Midwife scan clinic: response to increased demand for third trimester ultrasound

Abstract

In response to the high UK stillbirth rate, the Saving Babies' Lives care bundles of 2016 and 2019 recommended increased focus on reduced fetal movements and fetal growth restriction. Adopting the recommendations precipitated a sharp increase in third trimester scans, causing existing ultrasound services to be overwhelmed. A midwife scan clinic, established at Kingston Hospital NHS Trust in 2019, has been found to manage this increased scan demand efficiently and effectively. Midwife-sonographers triage scan requests, perform the scans and provide post-scan management in a one-stop-shop scenario. Evaluation of the service found that it has reduced multiple appointments, streamlined women's experience, provided continuity of care and proved cost-effective. Unexpected positive outcomes also occurred for breech presentation at term and for women under the care of the safeguarding team. Combining midwifery and ultrasound skills in a midwife scan clinic is a quality improvement initiative that facilitates the increasingly central role that ultrasound plays in fetal surveillance.