Ultrasound to enhance assessment of the fetal head position prior to instrumental delivery

Abstract

This thesis is aimed at investigating the role of ultrasound to enhance diagnosis of the fetal head position prior to instrumental delivery in order to make instrumental deliveries safer.There are four components to this thesis: (i) a literature review/ to explore the evidence regarding the use of ultrasound on the labour ward and particularly to diagnose the fetal head position in labour; (ii) a questionnaire survey to establish current practice of obstetricians in the United Kingdom and Ireland relating to assessment of women before instrumental delivery; (iii) a validation study to establish the accuracy of an ultrasound scan performed by a novice ultrasonographer in the second stage of labour and, also, to establish the acceptability of ultrasound in labour to women and the clinicians looking after them; and (iv) a randomised controlled trial to evaluate the role of ultrasound to enhance the diagnosis of the fetal head position prior instrumental delivery.