Purpose: To evaluate junior residency proficiency in Estimated Fetal Weight (EFW) by ultrasound and Leopold maneuvers
Background: Estimated fetal weight (EFW) is an integral part of labor management. Evaluating resident physicians’ proficiency in this skill in important in residency training.
Methods: As a part of a quality improvement program from 2014-2020, post graduate year 1 (PGY1) and PGY2 residents performed EFWs on ten term ( >37 weeks) patients using ultrasound and Leopold’s’ maneuvers and ten preterm ( >24 weeks and < 37 weeks) patients by ultrasound. Clinical characteristics, route of delivery and actual birthweights were recorded for each patient. The accuracy of these estimates were evaluated using mixed-effect regression models. P < 0.05 was considered significant.
Results: 33 residents and 1,697 estimations were evaluated. Controlling for actual birthweight, year of residency, estimation method, and term status were not related to the accuracy of residents’ estimation. Maternal BMI was associated with decreased accuracy of estimation of full-term fetuses for both methods (p’s < .002). Among the subset of residents who performed the EFWs in both PGY1 and 2 years, there was no statistically significant difference in residents’ mean accuracy between years; however, the mean ultrasound prediction accuracy improved in 70% of residents and mean Leopold prediction accuracy improved in 50% of residents.
Discussions: Resident physicians have accurate estimates of EFW beginning in their first year of residency whether by Leopold or ultrasound. While there was trend for improvement in PGY2 compared to PGY1, overall it appears that trainees begin to have accurate assessments early in training.
Topics: CREOG & APGO Annual Meeting, 2021, Resident, Residency Director, Patient Care, Medical Knowledge, Systems-Based Practice & Improvement, GME, Assessment, Quality & Safety, Maternal-Fetal Medicine, General Ob-Gyn,
Karren Lewis, MD/MPH, Harbor UCLA Medical Center; Alicia Lunardhi, BS; Trevor Pickering, PhD; Hindi Stohl, MD, JD
