Ramphul, Meenakshi, Ooi, Poh Vei, Burke, Gerard, Kennelly, Mairead M., Said, Soha A.T., Montgomery, Alan A. and Murphy, Deidre J.
(2014)
Instrumental delivery and ultrasound: a multicentre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery.
BJOG: An International Journal of Obstetrics and Gynaecology, 121
(8).
pp. 1029-1038.
ISSN 1471-0528
Full text not available from this repository.
Abstract
Objectives: To determine whether the use of ultrasound can reduce the incidence of incorrect diagnosis of the fetal head position at instrumental delivery and subsequent morbidity.
Design: Two-arm, parallel, randomised trial, conducted from June 2011 to December 2012.
Setting: Two maternity hospitals in the Republic of Ireland.
Sample: 514 nulliparous women at term (≥37 weeks' gestation) with singleton cephalic pregnancies, aiming to deliver vaginally were recruited prior to induction of labour or in early labour.
Methods: If instrumental delivery was required, women who had provided written consent were randomised to receive clinical assessment (standard care) or ultrasound scan and ultrasound assessment (ultrasound).
Main outcome: Incorrect diagnosis of the fetal head position.
Results: The incidence of incorrect diagnosis was significantly lower in the ultrasound group than the standard care group (4/257, 1.6% versus 52/257, 20.2%, odds ratio 0.06, 95% confidence interval (CI) 0.02 to 0.19, p value <0.001). The decision to delivery interval was similar in both groups (ultrasound mean 13.8 minutes, SD 8.7, versus standard care mean 14.6 minutes, SD 10.1, p value 0.35). The incidence of maternal and neonatal complications,4 failed instrumental delivery and caesarean section was not significantly different between the two groups.
Conclusions: An ultrasound assessment prior to instrumental delivery reduced the incidence of incorrect diagnosis of the fetal head position without delaying delivery but did not prevent morbidity. A more integrated clinical skills-based approach is likely to be required to prevent adverse outcomes at instrumental delivery.
| Item Type: |
Article
|
| RIS ID: |
https://nottingham-repository.worktribe.com/output/730159 |
| Additional Information: |
This is the pre-peer reviewed version of the following article: Ramphul M, Ooi PV, Burke G, Kennelly MM, Said SAT, Montgomery AA, Murphy DJ. Instrumental delivery and ultrasound (IDUS): a multicentre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery. BJOG 2014;121:1029–1038, which has been published in final form at 10.1111/1471-0528.12810. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. |
| Keywords: |
fetal head position; second stage of labour; intrapartum ultrasound, randomised controlled trial |
| Schools/Departments: |
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Units > Clinical Trials Unit |
| Identification Number: |
https://doi.org/10.1111/1471-0528.12810 |
| Depositing User: |
Daunt, Wendy
|
| Date Deposited: |
23 Nov 2017 13:55 |
| Last Modified: |
15 Aug 2024 15:15 |
| URI: |
https://eprints.nottingham.ac.uk/id/eprint/48300 |
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