• The effectiveness of intrapartum ultrasonography in assessing cervical dilatation, head station and position: A systematic review and meta-analysis

      Wiafe, Yaw Amo; Whitehead, Bill; Venables, Heather; Nakua, Emmanuel Kweku; University of Derby (2016-10-06)
    • Is ultrasound screening for vasa praevia clinically justified and a financially viable screening test? A literature review.

      Coleman, Gillian; Venables, Heather; University of Derby; College of Health and Social Care, University of Derby, Derby, UK; College of Health and Social Care, University of Derby, Derby, UK (Sage, 2018-02-01)
      Vasa praevia is an obstetric complication currently not screened for within the United Kingdom, which if undetected prenatally can lead to fetal death when the membranes rupture. Internationally, guidelines are available providing guidance on the best screening policy and management pathways. However, the UK National Screening Committee and Royal College of Obstetricians and Gynaecologists do not support screening due to a lack of evidence. Recent studies explore the ability of ultrasound to detect vasa praevia prenatally in both the general and high-risk populations. Whilst there is no consensus on the ‘best’ screening strategy, the majority of authors note that targeted screening of the high-risk population is the most achievable and cost-effective strategy. Although not infallible, a standard screening protocol could identify the majority of cases in the high-risk group. Introduction of a screening strategy would affect training needs of professionals within the UK and would have implications on the need to produce guidelines on management and quality assurance. Further research is also needed to define a relevant high-risk population and explore how this would impact on service provision. This review explores the current evidence base for systematic screening and the implications for service.
    • Sonographic parameters for diagnosing fetal head engagement during labour.

      Wiafe, Yaw Amo; Whitehead, Bill; Venables, Heather; Odoi, Alexander T.; University of Derby; Kwame Nkrumah University of Science and Technolog; Department of Nursing, Radiography and Healthcare, University of Derby, Derby, UK; Department of Nursing, Radiography and Healthcare, University of Derby, Derby, UK; Department of Nursing, Radiography and Healthcare, University of Derby, Derby, UK; Department of Obstetrics and Gynaecology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana (Sage, 2018-02-01)
      The purpose of this study was to investigate the diagnostic performance of the head–perineum distance, angle of progression, and the head–symphysis distance as intrapartum ultrasound parameters in the determination of an engaged fetal head. Two hundred and one women in labour underwent both ultrasound and digital vaginal examination in the estimation of fetal head station. The transperineal ultrasound measured head–perineum distance, angle of progression, and head–symphysis distance for values correlating with digital vaginal examination head station. Using station 0 as the minimum level of head engagement, correlating cutoff values for head–perineum distance, angle of progression, and head–symphysis distance were obtained. Receiver operating characteristics were used in determining the diagnostic performance of these cut-off values for the detection of fetal head engagement. With head–perineum distance of 3.6 cm the sensitivity and specificity of sonographic determination of engaged fetal head were 78.7 and 72.3%, respectively. A head–symphysis distance of 2.8 cm also had sensitivity and specificity of 74.5 and 70.8%, respectively, in determining engagement, whilst an angle of progression of 101 was consistent with engagement by digital vaginal examination with 68.1% sensitivity and 68.2% specificity. Ultrasound shows high diagnostic performance in determining engaged fetal head at a head–perineum distance of 3.6 cm, head–symphysis distance of 2.8 cm, and angle of progression of 101.
    • Ventilatory muscle strength, diaphragm thickness and pulmonary function in world-class powerlifters.

      Brown, Peter I.; Venables, Heather; Liu, Hymsuen; de Witt, Julie T.; Brown, Michelle R.; Faghy, Mark; University of Derby (Springer, 2013)
      Resistance training activates the ventilatory muscles providing a stimulus similar to ventilatory muscle training. We examined the effects of elite powerlifting training upon ventilatory muscle strength, pulmonary function and diaphragm thickness in world-class powerlifters (POWER) and a control group (CON) with no history of endurance or resistance training, matched for age, height and body mass.