{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:29:50Z","timestamp":1791462590799,"version":"4.3.4"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,4,11]],"date-time":"2014-04-11T00:00:00Z","timestamp":1397174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Health Research Board of Ireland","award":["POR\/2010\/55"],"award-info":[{"award-number":["POR\/2010\/55"]}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether the use of ultrasound can reduce the incidence of incorrect diagnosis of the fetal head position at instrumental delivery and subsequent morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      Two\u2010arm, parallel, randomised trial, conducted from\n                      <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>\n                      une 2011 to\n                      <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>\n                      ecember 2012.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      Two maternity hospitals in the\n                      <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>\n                      epublic of\n                      <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>\n                      reland.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample<\/jats:title>\n                    <jats:p>A cohort of 514 nulliparous women at term (\u226537\u00a0weeks of gestation) with singleton cephalic pregnancies, aiming to deliver vaginally, were recruited prior to an induction of labour or in early labour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>If instrumental delivery was required, women who had provided written consent were randomised to receive clinical assessment (standard care) or ultrasound scan and clinical assessment (ultrasound). [Correction added on 17 April 2014, after first online publication: Sentence was amended.]<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measure<\/jats:title>\n                    <jats:p>Incorrect diagnosis of the fetal head position.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence of incorrect diagnosis was significantly lower in the ultrasound group than the standard care group (4\/257, 1.6%, versus 52\/257, 20.2%; odds ratio 0.06; 95% confidence interval 0.02\u20130.19;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). The decision to delivery interval was similar in both groups (ultrasound mean 13.8\u00a0minutes,\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      8.7\u00a0minutes, versus standard care mean 14.6\u00a0minutes,\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      10.1\u00a0minutes,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.35). The incidence of maternal and neonatal complications, failed instrumental delivery, and caesarean section was not significantly different between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An ultrasound assessment prior to instrumental delivery reduced the incidence of incorrect diagnosis of the fetal head position without delaying delivery, but did not prevent morbidity. A more integrated clinical skills\u2010based approach is likely to be required to prevent adverse outcomes at instrumental delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.12810","type":"journal-article","created":{"date-parts":[[2014,4,11]],"date-time":"2014-04-11T02:52:07Z","timestamp":1397184727000},"page":"1029-1038","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":147,"title":["Instrumental delivery and ultrasound : a multicentre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery"],"prefix":"10.1111","volume":"121","author":[{"given":"M","family":"Ramphul","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Trinity College Dublin Coombe Women and Infants University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PV","family":"Ooi","sequence":"additional","affiliation":[{"name":"Mid\u2010Western Regional Maternity Hospital Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Burke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Graduate Entry Medical School University of Limerick Mid\u2010Western Regional Maternity Hospital Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MM","family":"Kennelly","sequence":"additional","affiliation":[{"name":"University College Dublin Coombe Women &amp; Infant's University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SAT","family":"Said","sequence":"additional","affiliation":[{"name":"Mid\u2010Western Regional Maternity Hospital Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AA","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Bristol Randomised Trials Collaboration School of Social and Community Medicine University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DJ","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Trinity College Dublin Coombe Women and Infants University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7451.1302"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-0528.2003.01463.x"},{"key":"e_1_2_7_4_1","first-page":"9","article-title":"Births: final data for 2010","volume":"61","author":"Martin J","year":"2012","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_7_5_1","unstructured":"BirthChoiceUK[Internet]. 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