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Training Midwives to Perform Basic Obstetric Point-of-Care Ultrasound in Rural Areas Using a Tablet Platform and
Sudhir Vinayak1, Joyce Sande1, Harvey Nisenbaum2
1Department of Imaging and Diagnostic Radiology, Aga Khan University Hospital, Nairobi, Kenya.
Ultrasound in Medicine & Biology
|July 19, 2017
Summary
Training midwives in point-of-care ultrasound (POCUS) using tablet devices and teleradiology significantly improves diagnostic accuracy in remote settings. This cost-effective approach enhances identification of high-risk pregnancies, leading to better maternal outcomes.
Area of Science:
- Medical Imaging
- Obstetrics and Gynecology
- Health Informatics
Background:
- Point-of-care ultrasound (POCUS) offers potential for improved diagnostics in resource-limited settings.
- Cost-effectiveness and accuracy of POCUS performed by non-specialists remain key considerations for global health applications.
Purpose of the Study:
- To evaluate the accuracy of images and reports generated by midwives using tablet-based POCUS.
- To assess the feasibility of a teleradiology model for remote validation of POCUS examinations by midwives.
- To determine the impact of this integrated approach on identifying high-risk pregnancies in rural areas.
Main Methods:
- Midwives with no prior ultrasound experience were trained to perform POCUS using tablet devices in rural locations.
- Images and provisional reports were transmitted electronically via a unique mobile phone-based teleradiology solution to radiologists for validation.
- Data on image quality, report accuracy, transmission times, and correlation with final pregnancy outcomes were collected and analyzed.
Main Results:
- Midwives achieved a high reporting accuracy of 99.63% with excellent correlation between provisional and validated reports.
- The teleradiology transmission was faultless, with short transmission times and excellent image quality, reducing overall turnaround time.
- The POCUS approach demonstrated high accuracy in identifying high-risk pregnancies, with only 2 discrepancies found among 20 identified cases.
Conclusions:
- Training midwives in POCUS and utilizing a teleradiology model is a valuable and accurate method for remote healthcare facilities.
- This integrated system effectively identifies high-risk pregnancies, potentially improving maternal and fetal outcomes in underserved regions.
- The tablet-based POCUS system with teleradiology offers a cost-effective solution for enhancing obstetric care in developing areas.
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