Diagnostic accuracy of handheld ultrasound, performed in community and hospital settings at 36 weeks to determine fetal presentation: the Sono-breech study protocol.

introductionAround 4% of babies are in breech presentation at the end of pregnancy but up to 43% of these are missed by abdominal palpation alone. Since women in the UK without additional risk factors do not routinely receive a scan in the third trimester, around 1%-2% of women present with undiagnosed breech presentation in labour, which is associated with poorer outcomes for both mothers and babies. Research suggests a point-of-care ultrasound (PoCUS) scan in late pregnancy could improve the rate of breech presentation detection. The Sono-breech study aims to determine the diagnostic accuracy and acceptability of handheld scans performed by midwives for fetal presentation at 36 weeks and how cost-effective this would be to implement in routine antenatal care in the National Health Service (NHS). METHODS AND ANALYSIS: Prior to delivering the study, midwives receive training for the detection of presentation and fetal heart rate using handheld ultrasound equipment.The study will take place in at least 10 NHS Trusts across England selected to ensure a diverse participant population and to include under-researched settings. Between 35 ETHICS AND DISSEMINATION: The study has obtained approval from the West Midlands-South Birmingham Research Ethics Committee and was approved by the Health Research Authority and Health and Care Research Wales. Publication will be in line with the National Institute of Health and Care Research (NIHR) Open Access policy.