Feasibility and acceptability of point-of-care ultrasound delivered by midwives during routine antenatal care in Malawi: a prospective implementation science study

作者：Chipiliro Payesa, Linly Seyama, Yamikani Chimwaza, Fidelis Sindani, Yankho Kanise, Elida Bvutula, Modesta Phiri, Pempho Nyangulu, Luis Gadama, Fanny Kachale, Gladys Gadama, Mary Mwale, Gayane Yenokyan, Pooja Sripad, Anne Hyre, Lisa Noguchi, Sufia Dadabhai · 发表于：BMJ Open · 年份：2025 · DOI：10.1136/bmjopen-2025-100515 · 被引用次数：5 · 研究领域：Ultrasound in Clinical Applications、Maternal and Perinatal Health Interventions、Global Maternal and Child Health

OBJECTIVES: To evaluate the feasibility and acceptability of integrating point-of-care ultrasound scan (POCUS) by midwives into routine antenatal care (ANC) services. DESIGN: Prospective, observational, multiphase, implementation science study. MAIN OUTCOME MEASURES: Primary outcomes included the proportion of midwives who completed training and competency checks for basic obstetric scanning using a POCUS device; the feasibility and acceptability of midwife-delivered POCUS from the perspectives of midwives and pregnant women captured on structured questionnaires; and the proportion of scans meeting predefined quality standards. Secondary outcomes included responses to acceptability-related questionnaires administered to midwives and pregnant women. SETTING: Rural, periurban and urban health centres in Blantyre District, Malawi. PARTICIPANTS: Pregnant women attending ANC and midwives providing care at participating health facilities. RESULTS: Obstetric registrars trained and mentored 45 midwives, and 42 (93%) completed the training. Most midwives (95%, n=40) found providing POCUS during ANC was feasible and acceptable. Overall, device durability was rated positively. Of the 1499 pregnant women who received a scan, 99% (n=1484) reported that receiving an ultrasound from a midwife during ANC was acceptable. Independent assessors determined that over 70% of the subsample of reviewed scans met minimum quality standards. CONCLUSIONS: Midwife-delivered POCUS is feasible and highly a...