Introduction of robot-assisted obstetric ultrasound in rural Northern Norway

Robot-assisted obstetric ultrasound is a method where the obstetrician in the hospital can control an ultrasound probe and assess biometric measurements and biophysical observations of a fetus, at a remote location. This two-aimed study evaluates the diagnostic accuracy of robot-assisted ultrasound compared to traditional ultrasound and explores patient experiences.

Forty-six middle-risk pregnant women in 2nd and 3rd trimester were recruited. Thirty women were recruited for an intra observer study to compare the quality of the robot-assisted obstetrical ultrasound and traditional obstetric ultrasound. Fifteen traditional ultrasound examinations and 15 robotic-assisted ultrasound examinations were performed and head circumference (HC), biparietal diameter (BPD), abdominal circumference (AC), femur length (FL), amniotic fluid index (AFI), Doppler in the umbilical arteria, and biophysical observations of the fetus were registered. Another 16 women were recruited to a mixed design study aiming to explore the women's experiences with the robot-assisted ultrasound method. These women completed a questionnaire of 20 questions about patient experience, using a 5-point Likert scale. Two of them also participated in qualitative interviews to provide deeper insights.

Biometric measurements showed excellent reliability (intraclass correlation coefficient 0.990-0.993) with acceptable limits of agreement. Twenty questions about patient experiences were asked and 94% of the women scored for highest level of satisfaction. Interviews revealed the value of avoiding long-distance travel when image quality and digital communication experiences are good.

Robot-assisted obstetric ultrasound is a reliable alternative to traditional ultrasound for middle-risk pregnancies in rural areas, offering high diagnostic accuracy and patient satisfaction. Most women would agree to a robotic ultrasound scan examination again. The patients' experiences are thus in line with the Norwegian governments' intention to use technology to secure equality in health care in rural areas.