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Obstetric ultrasound scanning by local health workers in a refugee camp on the Thai-Burmese border.

Rijken, MJ; Lee, SJ; Boel, ME; Papageorghiou, AT; Visser, GH; Dwell, SL; Kennedy, SH; Singhasivanon, P; White, NJ; Nosten, F; et al. Rijken, MJ; Lee, SJ; Boel, ME; Papageorghiou, AT; Visser, GH; Dwell, SL; Kennedy, SH; Singhasivanon, P; White, NJ; Nosten, F; McGready, R (2009) Obstetric ultrasound scanning by local health workers in a refugee camp on the Thai-Burmese border. Ultrasound Obstet Gynecol, 34 (4). 395 - 403. ISSN 1469-0705 https://doi.org/10.1002/uog.7350
SGUL Authors: Papageorghiou, Aris

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Abstract

Objectives Ultrasound examination of the fetus is a powerful tool for assessing gestational age and detecting obstetric problems but is rarely available in developing countries. The aim of this study was to assess the intraobserver and interobserver agreement of fetal biometry by locally trained health workers in a refugee camp on the Thai–Burmese border. Methods One expatriate doctor and four local health workers participated in the study, which included examinations performed on every fifth pregnant woman with a singleton pregnancy between 16 and 40 weeks' gestation, and who had undergone an early dating ultrasound scan, attending the antenatal clinic in Maela refugee camp. At each examination, two examiners independently measured biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL), with one of the examiners obtaining duplicate measurements of each parameter. Intraobserver measurement error was assessed using the intraclass correlation coefficient (ICC) and interobserver error was assessed by the Bland and Altman 95% limits of agreement method. Results A total of 4188 ultrasound measurements (12 per woman) were obtained in 349 pregnancies at a median gestational age of 27 (range, 16–40) weeks in 2008. The ICC for BPD, HC, AC and FL was greater than 0.99 for all four trainees and the doctor (range, 0.996–0.998). For gestational ages between 18 and 24 weeks, interobserver 95% limits of agreement corresponding to differences in estimated gestational age of less than ± 1 week were calculated for BPD, HC, AC and FL. Measurements by local health workers showed high levels of agreement with those of the expatriate doctor. Conclusions Locally trained health workers working in a well organized unit with ongoing quality control can obtain accurate fetal biometry measurements for gestational age estimation. This experience suggests that training of local health workers in developing countries is possible and could allow effective use of obstetric ultrasound imaging. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.

Item Type: Article
Additional Information: PMCID: PMC3438883 Full abstract added, record checked and made live 28/05/14 LM
Keywords: Biometry, Community Health Workers, Female, Femur, Fetus, Gestational Age, Head, Humans, Myanmar, Observer Variation, Pregnancy, Quality Assurance, Health Care, Refugees, Reproducibility of Results, Thailand, Ultrasonography, Prenatal, accuracy, developing country, fetal biometry, reproducibility, ultrasound
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: Ultrasound Obstet Gynecol
ISSN: 1469-0705
Dates:
DateEvent
1 October 2009Published
PubMed ID: 19790099
Web of Science ID: 19790099
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URI: https://openaccess.sgul.ac.uk/id/eprint/101562
Publisher's version: https://doi.org/10.1002/uog.7350

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