Measurement error for ultrasound fetal biometry performed by paramedics in rural Bangladesh

Neufeld, L.M.; Wagatsuma, Yukiko; Hussain, Rabia; Begum, Mohsina; Frongillo, Edward A.

doi:10.1002/uog.6385

Cited by 31 publications

(46 citation statements)

References 17 publications

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“…These measurements were taken on each fetus at each visit by one of two sonographers, who were blind to women's the allocation group. Prior to the start of the study, the two sonographers were trained in fetal biometry, and their measures were standardized according to the protocols as detailed and published by Neufeld, Wagatsuma, Hussain, Begum, and Frongillo (). Standardization exercises were performed for each outcome measure at each time point until a level of inter‐ and intra‐observer reliability deemed acceptable by the trainer was reached.…”

Section: Participants and Methodsmentioning

confidence: 99%

Association of prenatal lipid‐based nutritional supplementation with fetal growth in rural Gambia

Johnson

Darboe

Sosseh

et al. 2016

Maternal & Child Nutrition

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Prenatal supplementation with protein‐energy (PE) and/or multiple‐micronutrients (MMNs) may improve fetal growth, but trials of lipid‐based nutritional supplements (LNSs) have reported inconsistent results. We conducted a post‐hoc analysis of non‐primary outcomes in a trial in Gambia, with the aim to test the associations of LNS with fetal growth and explore how efficacy varies depending on nutritional status. The sample comprised 620 pregnant women in an individually randomized, partially blinded trial with four arms: (a) iron and folic acid (FeFol) tablet (usual care, referent group), (b) MMN tablet, (c) PE LNS, and (d) PE + MMN LNS. Analysis of variance examined unadjusted differences in fetal biometry z‐scores at 20 and 30 weeks and neonatal anthropometry z‐scores, while regression tested for modification of intervention‐outcome associations by season and maternal height, body mass index, and weight gain. Despite evidence of between‐arm differences in some fetal biometry, z‐scores at birth were not greater in the intervention arms than the FeFol arm (e.g., birth weight z‐scores: FeFol −0.71, MMN −0.63, PE −0.64, PE + MMN −0.62; group‐wise p = .796). In regression analyses, intervention associations with birth weight and head circumference were modified by maternal weight gain between booking and 30 weeks gestation (e.g., PE + MMN associations with birth weight were +0.462 z‐scores (95% CI [0.097, 0.826]) in the highest quartile of weight gain but –0.099 z‐scores (−0.459, 0.260) in the lowest). In conclusion, we found no strong evidence that a prenatal LNS intervention was associated with better fetal growth in the whole sample.

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Section: Participants and Methodsmentioning

confidence: 99%

Association of prenatal lipid‐based nutritional supplementation with fetal growth in rural Gambia

Johnson

Darboe

Sosseh

et al. 2016

Maternal & Child Nutrition

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“…Three measurements were taken and the average value was used for analysis. The intra-observer variation and quality control of ultrasound measurements were described elsewhere [17]. …”

Section: Methodsmentioning

confidence: 99%

First-trimester fetal growth restriction and the occurrence of miscarriage in rural Bangladesh: A prospective cohort study

Rashid

Ferdous

et al. 2017

PLoS ONE

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Fetal growth restriction in early pregnancy increases the risk of adverse pregnancy outcome, which has a significant social and psychological impact on women. There is limited information related to community-based study to evaluate early indicators related to miscarriage. The aim of this study is to examine the relationship between fetal growth restriction, measured by ultrasound crown-rump length (CRL), and subsequent occurrence of miscarriage in pregnant women in rural Bangladesh. The study was conducted within the Maternal and Infant Nutrition Interventions Trial in Matlab (MINIMat study), Bangladesh. A total of 4436 pregnant women were enrolled in the study when they were at less than 14 gestational weeks. The expected CRL was determined based on an established growth curve of gestational age and CRL, and deviation from this curve of CRL was expressed as a z-score. After identifying related covariates, the multiple Poisson regression model was used to determine the independent contribution from the CRL to miscarriage. A total of 3058 singleton pregnant women were included in analyses, with 92 miscarriages and 2966 continued pregnancies. The occurrence of miscarriages was significantly higher in the smaller categories of CRL z-score after adjustments for maternal age, parity, early pregnancy BMI, gestational age at CRL measurement and socioeconomic status (adjusted relative risk [95% confidence interval]: 1.03 [1.02–1.05] for less than -2 z-score). In a rural Bangladesh population, smaller than expected CRL for the gestational age was related to subsequent miscarriage. Ultrasound biometry information together with careful clinical assessment should provide much needed attention and care for pregnant women.

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“…In Bangladesh, nine paramedics (with no previous ultrasound experience) were trained and evaluated on their accuracy of measuring fetal biometrics. Results of the evaluation of 180 pregnant women (7-31 weeks) showed an inter-observer error rate that was quoted to be within an acceptable range for ultrasound technicians [28]. …”

Section: Introductionmentioning

confidence: 99%

Review article: Use of ultrasound in the developing world

et al. 2011

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As portability and durability improve, bedside, clinician-performed ultrasound is seeing increasing use in rural, underdeveloped parts of the world. Physicians, nurses and medical officers have demonstrated the ability to perform and interpret a large variety of ultrasound exams, and a growing body of literature supports the use of point-of-care ultrasound in developing nations. We review, by region, the existing literature in support of ultrasound use in the developing world and training guidelines currently in use, and highlight indications for emergency ultrasound in the developing world. We suggest future directions for bedside ultrasound use and research to improve diagnostic capacity and patient care in the most remote areas of the globe.

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Measurement error for ultrasound fetal biometry performed by paramedics in rural Bangladesh

Abstract: Objectives To document the accuracy and precision of sonographic fetal biometry performed by nine paramedics from rural Bangladesh. Methods Paramedics underwent intensive training (6 weeks) including hands-on

Cited by 31 publications

References 17 publications

Association of prenatal lipid‐based nutritional supplementation with fetal growth in rural Gambia

Association of prenatal lipid‐based nutritional supplementation with fetal growth in rural Gambia

First-trimester fetal growth restriction and the occurrence of miscarriage in rural Bangladesh: A prospective cohort study

Review article: Use of ultrasound in the developing world

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