‘Ultrasound is an invaluable third eye, but it can’t see everything’: a qualitative study with obstetricians in Australia

BMC Pregnancy and Childbirth

Ingrid Mogren¹  Ann Lalos¹  Margareta Persson²  Rhonda Small³  Kristina Edvardsson³ 

[1] Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, SE 901 87 Umeå, Sweden;School of Health and Social Studies, Dalarna University, SE 791 88 Falun, Sweden;Judith Lumley Centre, La Trobe University, Melbourne, Vic 3000, Australia

关键词: Qualitative study;    Pregnancy complications;    Perspectives;    Obstetrics;    Obstetricians;    Obstetric ultrasound;    Counselling;    Clinical management;    Clinical experiences;    Australia;   

Others  :  1092259
DOI  :  10.1186/1471-2393-14-363

 received in 2014-04-24, accepted in 2014-10-07,  发布年份 2014

【 摘 要 】

Background

Obstetric ultrasound has come to play a significant role in obstetrics since its introduction in clinical care. Today, most pregnant women in the developed world are exposed to obstetric ultrasound examinations, and there is no doubt that the advantages of obstetric ultrasound technique have led to improvements in pregnancy outcomes. However, at the same time, the increasing use has also raised many ethical challenges. This study aimed to explore obstetricians’ experiences of the significance of obstetric ultrasound for clinical management of complicated pregnancy and their perceptions of expectant parents’ experiences.

Methods

A qualitative study was undertaken in November 2012 as part of the CROss-Country Ultrasound Study (CROCUS). Semi-structured individual interviews were held with 14 obstetricians working at two large hospitals in Victoria, Australia. Transcribed data underwent qualitative content analysis.

Results

An overall theme emerged during the analyses, ‘Obstetric ultrasound - a third eye’, reflecting the significance and meaning of ultrasound in pregnancy, and the importance of the additional information that ultrasound offers clinicians managing the surveillance of a pregnant woman and her fetus. This theme was built on four categories: I:‘Everyday-tool’ for pregnancy surveillance, II: Significance for managing complicated pregnancy, III: Differing perspectives on obstetric ultrasound, and IV: Counselling as a balancing act. In summary, the obstetricians viewed obstetric ultrasound as an invaluable tool in their everyday practice. More importantly however, the findings emphasise some of the clinical dilemmas that occur due to its use: the obstetricians’ and expectant parents’ differing perspectives and expectations of obstetric ultrasound examinations, the challenges of uncertain ultrasound findings, and how this information was conveyed and balanced by obstetricians in counselling expectant parents.

Conclusions

This study highlights a range of previously rarely acknowledged clinical dilemmas that obstetricians face in relation to the use of obstetric ultrasound. Despite being a tool of considerable significance in the surveillance of pregnancy, there are limitations and uncertainties that arise with its use that make counselling expectant parents challenging. Research is needed which further investigates the effects and experiences of the continuing worldwide rapid technical advances in surveillance of pregnancies.

【 授权许可】

   
2014 Edvardsson et al.; licensee BioMed Central Ltd.

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