{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T18:25:17Z","timestamp":1774549517367,"version":"3.50.1"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Midwives are often the first point of contact for pregnant women; yet their roles, training, and referral practices regarding obstetric ultrasound vary widely. This study aimed to explore midwives\u2019 perspectives and experiences with obstetric ultrasound across key clinical and operational domains to assess the feasibility of conducting future multicentre maternal-foetal health research and surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A descriptive cross-sectional study was conducted among 475 practicing midwives across diverse healthcare settings in Ghana. A self-administered structured questionnaire was used to collect data on midwives\u2019 perspectives and experiences regarding obstetric ultrasound across multiple dimensions. Data analysis was performed using Microsoft Excel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Most midwives were female, aged 26\u201335 years, held diploma qualifications, and practiced within district hospitals. Key ultrasound measures prioritised by midwives in the 1\n                      <jats:sup>st<\/jats:sup>\n                      trimester include gestational age, foetal viability, estimated date of delivery (EDD), number of foetuses, and the presence of an intrauterine gestational sac. Comparatively, midwives emphasize foetal anomaly detection, amniotic fluid (liquor) volume, placental location, foetal viability, and gestational age during second trimester ultrasound screening, while in the 3\n                      <jats:sup>rd<\/jats:sup>\n                      trimester screening, they prioritise foetal presentation, amniotic fluid volume, estimated foetal weight, placental location, and foetal viability. Findings suggest infrequent ultrasound reports indicating foetal anomalies. We observed a moderate perceived ability among midwives to understand foetal anomalies on obstetric ultrasound reports. Only 57.5% indicated they refer patients between one and three times for obstetric ultrasound before delivery. From the findings, it was observed that there is a predominance of sonographers undertaking obstetric ultrasound scans. Midwives may have moderate competence in interpreting obstetric ultrasound reports. An overwhelmingly positive response indicated that obstetric ultrasound improved their work performance, and a high proportion expressed interest in learning how to undertake obstetric ultrasound.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings highlight the need to standardize midwifery practices and strengthen obstetric ultrasound literacy through targeted capacity-building initiatives, not only to improve clinical decision-making but also to establish a robust foundation for scalable maternal-foetal research in low-resource settings. Additionally, our study demonstrates the potential feasibility of engaging midwives as key stakeholders in multicentre maternal-foetal research initiatives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0330235","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T17:42:12Z","timestamp":1774546932000},"page":"e0330235","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring midwives\u2019 practice patterns and capacity for obstetric ultrasound imaging: Towards a multicentre longitudinal materno-foetal research readiness in a low-resource setting"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9167-0269","authenticated-orcid":true,"given":"Albert Dayor","family":"Piersson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6508-4389","authenticated-orcid":true,"given":"Philomena Ajanaba","family":"Asakeboba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Teiko","family":"Quartei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6320-2481","authenticated-orcid":true,"given":"Rachel","family":"Mendy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Arkorful","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0116-394X","authenticated-orcid":true,"given":"Ama Boahene","family":"Akomah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1628-2295","authenticated-orcid":true,"given":"Gilbertson","family":"Allorsey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"issue":"1","key":"pone.0330235.ref001","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1186\/s12909-023-04647-w","article-title":"The training of midwives to perform obstetric ultrasound scan in Africa for task shifting and extension of scope of practice: a scoping review","volume":"23","author":"S Lukhele","year":"2023","journal-title":"BMC Med Educ"},{"issue":"1","key":"pone.0330235.ref002","doi-asserted-by":"crossref","first-page":"1350451","DOI":"10.1080\/16549716.2017.1350451","article-title":"Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives\u2019 experiences and views of obstetric ultrasound","volume":"10","author":"S Holmlund","year":"2017","journal-title":"Glob Health Action"},{"issue":"8","key":"pone.0330235.ref003","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0272250","article-title":"Could ultrasound midwifery training increase antenatal detection of congenital anomalies in Ghana?","volume":"17","author":"A Abdul-Mumin","year":"2022","journal-title":"PLoS One"},{"key":"pone.0330235.ref004","unstructured":"ISUOG. ISUOG Practice Guidelines (updated): performance of 11\u201314-week ultrasound scan. https:\/\/www.isuog.org\/static\/f465db45-655c-42eb-96a196bcd2d34547\/ISUOG-Practice-Guidelines-Updated-performance-of-11-14-week-ultrasound-scan.pdf. 2023."},{"issue":"6","key":"pone.0330235.ref005","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1002\/uog.24888","article-title":"ISUOG Practice Guidelines (updated): performance of the routine mid-trimester fetal ultrasound scan","volume":"59","author":"LJ Salomon","year":"2022","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"1","key":"pone.0330235.ref006","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1002\/uog.27538","article-title":"ISUOG Practice Guidelines: performance of third-trimester obstetric ultrasound scan","volume":"63","author":"A Khalil","year":"2024","journal-title":"Ultrasound Obstet Gynecol"},{"key":"pone.0330235.ref007","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1186\/1471-2393-14-237","article-title":"Prenatal screening for congenital anomalies: exploring midwives\u2019 perceptions of counseling clients with religious backgrounds","volume":"14","author":"JT Gitsels-van der Wal","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"key":"pone.0330235.ref008","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.srhc.2017.11.007","article-title":"\u201cWithout ultrasound you can\u2019t reach the best decision\u201d - Midwives\u2019 experiences and views of the role of ultrasound in maternity care in Dar Es Salaam, Tanzania","volume":"15","author":"A \u00c5hman","year":"2018","journal-title":"Sex Reprod Healthc"},{"issue":"1","key":"pone.0330235.ref009","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1186\/s12884-017-1511-5","article-title":"Factors influencing the clinical decision-making of midwives: a qualitative study","volume":"17","author":"DOA Daemers","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"key":"pone.0330235.ref010","doi-asserted-by":"crossref","first-page":"564560","DOI":"10.3389\/fgwh.2020.564560","article-title":"Pregnant women in low- and middle-income countries require a special focus during the COVID-19 pandemic","volume":"1","author":"CR McDonald","year":"2020","journal-title":"Frontiers in Global Women\u2019s Health"},{"issue":"4","key":"pone.0330235.ref011","doi-asserted-by":"crossref","first-page":"2182","DOI":"10.1002\/nop2.1467","article-title":"The burden and predictors of late antenatal booking in a rural setting in Ghana","volume":"10","author":"CA Oduro","year":"2023","journal-title":"Nurs Open"},{"key":"pone.0330235.ref012","unstructured":"WHO. 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WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience: Ultrasound Examination. 2018. https:\/\/iris.who.int\/bitstream\/handle\/10665\/259946\/WHO-RHR-18.01-eng.pdf"},{"issue":"3","key":"pone.0330235.ref015","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.3689","article-title":"Ultrasonographic fetal nuchal translucency measurements and cytogenetic outcomes","volume":"7","author":"K Bellai-Dussault","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"3","key":"pone.0330235.ref016","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s10396-005-0048-9","article-title":"The dilemma surrounding nuchal translucency-thickness measurement in Japan","volume":"32","author":"S Kozuma","year":"2005","journal-title":"J Med Ultrason (2001)"},{"key":"pone.0330235.ref017","doi-asserted-by":"crossref","first-page":"62","DOI":"10.11604\/pamj.2014.18.62.3291","article-title":"Fetal nuchal translucency scan in Nigeria","volume":"18","author":"OA Oloyede","year":"2014","journal-title":"Pan Afr Med J"},{"issue":"1","key":"pone.0330235.ref018","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1186\/s12884-025-07640-x","article-title":"Spectrum of congenital anomalies detected through anatomy ultrasound at a referral hospital in Ghana","volume":"25","author":"A Swarray-Deen","year":"2025","journal-title":"BMC Pregnancy Childbirth"},{"issue":"11","key":"pone.0330235.ref019","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1002\/pd.5348","article-title":"An assessment of the general public\u2019s knowledge of fatal fetal anomalies","volume":"38","author":"S Power","year":"2018","journal-title":"Prenat Diagn"},{"issue":"4","key":"pone.0330235.ref020","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s12687-023-00654-y","article-title":"\u201cFruits of our past karma\u201d: a qualitative study on knowledge and attitudes about congenital anomalies among women in Pune district, India","volume":"14","author":"A Kar","year":"2023","journal-title":"J Community Genet"},{"key":"pone.0330235.ref021","doi-asserted-by":"crossref","first-page":"1085645","DOI":"10.3389\/fgwh.2023.1085645","article-title":"Pregnant women\u2019s knowledge of birth defects and their associated factors among antenatal care attendees in referral hospitals of Amhara regional state, Ethiopia, in 2019","volume":"4","author":"AA Ferede","year":"2023","journal-title":"Frontiers in global women\u2019s health"},{"key":"pone.0330235.ref022","first-page":"100242","article-title":"Prenatal ultrasound screening and congenital anomalies at birth by region: Pattern and distribution in Latvia","volume":"20","author":"I Zile-Velika","year":"2023","journal-title":"Eur J Obstet Gynecol Reprod Biol X"},{"issue":"1","key":"pone.0330235.ref023","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s13089-025-00420-w","article-title":"Knowledge and utilization of obstetric ultrasound and associated factors among pregnant mother in Africa: a systematic review and meta-analysis","volume":"17","author":"A Gashaw","year":"2025","journal-title":"Ultrasound J"},{"key":"pone.0330235.ref024","first-page":"4589120","article-title":"Perception of Ghanaian Primigravidas Undergoing Their First Antenatal Ultrasonography in Cape Coast","volume":"2020","author":"EKM Edzie","year":"2020","journal-title":"Radiol Res Pract"},{"issue":"1","key":"pone.0330235.ref025","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s13561-017-0180-4","article-title":"The operations of the free maternal care policy and out of pocket payments during childbirth in rural Northern Ghana","volume":"7","author":"PA Dalinjong","year":"2017","journal-title":"Health Econ Rev"},{"issue":"1","key":"pone.0330235.ref026","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s13561-023-00423-0","article-title":"An assessment of out of pocket payments in public sector health facilities under the free maternal healthcare policy in Ghana","volume":"13","author":"MT Kumbeni","year":"2023","journal-title":"Health Econ Rev"},{"issue":"4","key":"pone.0330235.ref027","article-title":"Assessment of availability, accessibility, and affordability of magnetic resonance imaging services in Ghana","volume":"23","author":"AD Piersson","year":"2017","journal-title":"Radiography (Lond)"},{"key":"pone.0330235.ref028","unstructured":"WHO. WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience: Summary. 2018. https:\/\/iris.who.int\/bitstream\/handle\/10665\/259947\/WHO-RHR-18.02-eng.pdf"},{"issue":"3","key":"pone.0330235.ref029","article-title":"Developing an optimal maternal\u2010fetal medicine ultrasound practice: A report and recommendations of the workshop of the Society for Maternal\u2010Fetal Medicine","volume":"1","author":"J Stone","year":"2025","journal-title":"Pregnancy"},{"issue":"4","key":"pone.0330235.ref030","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1002\/uog.23616","article-title":"ISUOG Practice Guidelines (updated): sonographic examination of the fetal central nervous system. 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