# Universal Utilization of Optimally Timed First Obstetric Ultrasound Among Pregnant Women in a Low‐Middle Income Country: A Multicenter Prospective Study

## TL;DR

This study found that about two-thirds of pregnant women in Ethiopia received optimally timed first obstetric ultrasounds, with private clinics and prior complications increasing the likelihood.

## Contribution

The study provides new evidence on ultrasound utilization in low-middle income countries, focusing on Ethiopia.

## Key findings

- Approximately 67.5% of pregnant women had optimally timed first obstetric ultrasounds.
- Women starting antenatal care at private clinics were more likely to have timely ultrasounds.
- Prior major obstetric complications increased the likelihood of timely ultrasound use.

## Abstract

Currently, the World Health Organization guidelines recommend universal utilization of optimally timed first obstetric ultrasound (defined as ultrasound before 24 weeks) in low‐middle income countries. However, there is inadequate evidence on this topic from these countries. Our study aimed to determine the rate of utilization of optimally timed first obstetric ultrasound among pregnant women who gave birth at three public hospitals in Ethiopia.

This was a multicenter prospective cross‐sectional study conducted on the utilization of optimally timed first obstetric ultrasound among pregnant women who delivered at public hospitals in Ethiopia in 2020. Data were collected prospectively using a structured questionnaire. Data were analyzed using SPSS Version 20. Simple descriptive statistics, chi‐squared test, and multiple regression analysis were performed as appropriate. p value less than 0.05 and adjusted odds ratio (AOR) with 95% CI were used to present result significance.

A total of 385 participants were included in this study. Approximately 67.5% of pregnant mothers had optimally timed 1st ultrasound. Compared to those having antenatal care (ANC) at health centers, those who started their ANC at private clinic were 1.7 times (95 CI: 1.8–7.9) more likely to have optimally timed ANC. Those who had their 1st ANC at private hospital were 3.2 times (95 CI: 1.8–7.9) more likely to have optimally timed 1st prenatal care. Those who had their first ANC at private health institutions and government hospitals were much more likely to have optimally timed 1st prenatal ultrasound with the following AOR for government hospital and private MCH centers: AOR = 7.4 (95 CI: 2.7–23) and AOR = 4.9 (95 CI: 2.8–14.1), respectively. Those who had previous major obstetric problem were 5.2 times (95 CI: 2.7–9.9) more likely to have optimally timed ultrasound than those without major previous obstetric problem.

We found that one‐third of pregnant women did not utilize optimally timed first obstetric ultrasound, despite obstetric ultrasound services being accessible at public health institutions. Place of first ANC contact and presence of prior major obstetric complication were associated with utilization of optimally dated first obstetric ultrasound.