Sono-breech
Research type
Research Study
Full title
Diagnostic accuracy of handheld ultrasound at 36-weeks of gestation to determine fetal presentation.
IRAS ID
318520
Contact name
Christoph Lees
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
2 years, 6 months, 0 days
Research summary
3-4% of babies are breech (buttocks-down) presentation at term (from 37 weeks gestation). Currently midwives can detect this at routine appointments by feeling the woman’s tummy, however 30-40% of breech presentations are missed using this method, thus approximately 1.6% of women present with breech presentation in labour. External cephalic version (ECV) can be offered to turn the baby to cephalic (head-down) presentation if breech presentation is detected towards the end of pregnancy, however later in pregnancy this becomes technically difficult with lower success rates, thus is not feasible in labour. Vaginal breech delivery is associated with increased risk to baby, and caesarean section in labour also poses increased risk to both mother and baby.
The ‘gold standard’ method for diagnosing fetal presentation is a conventional ultrasound scan by an ultrasound practitioner using hospital-based equipment. Point-of-care ultrasound (PoCUS) using portable devices has become popular in some acute specialties such as emergency medicine, and handheld PoCUS devices are a more recent development; they are small, portable and simple to use. It is not known if handheld ultrasound undertaken by midwives is comparable to conventional ultrasound scan by an ultrasound practitioner in diagnosing breech presentation.
This is a multicentre observational study in up to 20 maternity units recruiting over 18 months. The primary aim is to assess the accuracy (sensitivity and specificity) of midwives detecting breech presentation using handheld PoCUS compared to conventional ultrasound scan by a STP. The study will also aim to assess how acceptable handheld PoCUS is to midwives and pregnant women, assess how cost-effective it is, evaluate the training needs of midwives undertaking handheld PoCUS through surveys and questionnaires, and to explore if the rate of undetected breech presentations in labour will be reduced with routine use of PoCUS devices.
REC name
West Midlands - South Birmingham Research Ethics Committee
REC reference
24/WM/0143
Date of REC Opinion
3 Jul 2024
REC opinion
Further Information Favourable Opinion