Systematic introduction of obstetric ultrasound skills into practice

Abstract

Objective: To identify the present skill level of obstetric ultrasound, to set quality standards and to make recommendations in terms of obstetrics ultrasound service improvement. Methods: An audit was carried out in five provinces in Sri Lanka. At the beginning of the ultrasound workshops, attendees were requested to participate in this audit. Optimum ultrasound machine settings and biometry standards were defined at the beginning. Measures were taken to recruit a cross section of the obstetric service providers including postgraduate trainees and senior house officers (SHOO). They were asked to perform an ultrasound scan and obtain standard images. These images were assessed onsite and documented in structured data sheet. The level of competency was analyzed according to the pre-defined standards. A structured ultrasound training programs have been carried out to improve the existing knowledge and skills of the participants. In order to simulate their own scan environment and habits, participants were assessed without their knowledge in the second phase of this audit. Results: Overall skills in controlling machine settings were very poor. Almost all the participants did not manage to set the machine competently. Postgraduates were slightly better in obtaining correct landmarks for fetal biometry. It is encouraging to note that most of the postgraduates were able to improve their machine setting skills in subsequent audit. First trimester crown-rump length is the least improved fetal biometry in second phase. Conclusion: At present background skills of obstetric ultrasound are substandard and it can be improved by dedicated training. Systematic

Knowledge of Down’s syndrome Screening amongst Patients and Health Care Professionals in Sri Lanka

“…Of all available screening tests for Down's syndrome, an ultrasound based screening strategy would be most practical and cost effective in Sri Lankan at present as almost all the obstetric units in the public sector are equipped with ultrasound scanning machines. However, the main challenge is to train doctors to perform first trimester ultrasonography and fetal nuchal translucency [15]. Moreover, audit and monitoring of the screening system is essential in improving the quality of screening and ensure women receive the best available risk evaluation.…”

“…It is recommended therefore that nuchal translucency measurement should have an external quality assessment and assurance schemes. Systematic training of obstetric ultrasound skills has recently been started in Sri Lanka [15].…”

Twin pregnancy chorionicity determination in a tertiary care setting

“…It is appears that the present skill level in obstetric ultrasound is poor and it can be improved by training [10]. A systematic approach is needed in planning, training and auditing of obstetrics ultrasound skills.…”