Prevalence of abnormal umbilical arterial Doppler indices in apparently normal pregnancies in Calabar.

Intrauterine growth restriction (IUGR) may occur in the presence of normal fetal growth parameters, with resultant unanticipated perinatal morbidity and mortality. Umbilical arterial Doppler evaluation determines the fetuses susceptible to compromise by detecting IUGR early enough for successful intervention measures to be implemented. This study was aimed at determining the prevalence of abnormal umbilical arterial Doppler indices (UADI) in apparently normal pregnancies and to assess its correlation with amniotic fluid index (AFI). In this prospective cross-sectional study, obstetric sonographic examination and UADI evaluation were done on 310 apparently normal pregnant women between 26 to 40 weeks within a 6-months period. Abnormal UADI had a prevalence of 10.3%. Educational level (P = 0.000) and employment status (P = 0.000) were significantly associated with abnormal UADI. Abnormal umbilical arterial resistivity index (RI) had a significant correlation with EFW (P = 0.000) and HC/AC (P = 0.000) but no significant relationship with AFI (P = 0.593). The prevalence of abnormal umbilical arterial Doppler indices was high in apparently normal pregnancies mostly among women with low socio-economic status, with no demonstrable association with AFI.

An audit of the appointment booking system and patient waiting time in an ultrasound unit in Nigeria: A need to eliminate congestion in our public hospitals.

BACKGROUND: Congestion of patient waiting areas at commencement of work is the usual scenario in Nigeria's public hospitals. This strains the personnel and facilities. Patients are dissatisfied and lose faith in the system. This study aims to audit the booking system, patient waiting time, and causes of congestion in an ultrasound unit. MATERIALS AND METHODS: This is a prospective, descriptive study involving 350 patients referred from general outpatient and specialist clinics to the ultrasound unit, twice weekly for 6 weeks. Patients were grouped into two: those with scheduled appointments and the unbooked. The time of scheduled appointment and arrival in the unit and the time of commencement and conclusion of the examination were recorded. RESULTS: Three hundred and eighteen patients had scheduled appointments, while 32 were unbooked. Half of the later were emergencies and the other half were walk-ins. There was no consistency in number of slots and block size. Large blocks of over 20 patients were observed on 33.3% of the days and 51.26% of the patients were given 8:00 am appointments. The average patient waiting time is 132.11 minutes but range from 62 to 220 minutes daily. The radiologists resumed work between 8:17 and 9:29 am each scan day. The average waiting time is shorter for patients who arrived after 11:00 am. CONCLUSION: Ineffective booking of appointments and Sonologist's tardiness are major predisposition to congestion. Appointments in small blocks at 30 minutes intervals will eliminate congestion, reduce patient waiting time, and improve satisfaction. Point-of-care ultrasound should be introduced in outpatient clinics.