Academic Department of Maternal and Fetal Medicine, UCL Elizabeth Garrett Anderson Institute for Women's Health, London, UK; Medical Aid Films, London, UK.
Medical Aid Films, London, UK.
Int J Gynaecol Obstet. 2014 Mar;124(3):274-7. doi: 10.1016/j.ijgo.2013.09.018. Epub 2013 Dec 4.
To evaluate the feasibility and sustainability of basic obstetric ultrasound training in rural Africa.
An 8-week training course, led by UK-based sonographers, was supported by training videos and followed by 10 months of remotely supported scanning in Mandimba, Mozambique. Data were collected prospectively using an Android tablet and the EpiCollect web application.
The study group included 1744 pregnant women: 804 scanned by trainees under direct supervision and 940 scanned by trainees alone. Ultrasound identified 36 (2.1%) twin pregnancies, 230 (13.2%) breech presentations, 83 (4.8%) transverse presentations, and 22 (1.3%) cases of placenta previa. The detection rates for the above features were similar in the 2 groups. A subgroup of 230 (13.2%) women had a follow-up scan and 62 (3.6%) were referred to a doctor; 21 of these women required cesarean delivery.
Ultrasound training in a rural setting supported remotely is feasible, efficient, and sustainable. It can help local healthcare workers to screen their prenatal populations for obstetric and neonatal risks, and therefore has the potential to improve outcomes at delivery and provide site-specific epidemiologic data that can be used to develop new healthcare provision strategies.
评估在非洲农村地区开展基础产科超声培训的可行性和可持续性。
由英国超声医师主导的 8 周培训课程得到了培训视频的支持，并在莫桑比克 Mandimba 进行了 10 个月的远程支持扫描。数据使用 Android 平板电脑和 EpiCollect 网络应用程序进行前瞻性收集。
研究组纳入了 1744 名孕妇：804 名由受训者在直接监督下扫描，940 名由受训者单独扫描。超声检查发现 36 例（2.1%）双胎妊娠，230 例（13.2%）臀位，83 例（4.8%）横位，22 例（1.3%）前置胎盘。两组中上述特征的检出率相似。230 名（13.2%）妇女的亚组进行了随访扫描，62 名（3.6%）被转介给医生；其中 21 名妇女需要剖宫产。
在农村地区远程支持下进行超声培训是可行、高效和可持续的。它可以帮助当地的医疗保健工作者为产前人群筛查产科和新生儿风险，因此有可能改善分娩结局，并提供可用于制定新的医疗保健提供策略的特定地点的流行病学数据。
