Knowledge, attitudes, and barriers to second-trimester fetal anomaly scan utilization among pregnant women in Jordan: a cross-sectional study

BACKGROUND: Second-trimester fetal anomaly scan is an important modality of care in antenatal settings for detecting congenital abnormalities and improving maternal and neonatal outcomes. Despite the importance of second-trimester ultrasound anomaly scan, its utilization remains suboptimal in Jordan, due to the existing knowledge gaps, prevailing attitudes, and various barriers which affect utilization and access to this type of diagnostic procedure. AIM: To assess the knowledge, attitudes, and barriers related to the utilization of second-trimester anomaly scans among pregnant Jordanian women and to identify the predictors of women's knowledge regarding anomaly scan capabilities. METHODS: A total of 468 pregnant women attending antenatal clinics in Jordan participated in this cross-sectional study. A valid and self-administered questionnaire was used. Descriptive statistics summarized demographic and clinical characteristics and multiple linear regressions identified the predictors of knowledge regarding anomaly scan capabilities. RESULTS: The findings revealed that 87.0% had good knowledge about anomaly scan capabilities and 13.0% had poor knowledge. The statistically significant predictors of a high level of knowledge were previous anomaly scan history (B = 0.591, p < 0.001), family history of congenital anomalies (B = 0.793, p < 0.001), consanguinity (B = 0.440, p = 0.002), and number of miscarriages (B = 0.221, p = 0.009). The main barriers included: fear of detecting fetal malformations, 17.5%; religious objections to pregnancy termination, 16.6%; and financial barriers, 12.4%. Although most participants (87.8%) expressed an attitude that considered ultrasound to be safe, there were still misconceptions about its potential risks. CONCLUSION: The study highlights the critical role of personal and familial experiences in shaping women's knowledge about anomaly scans. Although attitudes toward the safety and usefulness of ultrasound were generally positive, targeted educational interventions are needed to address misconceptions about fetal ultrasound scans and barriers to their utilization. Strengthening healthcare provider training and offering counseling during antenatal visits could improve knowledge and utilization rates. Additionally, this study urges health policymakers to ensure anomaly scan coverage for all pregnant women.