Examining the Quality of Ultrasound Examination Reports in Obstetric Imaging: A Multi-Centre Gap Analysis in Anambra and Imo States

The quality of obstetric ultrasound examination reports determines the clinical information available to obstetricians for antenatal decision-making, and systematic evaluation of report quality against accepted reporting standards identifies gaps that compromise care planning and medico-legal documentation. In Anambra and Imo States, South East Nigeria, obstetric ultrasound report quality across facilities has not been investigated using a validated gap analysis methodology. This study examines the quality of obstetric ultrasound reports in a multi-centre gap analysis across secondary and tertiary hospitals in Anambra and Imo States. A retrospective audit of 400 archived obstetric ultrasound reports (200 per state) from 2022 to 2023 is conducted using a validated Obstetric Ultrasound Report Quality Scoring Tool measuring 22 mandatory and recommended elements, including biometric measurements, foetal presentation, placental localisation, amniotic fluid index, foetal anomaly screening documentation, and final diagnostic impression. Inter-rater reliability for the scoring tool is assessed using Cohen's kappa. Descriptive statistics and chi-square tests comparing report quality across facility types are computed in SPSS. Available obstetric reporting literature from South East Nigeria identifies absent foetal anomaly screening documentation and missing amniotic fluid assessment as the most prevalent report quality gaps. The ISUOG Reporting Standards for Obstetric Ultrasound and RCOG ultrasound reporting guidelines provide the analytical benchmark. Findings are expected to reveal lower overall report quality in secondary facilities compared to tertiary centres. Recommendations address standardised obstetric ultrasound report templates, operator reporting training, and facility-level report quality audit at Anambra and Imo State hospitals. Keywords: obstetric ultrasound, report quality, gap analysis, South East Nigeria, Anambra and Imo States.