Role of ultrasound scan in preventing maternal mortality in Ghana

The joy that every expectant couple, family, or community has when a woman gets pregnant is suddenly turned into sorrow and mourning when the woman dies during pregnancy or childbirth, or when the baby dies.

According to the World Health Organization (WHO), the five major causes of maternal mortality are hemorrhage, sepsis, complications of abortion, eclampsia, and obstructed labor (Bale et al, 2003).

The WHO similarly lists the common cause of neonatal mortality as infections, birth asphyxia, birth injuries, preterm birth defects (Bale et al, 2003). It is worth noting that these mortality causes are conditions for which timely ultrasound imaging could be of immense help in early diagnoses and hence intervention, leading to the reduction of mortality rates among mothers and their babies.

It is also notable that most of these avoidable deaths (99%) occur in developing countries, where ultrasound imaging is currently underutilized, and financial constraints have been cited as the main reason.

However, the usefulness of ultrasound imaging in preventing these needless deaths has not been fully exploited. It is anticipated that low resource settings could benefit by prudent application of this modern technology which is relatively affordable and safe imaging modality. In recent times technology has made this modality so affordable and widely available that is unacceptable to watch such needless deaths occur when ultrasound application could help improve survival rates.

Ectopic pregnancy, abortion, and gestational trophoblastic diseases (GTDs) are the common conditions of the first trimester that can cause maternal mortality, due to the possibility of severe hemorrhage, shock or sepsis.

Patients usually present with bleeding and/or pain but can also remain asymptomatic for a long time. In some cases patients don’t even realize they are pregnant, particularly in some cases of ectopic pregnancy and missed abortion.

Ultrasound imaging is extremely useful for obtaining accurate diagnoses for the first trimester conditions. It is therefore important to exclude early pregnancy pathology in every woman of reproductive age who presents with amenorrhea, abnormal bleeding and pain, using the diagnostic ultrasound imaging.

This approach to medical care can potentially reduce maternal mortality.

In the first trimester a pregnant mother can benefit from ultrasound imaging in the estimation of gestational age (GA), particularly those who cannot recall their last menstrual period (LMP), or those who do not have regular 28 day menstrual cycle. Gestational age has emerged as one of the most important predictors of perinatal mortality (Markestad et al, 2005).

The outcome of pregnancy is more closely related to gestational age as determined by ultrasound imaging. Accurate GA enables future detection of intrauterine growth restriction, large gestational age, and also essential in decision making for delivery or conditions such as premature rupture of membranes (PROM), postdates, placenta previa, hypertensive disorders, etc.

Ultrasonography is the diagnostic tool or choice for detecting multiple pregnancies (as early as five weeks gestation. Routine obstetric scanning refers to regular ultrasound imaging for each and every pregnancy conducted either at the first, second or third trimester to separate specific pregnancy abnormalities from normally progressing pregnancies. In many developed countries, such as Great Britain, Germany, and France, routine obstetric ultrasound scanning at about 18 weeks has become standard of care.

In Ghana and in the Eastern Region, ultrasound scan is routine for all pregnant women but one major challenge is the scan machines not many enough in the region.
The few machines we have are only found in the district hospitals only and hence pregnant mothers are expected to travel from the villages to queue for the service.

Most pregnant women could not even afford to pay for transportation to the district hospital. This stressful atmosphere has prevented most people in accessing the service and therefore making it difficult in promoting maternal health in the country.

The use of only a midwife or a doctor in assessing pregnant women without the use of ultrasound imaging alone will not help us achieve the MDG 4 and 5.

According to the Maternal Mortality Estimation Inter- Agency Group of the World Health organization, it is estimated that Ghana’s maternal mortality has gone up from 350 per 100000 live births to 380.

Divine Mother and Child Foundation(DMAC FOUNDATION) is a Non-Governmental Organization (NGO) in Koforidua, Ghana and founded by Edmund Duodu Atweri, a young Registered Nurse to identify, address and prevent complications that arise during pregnancy, labor and postpartum periods and ultimately decrease maternal and infant mortality rates in Ghana.

Our vision is a community where all mothers access to the availability of skilled attendance before, during pregnancy, Childbirth and postpartum care services, and the provision of preventive health education, affordable quality health care service, including protection from all forms of violence and mission is Implementing sustainable and cost effective maternal, neonatal and child health projects to reduce maternal/neonatal mortality in Ghana.

As part of our programs to reduce maternal and child mortality, we are offering free ultrasound scan services to pregnant women in the rural areas who can’t afford the cost and the stress of travelling.

Our approach is so unique and seeks to provide the service to our pregnant women in their own environment.

Our objectives are
To help provide free ultrasound scan to 2000 pregnant women who can’t afford or get access to the service in two years in their own community.

To reduce maternal mortality and improve maternal and child health by 30% by the year 2017 in the eastern region.

To identify and treat early pregnancy related conditions and refer appropriately to the nearest health facility.

To work collaboratively with the regional coordinating council, regional and district health directorates to promote the health of pregnant women.

To monitor and evaluate as well as keep data on pregnant women.

We also offer free health screening on Malaria, Syphilis, Hypertension, Diabetes, HIV, Anemia, Breast cancer to our poor women and children.

About 15000 women and children have benefited from our health screening and as well as 500 pregnant women benefiting from our free ultrasound scan services.

Our major challenge is getting funding to support our activities and therefore we are appealing to funders and individuals interested in promoting maternal and child health especially in Africa.

For more information about us visit our website www.dmacfoundation.org
Email: divinemotherchildfoundation@gmail.com
Facebook: www.facebook.com/divine mother and child foundation
Twitter: @dmac_foundation

Or you can contact the President and Founder
Email: edmundduodu@gmail.com
Skype: duodie1
Telephone: +233249396497/+233506494514