Factors Influencing Sonographer Grasp and Pincher Strength Before and After Fetal Echocardiograms

Work-related musculoskeletal disorders (WRMD) is an ongoing concern for fetal cardiac sonographers (f-CS). Decreased grasp and pincher strength have been associated with an increased risk of WRMD. This report aimed to determine if certain variables associated with fetal echocardiographic (f-echo) studies correlated with grasp and pincer strength. Grasp and pincer strength values for the f-CS's scanning hand were obtained immediately pre- and post-f-echo. Maternal, f-echo, and fetal characteristics were recorded. Values are presented as mean and standard deviation or percentage. Univariable linear mixed-effects regression models were performed to determine possible associations with grasp and pincher value changes versus f-echo variables with secondary analyses adjusting for additional clinical factors via multivariable models. Total of 304 f-echo were performed with 292 paired pre- and post-grasp and pre- and post-pincher values recorded. Maternal body mass index (BMI) was 33 (9) kg/m², scan length was 33 (15) minutes, and f-CS reported image quality was rated 7 out of 10 (6, 8). 96% of f-echo were performed on singleton pregnancies, 71% of f-echo were reported as normal, placental position was posterior in 54%, fluid status was normal in 97%, fetus was vertex 67%, and spine position was predominantly either right (33%) or left (30%) side up. Pre-grip was 26.2 (3.9) kg and post-grip was 25.9 (4.1) kg. Pre-pincher was 6.0 (1.1) kg and post-pincher was 5.9 (1.3) kg. There was a significant negative correlation between grip strength change and maternal BMI (β = -0.05, 95% CI = -0.08, -0.01, p = 0.013) and with twin scans (β = -2.00, 95% CI = -3.8, -0.26, p = 0.03). No other significant correlations existed between grip or pincher strength changes and recorded f-echo variables. Increasing maternal BMI and twin status significantly decreased grip strength in f-CS after f-echo. Future studies are needed to determine how to minimize the risk of WRMD when performing f-echo on mothers with these characteristics.