Obstetric ultrasound scanning by local health workers in a refugee camp on the Thai-Burmese border.
Obstetric ultrasound scanning by local health workers in a refugee camp on the Thai-Burmese border.
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DOI：
10.1002/uog.7350
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发表时间：
2009-10
影响因子：
7.1
通讯作者：
McGready, R.
中科院分区：
文献类型：
--
作者：
Rijken, M. J.;Lee, S. J.;Boel, M. E.;Papageorghiou, A. T.;Visser, G. H. A.;Dwell, S. L. M.;Kennedy, S. H.;Singhasivanon, P.;White, N. J.;Nosten, F.;McGready, R.
胎儿超声检查是评估胎龄和发现产科问题的有力工具，但在发展中国家很少使用。本研究的目的是评估在泰缅边境的难民营中由当地培训的卫生工作者进行的胎儿生物测量的观察者内和观察者间的一致性。一名外籍医生和四名当地保健工作者参加了这项研究，其中包括对每五名在Maela难民营产前诊所接受过早期超声波扫描的怀孕16至40周的单胎孕妇进行检查。每次检查时，两名检查员独立测量双顶径（BPD）、头围（HC）、腹围（AC）和股骨长度（FL），其中一名检查员重复测量每个参数。使用组内相关系数（ICC）评估观察者内测量误差，使用Bland和Altman 95%一致性限方法评估观察者间误差。2008年，在349例中位胎龄为27周（范围：16-40周）的孕妇中，共进行了4188次超声测量（每名妇女12次）。所有四名受训人员和医生的BPD、HC、AC和FL的ICC均大于0.99（范围：0.996-0.998）。对于18 - 24周的胎龄，计算了BPD、HC、AC和FL的观察者间95%一致性限度（对应于估计胎龄差异小于± 1周）。当地卫生工作者的测量结果显示与外籍医生的测量结果高度一致。在一个组织良好的单位中工作的当地训练有素的卫生工作者，通过持续的质量控制，可以获得准确的胎儿生物测量结果，用于估计胎龄。这一经验表明，在发展中国家培训当地卫生工作者是可能的，并可使产科超声波成像得到有效利用。Copyright © 2009 ISUOG.出版社：John Wiley & Sons，Ltd
Ultrasound examination of the fetus is a powerful tool for assessing gestational age and detecting obstetric problems but is rarely available in developing countries. The aim of this study was to assess the intraobserver and interobserver agreement of fetal biometry by locally trained health workers in a refugee camp on the Thai–Burmese border. One expatriate doctor and four local health workers participated in the study, which included examinations performed on every fifth pregnant woman with a singleton pregnancy between 16 and 40 weeks' gestation, and who had undergone an early dating ultrasound scan, attending the antenatal clinic in Maela refugee camp. At each examination, two examiners independently measured biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL), with one of the examiners obtaining duplicate measurements of each parameter. Intraobserver measurement error was assessed using the intraclass correlation coefficient (ICC) and interobserver error was assessed by the Bland and Altman 95% limits of agreement method. A total of 4188 ultrasound measurements (12 per woman) were obtained in 349 pregnancies at a median gestational age of 27 (range, 16–40) weeks in 2008. The ICC for BPD, HC, AC and FL was greater than 0.99 for all four trainees and the doctor (range, 0.996–0.998). For gestational ages between 18 and 24 weeks, interobserver 95% limits of agreement corresponding to differences in estimated gestational age of less than ± 1 week were calculated for BPD, HC, AC and FL. Measurements by local health workers showed high levels of agreement with those of the expatriate doctor. Locally trained health workers working in a well organized unit with ongoing quality control can obtain accurate fetal biometry measurements for gestational age estimation. This experience suggests that training of local health workers in developing countries is possible and could allow effective use of obstetric ultrasound imaging. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.
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影响因子：
3.3
作者：
Bussmann, H;Koen, E;Troeger, J
通讯作者：
Troeger, J
影响因子：
--
作者：
Bland, JM;Altman, DG
通讯作者：
Altman, DG
影响因子：
5.1
作者：
DUBOWITZ, LM;DUBOWITZ, V;GOLDBERG, C
通讯作者：
GOLDBERG, C
DOI：
10.1016/0035-9203(91)90205-d
发表时间：
1991-07-01
影响因子：
2.2
作者：
NOSTEN, F;TERKUILE, F;WHITE, NJ
通讯作者：
WHITE, NJ
影响因子：
19.7
作者：
HADLOCK, FP;DETER, RL;PARK, SK
通讯作者：
PARK, SK