Via Research Recognition Day 2024 VCOM-Carolinas

Educational Reports

ULTRASOUND COMPATIBLE TRAINING HARDWARE FOR DETERMINING FETAL CROWN-RUMP LENGTH MEASUREMENT IN UTERO Alyssa McMandon, OMS-II*; Haleigh Stein, MS, OMS-II*; Michael Benavidez Arias, MA, OMS-II; Cesar Prugue, OMS-II; Michael Parks, MPA, NREMT; Tom Lindsey, DO, FACOS, CHSE Edward Via College of Osteopathic Medicine, Spartanburg, SC Introduction Development Conclusions

Background: Crown-Rump Length (CRL) is an essential measurement during prenatal care. 1 CRL is the distance from cranial to caudal ends of the fetus. 2 This measurement helps to estimate gestational age from weeks 6 to 13 due to the variability in fetal size during early pregnancy. 3 Measurement errors can significantly affect the estimated fetal weight leading to flaws in clinical assessment and patient management. 1 Challenge: During the didactic years, medical students often experience obstacles in attaining access to interactions with actual patients.There is not currently a training model to develop the skill required to collect CRL measurements. Rational: Simulation learning can provide hands-on training in a safe, controlled environment. Such a model would facilitate better outcomes when measuring CRL in the clinical setting. Objective: Development of a cost-effective, ultrasound compatible training device that accurately simulates measuring CRL in utero to prepare medical students to perform this skill during clinical encounters.

Conclusion: Implementation of an anatomically accurate, ultrasound-compatible device capable of allowing medical students to practice determining CRL in the didactic years stands to be done. Introduction of this hardware device to the medical curriculum would provide students the opportunity to practice successfully determining CRL and prepare them to do so in the clinical setting. Proof of Concept: Preliminary data effectively demonstrated that this device is a useful tool allowing students to determine CRL via ultrasound. Based on the preliminary data, combined with ultrasound and CRL training, this model will serve as a useful resource in allowing students to practice the skill of accurately measuring CRL to determine gestational age. Impact: Future applications of this device could be adapted for students to practice identifying fetal pathologies. Fetal models exhibiting various pathologies could enable students to practice diagnosis via ultrasound. Additionally, the use of this device within an anatomically accurate pelvic cavity, wearable device, or mannikin could support the development of realistic simulations which closely mirror clinical encounters.

Fetal Crown Rump Length Trainer Development

B.

A.

Figure 1. Process for Trainer Development The replication of the fetus was molded from a clay model to be 50.8 mm and then was casted using Reynold's Advance Materials (A) . The CRL trainer was crafted with three layers, each mimicking specific aspects - one replicating the fetus, another replicating gestational features, and a third layer compatible with ultrasound imaging, resembling skin (B) .

Data Collection

Procedure Development A.

Preliminary Data

References

B.

Student

Measurement

1 2 3 4 5

45.7 mm 63.1 mm 46.7 mm 68.3 mm 49.1 mm 50.8 mm

1. Gadsbøll, K., Wright, A., Kristensen, S. E., Verfaille, V., Nicolaides, K. H., Wright, D., & Petersen, O. B. (2021). Crown – rump length measurement error: impact on assessment of growth. Ultrasound in Obstetrics and Gynecology, 58(3), 354 – 359. https://doi.org/10.1002/uog.23690 2. Blaas, H. G. K., & Carrera, J. A. M. (2009). Investigation of early pregnancy. Ultrasound in Obstetrics and Gynaecology Book and CD-ROM, 57 – 78. https://doi.org/10.1016/B978-0-444-51829-3.00004-0 3. Jones, J., & Gaillard, F. (2008). Crown rump length. In Radiopaedia.org. Radiopaedia.org. https://doi.org/10.53347/rID-1186

Actual Measurement

Table 1. Crown-Rump Length Measurement • 5 second-year medical students from VCOM - Carolinas were instructed to use prerequisite ultrasound knowledge to measure CRL of the hardware device. • Further data collection will be performed with a group of ultrasound-trained participants determining a range of fetal model sizes.

Figure 2. Ultrasound of CRL Model An ultrasound machine was used to identify the location of the replicated fetus within the CRL trainer (A) . Each medical student measured the CRL by drawing a line from the most cranial point to most caudal point of the fetus (B) .

We would like to thank the Sim Center for their investment in our education and resources used for our project.

98

2024 Research Recognition Day