OP08.11: Validity of three obstetrical ultrasound simulators in the assessment of ultrasound skills

Abstract

Short oral presentation abstractsMethods: The study includes data from Norfolk and Norwich University Hospitals (NNUH) where a policy of routine POCUS was adopted from November 2020 following stage-wise implementation in 2016. We included two groups: a historical cohort of women who received routine care (2015) and those who had POCUS at the 36-week visit (November 2020-2021). Women with multiple pregnancies, preterm birth < 37 weeks, congenital abnormalities and those undergoing planned Caesarean section (CS) for breech presentation were excluded. Undiagnosed breech presentation was defined as: a) women who presented in labour or with ruptured membranes at term and were subsequently discovered to have a baby in a breech presentation, and b) women who attended for induction of labour at term and were found to have a breech presentation before commencing induction of labour. The primary outcome was undiagnosed breech presentation in labour. Secondary outcomes included mode of birth and neonatal adverse outcomes. Percentages were compared using chi squared test. Results: The analysis included 5013 pregnancies before and 4474 pregnancies after routine implementation of POCUS. After the implementation of routine POCUS, the rate of undiagnosed breech presentation reduced from 4.8/1000 births to 1.1/1000 births. The risk of undiagnosed breech in labour reduced by 77% with routine POCUS (Relative Risk: 0.23, 95% CI 0.09-0.61, p = 0.003). There was also a significant reduction in the incidence of emergency CS and breech delivery at term by 22.2% (p = 0.02) and 8.8% (p = 0.01), respectively. Approximately 271 POCUS would be required to prevent one undiagnosed breech presentation in labour. Conclusions: POCUS was associated with a reduction in undiagnosed breech in labour and emergency CS at term.