ultrasound is very beneficial to the referring clinician in obstetric management of patients. Many unsuspected foetal and maternal problems can be detected and appropriate interventional measures initiated well on time.
        Pregnant women can see their first ultrasound as a tool that enables them to reach different goals during their pregnancy. Many of goals concern meeting and connecting with the baby, suggesting that pregnant women consider the examination an important step towards parenthood.
          The knowledge, attitude, perception, psychological reaction and practices of pregnant women and women of child bearing age towards obstetric intervention are becoming important areas of concern noted by some group of scientist in the early 80’s . The reaction varies from little or no knowledge of the investigating modalities, its usefulness, harmfulness if any, to some even suspecting it could harm their unborn baby, cause cancer, while others leave all concerns to the referring obstetrician and radiologist who must know what they are doing. It has been observed that interactions among patients can instil fears and can also alleviate fear in most women9.
          This realization has resulted in several studies carried out in the in the western world to determine how patients in general and in particular antenatal care, perceive and react to ultrasonography. Some interesting findings include the women’s dissatisfaction of non-communication with the person carrying out the examination, over expectation of what ultrasonography is able to do, leaving the women frustrated when these expectations are not met. It is the desire of healthcare providers to attend to patients in such a way that their burdens are significantly alleviated before leaving the hospital10. 
       The purpose of the present study is to explore the knowledge, attitude and practices of pregnant women about routine sonography in Enugu urban.
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