Focused maternal ultrasound by midwives in rural Zambia

Ultrasound Med Biol. 2010 Aug;36(8):1267-72. doi: 10.1016/j.ultrasmedbio.2010.05.017.


Point-of-care ultrasound is being increasingly implemented in resource-poor settings in an ad hoc fashion. We developed a focused maternal ultrasound-training program for midwives in a rural health district in Zambia. Four hundred forty-one scans were recorded by 21 midwives during the 6-month study period. In 74 scans (17%), the ultrasound findings prompted a change in clinical decision-making. Eight of the midwives were evaluated with a 14-question observed structured clinical examination (OSCE) and demonstrated a slight overall improvement with mean scores at 2 and 6 months of 10.0/14 (71%) and 11.6/14 (83%), respectively. Our pilot project demonstrates that midwives in rural Zambia can be trained to perform basic obstetric ultrasound and that it impacts clinical decision-making. Ultrasound skills were retained over the study period. More data is necessary to determine whether the introduction of ultrasound ultimately improves outcomes of pregnant women in rural Zambia.

MeSH terms

  • Female
  • Humans
  • Midwifery / statistics & numerical data*
  • Mothers
  • Pilot Projects
  • Pregnancy
  • Rural Population / statistics & numerical data*
  • Ultrasonography, Prenatal / statistics & numerical data*
  • Zambia / epidemiology