Focused maternal ultrasound by midwives in rural Zambia.
Point-of-care ultrasound is being increasingly implemented in resource-poor settings in an ad hoc fashion. We developed a focused maternal ultrasound-training program for midwives in a rural health district in Zambia. Four hundred forty-one scans were recorded by 21 midwives during the 6-month study period. In 74 scans (17%), the ultrasound findings prompted a change in clinical decision-making. Eight of the midwives were evaluated with a 14-question observed structured clinical examination (OSCE) and demonstrated a slight overall improvement with mean scores at 2 and 6 months of 10.0/14 (71%) and 11.6/14 (83%), respectively. Our pilot project demonstrates that midwives in rural Zambia can be trained to perform basic obstetric ultrasound and that it impacts clinical decision-making. Ultrasound skills were retained over the study period. More data is necessary to determine whether the introduction of ultrasound ultimately improves outcomes of pregnant women in rural Zambia.
Kimberly
Heidi Harbison
HH
Department of Emergency Medicine, Brigham & Women's Hospital, Boston, MA 02115, USA. hkimberly@partners.org
Murray
Alice
A
Mennicke
Maria
M
Liteplo
Andrew
A
Lew
Jason
J
Bohan
J Stephen
JS
Tyer-Viola
Lynda
L
Ahn
Roy
R
Burke
Thomas
T
Noble
Vicki E
VE
D005260:Female; D006801:Humans; D008880:Midwifery / Q000706:statistics & numerical data*; D009035:Mothers; D010865:Pilot Projects; D011247:Pregnancy; D012424:Rural Population / Q000706:statistics & numerical data*; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*; D015024:Zambia / Q000453:epidemiology