Natalie Greenwold1, Sarah Wallace2, Anne Prost2, Eric Jauniaux3. 1. Academic Department of Maternal and Fetal Medicine, UCL Elizabeth Garrett Anderson Institute for Women's Health, London, UK; Medical Aid Films, London, UK. 2. Medical Aid Films, London, UK. 3. Academic Department of Maternal and Fetal Medicine, UCL Elizabeth Garrett Anderson Institute for Women's Health, London, UK; Medical Aid Films, London, UK. Electronic address: e.jauniaux@ucl.ac.uk.
Abstract
OBJECTIVE: To evaluate the feasibility and sustainability of basic obstetric ultrasound training in rural Africa. METHODS: An 8-week training course, led by UK-based sonographers, was supported by training videos and followed by 10 months of remotely supported scanning in Mandimba, Mozambique. Data were collected prospectively using an Android tablet and the EpiCollect web application. RESULTS: The study group included 1744 pregnant women: 804 scanned by trainees under direct supervision and 940 scanned by trainees alone. Ultrasound identified 36 (2.1%) twin pregnancies, 230 (13.2%) breech presentations, 83 (4.8%) transverse presentations, and 22 (1.3%) cases of placenta previa. The detection rates for the above features were similar in the 2 groups. A subgroup of 230 (13.2%) women had a follow-up scan and 62 (3.6%) were referred to a doctor; 21 of these women required cesarean delivery. CONCLUSION: Ultrasound training in a rural setting supported remotely is feasible, efficient, and sustainable. It can help local healthcare workers to screen their prenatal populations for obstetric and neonatal risks, and therefore has the potential to improve outcomes at delivery and provide site-specific epidemiologic data that can be used to develop new healthcare provision strategies.
OBJECTIVE: To evaluate the feasibility and sustainability of basic obstetric ultrasound training in rural Africa. METHODS: An 8-week training course, led by UK-based sonographers, was supported by training videos and followed by 10 months of remotely supported scanning in Mandimba, Mozambique. Data were collected prospectively using an Android tablet and the EpiCollect web application. RESULTS: The study group included 1744 pregnant women: 804 scanned by trainees under direct supervision and 940 scanned by trainees alone. Ultrasound identified 36 (2.1%) twin pregnancies, 230 (13.2%) breech presentations, 83 (4.8%) transverse presentations, and 22 (1.3%) cases of placenta previa. The detection rates for the above features were similar in the 2 groups. A subgroup of 230 (13.2%) women had a follow-up scan and 62 (3.6%) were referred to a doctor; 21 of these women required cesarean delivery. CONCLUSION: Ultrasound training in a rural setting supported remotely is feasible, efficient, and sustainable. It can help local healthcare workers to screen their prenatal populations for obstetric and neonatal risks, and therefore has the potential to improve outcomes at delivery and provide site-specific epidemiologic data that can be used to develop new healthcare provision strategies.
Authors: Robert Nathan; Jonathan O Swanson; William Marks; Nicole Goldsmith; Cheryl Vance; Ntale Brian Sserwanga; David Swanson; Elizabeth M McClure; Holly Franklin; Waseem Mirza; Musaku Mwenechanya; David Muyodi; Lester Figuero; Victor Lokomba Bolamba; Robert L Goldenberg; Irma Sayury Pineda Journal: Ultrasound Q Date: 2014-12 Impact factor: 1.657
Authors: Robert O Nathan; Jonathan O Swanson; David L Swanson; Elizabeth M McClure; Victor Lokomba Bolamba; Adrien Lokangaka; Irma Sayury Pineda; Lester Figueroa; Walter López-Gomez; Ana Garces; David Muyodi; Fabian Esamai; Nancy Kanaiza; Waseem Mirza; Farnaz Naqvi; Sarah Saleem; Musaku Mwenechanya; Melody Chiwila; Dorothy Hamsumonde; Dennis D Wallace; Holly Franklin; Robert L Goldenberg Journal: Curr Probl Diagn Radiol Date: 2016-11-10
Authors: Elizabeth M McClure; Robert O Nathan; Sarah Saleem; Fabian Esamai; Ana Garces; Elwyn Chomba; Antoinette Tshefu; David Swanson; Hillary Mabeya; Lester Figuero; Waseem Mirza; David Muyodi; Holly Franklin; Adrien Lokangaka; Dieudonne Bidashimwa; Omrana Pasha; Musaku Mwenechanya; Carl L Bose; Waldemar A Carlo; K Michael Hambidge; Edward A Liechty; Nancy Krebs; Dennis D Wallace; Jonathan Swanson; Marion Koso-Thomas; Rexford Widmer; Robert L Goldenberg Journal: BMC Pregnancy Childbirth Date: 2014-02-17 Impact factor: 3.007