Impact of Sonographer Experience, Insonation Angle, and Bladder Filling on Uterine Artery Doppler Measurements in the First Trimester of Pregnancy

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine Pub Date : 2024-09-09 DOI:10.1002/jum.16572

Sabrina Einig MD, Cécile Monod MD, Hanna Baumann MD, Annkathrin Butenschön MD, Jasmin Engesser-Mussbah MD, Hubertina Reina MD, Andreas Schoetzau, Beatrice Mosimann MD, Gwendolin Manegold-Brauer MD

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Abstract

Objective

To investigate the influence of different measurement conditions and ultrasound training level on uterine artery pulsatility index (UtA-PI) measurements as required for combined first trimester preeclampsia (PE) screening.

Methods

This was a prospective study of consecutive patients with singleton pregnancies presenting for an ultrasound examination between 11 and 14 weeks' gestation. UtA-PI measurements were conducted by residents in training and repeated by experienced sonographers thereafter. UtA-PI measurements were conducted under different examination conditions. First, the trainee sonographers performed transabdominal sagittal and transverse UtA-PI measurements without bladder filling. These measurements were then repeated by the expert sonographers. Additionally, the expert sonographers also performed transvaginal UtA-PI measurements and transabdominal measurements with bladder filling. Statistical analysis was conducted with the statistical software R and included descriptive statistics as well as 2-sided paired t tests.

Results

A total of 100 women were included in the study. Mean age was 31.7 ± 4.92 years and mean gestational week was 12.5 ± 0.53 weeks. A total of 56% were nulliparous and 44% were parous. UtA-PI was significantly lower if performed by a sonographer in training versus an experienced sonographer (P = .031). No significant difference was observed in comparing transverse and sagittal techniques (P = .241). There was also no significant difference in transabominal versus transvaginal measurements (P = .806) and with an empty versus full bladder (P = .444).

Conclusion

Experience of sonographer has a significant impact on UtA-PI. Supervised onsite training is necessary to improve reliability and consistency of UtA-PI measurements and make PE screening reliable for implementation in a universal screening setting.

Abstract Image

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超声技师的经验、声纳角和膀胱充盈度对妊娠头三个月子宫动脉多普勒测量的影响

目的研究不同测量条件和超声培训水平对子宫动脉搏动指数（UtA-PI）测量结果的影响，该测量结果是合并妊娠头三个月子痫前期（PE）筛查的必要条件。UtA-PI 测量由正在接受培训的住院医生进行，之后由经验丰富的超声技师重复测量。UtA-PI 测量是在不同的检查条件下进行的。首先，受训超声技师在没有膀胱充盈的情况下进行经腹矢状面和横向 UtA-PI 测量。然后由专业超声技师重复这些测量。此外，专业超声技师还在膀胱充盈的情况下进行了经阴道的 UtA-PI 测量和经腹测量。统计分析使用 R 统计软件进行，包括描述性统计和双侧配对 t 检验。平均年龄为（31.7 ± 4.92）岁，平均孕周为（12.5 ± 0.53）周。56%的妇女为单胎，44%为双胎。由接受过培训的超声技师与经验丰富的超声技师相比，UtA-PI明显较低（P = 0.031）。横切和矢状切面技术比较无明显差异（P = .241）。经腹与经阴道测量（P = .806）以及空膀胱与满膀胱测量（P = .444）也无明显差异。为了提高 UtA-PI 测量的可靠性和一致性，并使 PE 筛查可靠，以便在普遍筛查环境中实施，有必要进行有监督的现场培训。

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来源期刊

Journal of Ultrasound in Medicine 医学-核医学

CiteScore

5.10

自引率

4.30%

发文量

205

审稿时长

1.5 months

期刊介绍： The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound