Ultrasound Measurement of Placental Thickness: A Reliable Estimation of Gestational Age in Normal Singleton Pregnancies in Nigerian Women.

Purpose: The aim of this article is to evaluate the accuracy of placental thickness (PT) in determination of gestational age (GA) in normal singleton foetuses. Materials and Methods: The study was a cross-sectional descriptive study which recruited consecutively a total of 406 pregnant women with singleton pregnancies (at 15-40 weeks of gestation), referred for routine obstetric ultrasound (US) scan at the National Hospital, Abuja from October to December 2019. Biparietal diameter (BPD), femur length (FL), head circumference (HC), abdominal circumference (AC), and PT were measured using standard protocols. All measurements were calculated by taking three best measurements, and the mean of the measurements was taken and recorded for each participant. Pearson's correlation analysis was computed to determine linear relationships between variables. A significant statistical level was determined at a critical value of P < 0.05. Results: The mean age was 31.8 ± 4.8 years. The mean PTs in the second and third trimesters were 23.2 ± 3.1 and 34.1 ± 3.7 mm, respectively. PT had a linear relationship and a statistically significant positive correlation (r=0.99, P = 0.00) with GA. There was also a statistically significant positive correlation between PT on the one hand, and BPD, AC, HC, FL, PT, and GA, on the other hand. Conclusion: There was a significant and strong positive correlation between PT and GA. The study shows that US measurement of PT is a reliable method of estimating GA in singleton pregnancies in Nigeria.

COVID-19: Challenges and coping strategies in radiology departments in Nigeria.

Context: COVID-19 came suddenly, bringing to the fore the challenges inherent in the health system. In a developing country, such as Nigeria, which already had myriad problems with funds and equipment in the health sector. Aims: This study aims to examine the challenges encountered by the staff in Radiology facilities and how they combated the challenges. Settings and Design: A descriptive cross-sectional study of radiology facilities in Nigeria. Subjects and Methods: Radiologists from nine government and four private facilities who attended to COVID-19 patients were asked to fill questionnaires on challenges faced and their coping strategies. Responses were sent through E-mail. Statistical Analysis Used: Data from the responses were analyzed using Microsoft excel for Mac 2011 and presented as figures and tables. Results: Majority of the government 7 (77.8%) and private facilities 4 (100%) had no equipment dedicated only to COVID-19 patients. Seven (77.8%) government facilities complained of inadequate staff, poor availability of personal protective equipment (PPEs) 8 (88.9%), and lack of technology for remote viewing 7 (77.8%). Fear of cross-infection was a challenge in one of the facilities 1 (11.1%). Coping strategies adopted include ensuring less traffic in the department by discouraging walk-in patients and canceling non-emergent cases, booking suspected/confirmed cases for lighter times, using old film for face shields and cloth for facemasks, staff education on COVID-19 and preventive measures, and sending reports to physicians through E-mail. Conclusions: There were a lot of challenges during the COVID-19 crisis, with government hospitals experiencing more challenges than private facilities. The challenges included among others inadequate staff strength and lack of technology for remote viewing. Some were overcome using education and by production of facemasks/shields production using recycled materials.

RésuméLe contexte: COVID-19 came suddenly, bringing to the fore the challenges inherent in the health system. Dans un pays en développement, comme Le Nigeria, qui avait déjà une myriade de problèmes de fonds et d'équipements dans le secteur de la santé. Objectifs : Cette étude vise à examiner les défis rencontrés par le personnel des établissements de radiologie et comment ils ont relevé les défis. Paramètres et conception: une section descriptive étude des installations de radiologie au Nigeria. Sujets et méthodes: Radiologues de neuf établissements publics et de quatre établissements privés qui ont participé aux patients COVID-19 ont été invités à remplir des questionnaires sur les défis rencontrés et leurs stratégies d'adaptation. Les réponses ont été envoyées par courrier électronique. Analyse statistique utilisée: Les données des réponses ont été analysées à l'aide de Microsoft Excel pour Mac 2011 et présentées sous forme de figures et de tableaux. Résultats: La majorité des établissements publics 7 (77,8 %) et privés 4 (100 %) ne disposaient d'aucun équipement dédié uniquement aux patients COVID-19. Sept (77,8 %) établissements publics se sont plaints d'un personnel inadéquat, d'une faible disponibilité des équipements de protection individuelle (EPI) 8 (88,9 %), et le manque de technologie pour la visualisation à distance 7 (77,8 %). La peur d'une infection croisée était un défi dans l'un des établissements 1 (11,1 %). Faire faceles stratégies adoptées comprennent la réduction de la circulation dans le service en décourageant les patients sans rendez-vous et en annulant les cas non urgents, en réservant les cas suspects/confirmés pour des périodes plus légères, en utilisant un vieux film pour les écrans faciaux et un tissu pour les masques faciaux, la formation du personnel sur COVID-19 et mesures préventives et l'envoi de rapports aux médecins par courrier électronique. Conclusions: Il y a eu beaucoup de défis pendant la COVID-19 crise, les hôpitaux publics étant confrontés à plus de défis que les établissements privés. Les défis comprenaient entre autres l'insuffisance la force du personnel et le manque de technologie pour la visualisation à distance. Certains ont été surmontés grâce à l'éducation et à la production de masques faciaux/boucliers utilisant des matériaux recyclés. Mots-clés: défis, les stratégies d'adaptation, COVID-19, Nigeria.

Bland-Altman Plot: Agreement Between Ultrasound-measured Placenta Thickness and Other Biometric Parameters in the Determination of Gestational Age.

Purpose: The aim of this article is to evaluate the agreement of placenta thickness (PT) with other foetal biometric parameters in the determination of gestational age (GA) in normal singleton foetuses. Materials and Methods: The study was a cross-sectional descriptive study conducted among 406 consecutively recruited pregnant women with singleton foetuses at 15-40 weeks of gestation at the National Hospital, Abuja, Nigeria from October to December 2019. Biparietal diameter (BPD), femur length (FL), head circumference (HC), abdominal circumference (AC), and PT were measured using standard measurement protocols. Bland and Altman (BA) plots were used to compare PT and other foetal biometric parameters. The significant statistical level was determined at a critical value of P < 0.05. Results: The mean age of study participants was 31.8 ± 4.8 years. The BA plot of PT and HC demonstrated a normal distribution; the mean difference was around zero (3.968) and 95% of the measurements fell within 2SD of the mean. The BA plot of HC and AC measurements also showed that the 95% limits of agreement for differences fell within 10% of the mean of the measurements (-4.236 to 15.987 with a mean difference of 5.876), indicating good agreement between the two pairs of variables. However, BA plots between PT and BPD as well as PT and FL showed no agreement. Conclusion: This study indicates that there is good agreement or comparability between PT and HC measurements as well as between PT and AC measurements. Hence, either HC or AC measurements may be interchangeable with PT measurements in the ultrasound determination of GA. However, PT measurements did not agree well with BPD and FL measurements, respectively.

Comparison of clinical and ultrasonographic estimation of foetal weight at term and their correlation with birth weight.

The study compares the accuracy of clinical and ultrasonographic estimation of foetal weight at term in predicting birth weight. It was a prospective comparative study conducted in a tertiary hospital in Abuja, Nigeria between May and August 2018. Three hundred pregnant women planned for delivery were recruited. In-utero clinical estimation of foetal weight was carried out using Dare's clinical method and sonographic estimation using Hadlock 3 formula. The newborn babies were weighed within 30 minutes of delivery. The difference in the accuracy of the clinical method (75.3%) and the ultrasonographic method (82.3%) was statistically significant (p-value=0.023). The accuracy of the clinical method among parturients whose BMI were <30kg/m2 and ≥30.0kg/m2 were 83.5% and 68.5% respectively while that of the ultrasonographic method were 85.2% and 80% respectively. We conclude that ultrasonographic estimation of foetal weight is more accurate than the clinical method. However clinical method may be used when an ultrasound scan is not accessible.