Aktoz Fatih, Tercan Can, Vurgun Eren, Aslancan Reyhan, Ürün Hanife, Yücel Burak, Dursun Sezgin
Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
Clinic of Medical Biochemistry, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul, Turkey
J Turk Ger Gynecol Assoc. 2022 Jun 1;23(2):95-98. doi: 10.4274/jtgga.galenos.2022.2021-12-3.
Residency training programs are challenging for young physicians with heavy workloads. Although ultrasonography (USG) is an imaging method that is frequently used in obstetrics practice, some basic USG skills can be acquired late in this intensive learning process. Likewise determining the fetal heart axis is an elementary evaluation but can turn into a challenging and time-consuming process, especially for inexperienced clinicians.
Pregnant women between 20 and 37 weeks of gestation were recruited. Two observers assessed the axis of fetal heart by standard, Bronshtein and clock position methods. Fetal heart axis evaluation times were compared. Inter-observer and intra-observer agreements of the three methods were measured. One factor learning rates were calculated.
A total of 31 pregnant patients between the ages of 18 and 40 years were included in the study. Fetal heart axis evaluation time by the clock position method was shorter than the Bronshtein and standard method in both observers. Furthermore diagnostic accuracy for both observers was 100% with the clock position method, while this fell to 100% in observer-1 and 96.8% in observer-2 using the Bronshtein method. The clock position method was learned faster than either of the other methods.
Clock position method is an easy and feasible method for inexperienced resident physicians in terms of learning and application to determine the fetal heart axis. The advantages of this method increase when patient numbers are higher.
住院医师培训项目对年轻医生来说具有挑战性，工作量很大。尽管超声检查（USG）是产科实践中常用的一种成像方法，但一些基本的超声检查技能在这个强化学习过程中可能掌握得较晚。同样，确定胎儿心脏轴是一项基本评估，但对于经验不足的临床医生来说，可能会变成一个具有挑战性且耗时的过程。
招募妊娠20至37周的孕妇。两名观察者通过标准方法、布朗施泰因方法和时钟定位法评估胎儿心脏轴。比较胎儿心脏轴评估时间。测量三种方法的观察者间和观察者内一致性。计算单因素学习率。
共有31例年龄在18至40岁之间的孕妇纳入研究。在两名观察者中，时钟定位法评估胎儿心脏轴的时间均短于布朗施泰因法和标准法。此外，时钟定位法对两名观察者的诊断准确率均为100%，而使用布朗施泰因法时，观察者1的诊断准确率降至100%，观察者2的诊断准确率降至９６.８％。时钟定位法比其他任何一种方法学得都快。
对于经验不足的住院医师而言，时钟定位法在学习和应用以确定胎儿心脏轴方面是一种简单可行的方法。当患者数量较多时，该方法的优势会增加。
