Perception and Expectation among Women Attending a Routine Ultrasound Screening in Japan

Monday, 7 July 2008
Kyoko Murakami, PhD, RN, NMW , Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
Kumiko Tsujino, PhD, RN , Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
Misae Ito, MSN, RN, NMW , Department of Nursing, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
Sue Turale, EdD, MSt, RN, RPN, FRCNA, FACMHN , Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
Hidechika Iino, RN, MEd , Department of Nursing, Yamaguchi University Hospital, Ube, Yamaguchi, Japan
Masato Tsukahara, PhD, MD , Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan

Learning Objective 1: understand diversity of attitude for prenatal testing.

Learning Objective 2: consider about informed consent on prenatal ultrasound screening.

Background:

For some years ultrasound scans have been routine in prenatal care in many countries, including Japan where an ultrasound is sometimes performed on each doctor's visit. Scans potentially provide reassurance about a healthy child or detect problems, including unsuspected and devastating fetal anomalies. However, in Japan no formal guidelines exist regarding usage of ultrasound, and it is a very sensitive topic to provide information about a test that might provoke patient anxiety.

Purpose:

To provide clarification of pregnant women's understanding, perceptions and expectations of routine prenatal ultrasound screening.

Methods:

In the study, 238 pregnant women in three obstetric clinical settings, 14-37 weeks gestation, with no apparent obstetric risk factors, were asked after their scan to complete a four-part questionnaire. The statistical significance of differences in proportions was assessed using Chi square test.

Results:

Participants identified the reasons for their ultrasound screening were to: check for fetal growth (n=234, 98%); see whether pregnancy was normal (n=228, 96%); and check for fetal abnormalities (n=217, 91%). About 203 (85%) participants wanted a photo of the fetus to show their partners/family. Ultrasounds were considered a social experience for the majority of participants and partners. Affection for their fetus increased in 232 (97%) participants as a result of an ultrasound, and all felt reassurance that they were having this test. Participants 14-22 weeks were significantly more reassured by a scan than those of 22-30 weeks (p < 0.05). The majority (n=235) wanted to know if their fetus had a disease but only half had information about prenatal ultrasound by book, friends, and professionals.

Conclusion:

It is critical that all women receive ultrasound information before testing to enable them to prepare questions, or anticipate issues arising. Clearly nurses and other health professionals need to ensure this is done in Japan.