Department of Medicine and Surgery, Obstetrics and Gynecology Unit, University of Parma, Parma, Italy.
Frankfurt Oder Klinikum, Frankfurt, Germany.
Fetal Diagn Ther. 2021;48(2):120-127. doi: 10.1159/000512047. Epub 2020 Dec 9.
We conducted a randomized study to determine whether a training session on a dedicated simulator (IUSim™) would facilitate the midwives in learning the technique of transperineal intrapartum ultrasound.
Following a 30-min multimedia presentation including images and videos on how to obtain and measure the angle of progression (AoP) and the head-perineum distance (HPD), 6 midwives with no prior experience in intrapartum ultrasound were randomly split into 2 groups: 3 of them were assigned to the "training group" and 3 to the "control group." The midwives belonging to the former group were taught to measure the 2 sonographic parameters during a 3-h practical session conducted on IUSim™ under the supervision of an expert obstetrician. In the following 3 months, all the 6 midwives were asked to independently perform transperineal ultrasound during their clinical practice and to measure on the acquired images either the AoP or the HPD. The sonographic images were examined in blind by the teaching obstetrician who assigned a 0-3 score to the image quality (IQS) and to the measurement quality (MQS).
A total of 48 ultrasound images (24 patients) from 5 midwives were acquired and included in the study analysis. A midwife of the "training group" declined participation after the practical session. Independently from the randomization group, the image quality score (IQS + MQS) was significantly higher for the HPD compared with the AoP (2.5 ± 0.66 vs. 1.79 ± 1.14; p = 0.01). In the training group, the MQS of either AoP (2.66 ± 0.5 vs.1.46 ± 1.45. p = 0.038) and the HPD (2.9 ± 0.33 vs. 1.87 ± 0.83 p = 0.002) was significantly higher in comparison with the control group, while the IQS of both measurements was comparable between the 2 groups (1.91 ± 1.24 vs. 2.25 ± 0.865; p = 0.28).
The use of a dedicated simulator may facilitate the midwives in learning how to measure the AoP and the HPD on transperineal ultrasound images.
我们进行了一项随机研究，以确定专门模拟器（IUSim™）上的培训课程是否有助于助产士学习经会阴分娩期超声技术。
在 30 分钟的多媒体演示之后，包括如何获取和测量进展角度（AoP）和头会阴距离（HPD）的图像和视频，6 名没有分娩期超声经验的助产士被随机分为 2 组：3 名被分配到“培训组”，3 名被分配到“对照组”。前一组的助产士在专家产科医生的监督下，在 IUSim™上进行 3 小时的实践课程，学习测量这 2 个超声参数。在接下来的 3 个月中，所有 6 名助产士被要求在临床实践中独立进行经会阴超声检查，并在获得的图像上测量 AoP 或 HPD。教学产科医生对超声图像进行盲法检查，并对图像质量（IQS）和测量质量（MQS）进行 0-3 分评分。
共有 5 名助产士的 48 个超声图像（24 例患者）被纳入研究分析。培训课后，一名培训组的助产士拒绝参与。与随机分组无关，HPD 的图像质量评分（IQS+MQS）明显高于 AoP（2.5±0.66 比 1.79±1.14；p=0.01）。在培训组中，AoP（2.66±0.5 比 1.46±1.45，p=0.038）和 HPD（2.9±0.33 比 1.87±0.83，p=0.002）的 MQS 明显高于对照组，而两组的 IQS 相似（1.91±1.24 比 2.25±0.865，p=0.28）。
使用专用模拟器可能有助于助产士学习如何在经会阴超声图像上测量 AoP 和 HPD。
