Instrumental delivery and ultrasound: a multicentre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

Ramphul, Meenakshi; Ooi, Poh Vei; Burke, Gerard; Kennelly, Mairead M.; Said, Soha A.T.; Montgomery, Alan A.; Murphy, Deidre J.

Abstract

Objectives: To determine whether the use of ultrasound can reduce the incidence of incorrect diagnosis of the fetal head position at instrumental delivery and subsequent morbidity.

Design: Two-arm, parallel, randomised trial, conducted from June 2011 to December 2012.

Setting: Two maternity hospitals in the Republic of Ireland.

Sample: 514 nulliparous women at term (?37 weeks' gestation) with singleton cephalic pregnancies, aiming to deliver vaginally were recruited prior to induction of labour or in early labour.

Methods: If instrumental delivery was required, women who had provided written consent were randomised to receive clinical assessment (standard care) or ultrasound scan and ultrasound assessment (ultrasound).

Main outcome: Incorrect diagnosis of the fetal head position.

Results: The incidence of incorrect diagnosis was significantly lower in the ultrasound group than the standard care group (4/257, 1.6% versus 52/257, 20.2%, odds ratio 0.06, 95% confidence interval (CI) 0.02 to 0.19, p value

• Journal Article Type: Article
• Acceptance Date: Feb 26, 2014
• Online Publication Date: Apr 10, 2014
• Publication Date: Jun 24, 2014
• Deposit Date: Nov 23, 2017
• Publicly Available Date: Nov 23, 2017
• Journal: BJOG: An International Journal of Obstetrics and Gynaecology
• Print ISSN: 1470-0328
• Electronic ISSN: 1471-0528
• Publisher: Wiley
• Peer Reviewed: Not Peer Reviewed
• Volume: 121
• Issue: 8
• DOI: https://doi.org/10.1111/1471-0528.12810
• Keywords: fetal head position; second stage of labour; intrapartum ultrasound, randomised controlled trial
• Public URL: https://nottingham-repository.worktribe.com/output/730159
• Additional Information: This is the pre-peer reviewed version of the following article: Ramphul M, Ooi PV, Burke G, Kennelly MM, Said SAT, Montgomery AA, Murphy DJ. Instrumental delivery and ultrasound (IDUS): a multicentre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery. BJOG 2014;121:1029–1038, which has been published in final form at 10.1111/1471-0528.12810. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.