IMR Press / CEOG / Volume 47 / Issue 3 / DOI: 10.31083/j.ceog.2020.03.5307
Open Access Original Research
Ultrasound by midwives in the postpartum period: feasibility, reproducibility and midwives’ perspectives
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1 Department of Obstetrics and Gynaecology, Antwerp University Hospital UZA and Antwerp University UA, ASTARC and Global Health, Edegem, Belgium
*Correspondence: (YVES JACQUEMYN)
Clin. Exp. Obstet. Gynecol. 2020, 47(3), 348–354;
Submitted: 7 June 2019 | Accepted: 24 September 2019 | Published: 15 June 2020
Copyright: © 2020 Coremans et al. Published by IMR press.
This is an open access article under the CC BY 4.0 license

Objective: To describe feasibility, reproducibility, and acceptability of introducing ultrasound by midwives as a routine in postpartum care. Materials and Methods: A quantitative, monocentric cross-sectional study used questionnaires to evaluate the viewpoint of the midwife and the mother; repeat transabdominal ultrasound measurements were made of uterine length, width, height, and endometrial thickness by midwives, junior gynaecology trainees, and experienced gynaecologic ultrasonographers, 24 to 48 hours after delivery; Bland-Altman plotting assessed interand intra-observer variability. Results: Fifty-five percent of midwives considered implementation of ultrasound in postpartum care as feasible; time restrictions were seen as an obstacle by 60%, and 97% considered themselves after training as capable to perform postpartum ultrasound autonomously. Almost all mothers valued the ultrasound as non-disturbing and interesting. Inter-observer variability demonstrated a fixed bias between midwives and gynaecologists for total uterine length but not for other measurements. Intra-observer variability decreased with experience but was generally low and there was no fixed bias. Conclusion: Midwives saw postpartum ultrasound as feasible in daily practice, reproducibility was acceptable, and the mothers’ experience was positive. More study is needed to evaluate the eventual clinical value of routine postpartum ultrasound.

Retained products of conception
Figure 1.
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