Obstetric ultrasonography practice in Fiji

In Fiji, a Pacific island nation, ultrasonography practice is still in its infancy. Ultrasounds are performed by radiographers who independently interpret the ultrasonographic images and write the diagnostic reports on behalf of the radiologists. This paper presents research on the practices and procedures that are used to perform the mid-trimester obstetric ultrasonography examinations at an urban public hospital in Fiji. The participants comprised a cohort of "on-the-job" trained radiographers, radiologists and obstetricians involved in obstetric ultrasonography. In-field observations, questionnaires and interviews yielded predominantly qualitative data. The radiographers' scanning criteria were evaluated against the stipulated ASUM mid-trimester guidelines. This study revealed that even the most experienced radiographers barely met 50% of ASUM's mid-trimester scanning requirements. They spent less than five minutes performing a scan and insufficient expertise, training and supervision, excessive workload and a lack of resources were major constraints affecting the standards of ultrasonography practice in Fiji. However, the absence of a standard protocol was also a major cause for disparate scanning patterns amongst the radiographers. This paper highlights the gaps and limitations associated with the obstetric ultrasonography practice in Fiji, and suggests the need for international assistance in ultrasonography education.