The role of obstetric ultrasound in primary health care at a secondary hospital in South Africa

Abstract

Ultrasound has, until recently, been regarded as a sophisticated diagnostic modality, reserved for tertiary health care. In reality, it is a cost-effective, reliable and safe modality that is highly suited to primary health care. Secondary level centres provide the only access to ultrasound for many of the obstetric primary health care patients, as primary health care has limited ultrasound resources. The increasing monthly statistics, at one secondary centre, bares witness to the need for ultrasound in primary health care.

At the time of this study ultrasound scans were not routine for every obstetric patient. Experience indicates that only the patients who clinically suggest a possible risk are referred for ultrasound to confirm, or rule out problems. However, there are a number of complications, which have little or no early clinical indications. [Palmer, 1995:285] This means that many of the problems encountered are often in late gestation and they have a marked bearing on the obstetric management of the patient.

This was a retrospective study, of approximately 1000 patients attending an ultrasound department at a secondary centre. Most of the obstetric patients that were sent for an ultrasound examination came from the primary health care centres in the region.