Packet Bram, Adela Samešová, Jute Richter
Department of Development and Regeneration, Unit of Woman and Child, Catholic University of Leuven, Leuven, Belgium.
Department of Obstetrics and Gynecology, University Hospital Leuven, Leuven, Belgium.
Eur J Midwifery. 2024 Dec 11;10. doi: 10.18332/ejm/195498. eCollection 2024.
Intrapartum ultrasound (IPUS) allows for a more reliable and reproducible assessment of fetal head station and position during labor. This study aimed to investigate how an online education module on IPUS impacts midwives' knowledge, attitudes, and practices (KAP) regarding this topic.
Midwives working in the labor ward of the University Hospital of Leuven (Belgium) were invited to participate in an educational program on IPUS in April 2023. A baseline KAP survey was completed upon enrolment, followed by an online education module on the intrapartum sonographic assessment of head station and position. Afterwards, a second KAP survey was completed. Score were compared using a two-sided Wilcoxon signed-rank test. A p<0.05 was considered significant. Statistical analyses were conducted using SPSS (version 29.0.2.0).
A total of 45 midwives were eligible for inclusion and invited to participate. From these, 46.7% (21/45) agreed to take part. Attitudes towards IPUS were positive, as most perceived it as safe, time-efficient, and beneficial for medical-decision making. However, only two midwives (9.1%) sometimes used IPUS themselves during the second stage, whereas none used it during the first stage. A significant improvement in knowledge scores was recorded after the online education module for both the sections on fetal head station (median score 0/5 to 2.75/5, p=0.01) and position (median score 2.5/5 to 3.5/5, p=0.04). No significant differences were observed in the overall attitude scores, as they remained overall positive (4.5/5 to 5/5, p=0.18).
Although having little experience with IPUS themselves, most participating midwives perceive it as an acceptable, time-efficient, and safe imaging modality. A short online education module resulted in a significant improvement in their knowledge of these topics. Further implementation research is needed to investigate how the uptake of IPUS amongst midwives can be improved, and how this can improve overall labor care.
产时超声（IPUS）能够在分娩期间对胎儿头部位置和入盆情况进行更可靠且可重复的评估。本研究旨在调查关于产时超声的在线教育模块如何影响助产士对此主题的知识、态度和实践（KAP）。
邀请在比利时鲁汶大学医院产房工作的助产士参加2023年4月举办的关于产时超声的教育项目。入组时完成基线KAP调查，随后进行关于产时胎儿头部位置和入盆情况超声评估的在线教育模块学习。之后，完成第二次KAP调查。使用双侧Wilcoxon符号秩检验比较得分。p<0.05被认为具有统计学意义。使用SPSS（版本29.0.2.0）进行统计分析。
共有45名助产士符合纳入条件并被邀请参与。其中，46.7%（21/45）同意参加。助产士对产时超声的态度积极，多数人认为其安全、省时且对医疗决策有益。然而，只有两名助产士（9.1%）在第二产程有时会自己使用产时超声，而在第一产程无人使用。在线教育模块学习后，胎儿头部入盆情况（中位数得分从0/5提高到2.75/5，p = 0.01）和位置（中位数得分从2.5/5提高到3.5/5，p = 0.04）这两个部分的知识得分均有显著提高。总体态度得分未观察到显著差异，仍总体呈积极（从4.5/5到5/5，p = 0.18）。
尽管大多数参与的助产士自身对产时超声经验较少，但他们认为这是一种可接受、省时且安全的成像方式。一个简短的在线教育模块使其对这些主题的知识有了显著提高。需要进一步开展实施研究，以调查如何提高助产士对产时超声的应用，以及这如何改善整体分娩护理。
