EP19.14: Seeing the unseen: obstetricians' perspectives on intrapartum ultrasound in delivery rooms

In recent years, the integration of ultrasound (US) in labour has advanced significantly, potentially influencing clinical decisions and outcomes for mothers and neonates. Despite accumulating evidence suggesting its safety, intrapartum US remains a contentious adjunctive tool in delivery rooms, lacking consensus and demonstrating limited statistically significant benefits. This study aimed to explore obstetricians' attitudes and practices regarding intrapartum US. We conducted a web-based survey to gather insights into obstetricians' general approach to intrapartum US and its utilization across various stages of labour. Overall, 229 obstetricians received the questionnaire, completed by 58 interns and 59 senior obstetricians (74% female, 26% male). According to respondents, 85% use US before operative vaginal delivery, and 36% employ it for coached US-guided maternal pushing. The majority view US as a complementary tool, not replacing digital exams for assessing station and position. Regardless of seniority or gender, most state that integrating US in delivery rooms can reduce maternal and neonatal morbidity and improve the labour experience (69% males vs. 74% females, 64% interims vs. 77% senior doctors). Perception of intrapartum US benefits correlates inversely with centre size, with larger centres expressing more scepticism compared to small and medium-sized centres (50% vs. 74% vs. 80%, respectively, p value<0.05). While US is commonly used to determine position and head station during active and second stages, its utilization for cervical dilation and effacement assessment remains limited. In the third stage, most obstetricians employ US after uterine revision but not before (73% vs 41%). This study shows promising acceptance of intrapartum ultrasound as an adjunctive tool, yet its utilization lags behind perceived benefits. Training within residency programs and enhanced equipment provision in delivery rooms may increase exposure and encourage broader use of intrapartum US, potentially enhancing obstetric outcomes.