The validity and reliability of the StationMaster: A device to improve the accuracy of station assessment in labour

ObjectiveTo compare the accuracy of digital assessment and the StationMaster (SM) in the assessment of fetal head station. The SM is a simple modification of the amniotomy hook which works by relocating the point of reference for station assessment from the ischial spines to the posterior fourchette. It is first adjusted to the woman's pelvic size, and then inserted into the vagina until it touches the fetal head. The station is then read off at the posterior fourchette in cm.Study designAn in vitro study of test validity and reliability was conducted at Liverpool Women's Hospital, Liverpool, UK. An apparatus was constructed in which a model fetal head could be accurately positioned within a mannequin's pelvis. Twenty midwives and 20 doctors (in current labour ward practice) gave their consent to take part. First, the head was placed in 5 random stations (−2 to +7 cm) and the participant asked to record their digital assessment for each. The participant was then taught to use the SM and the experiment repeated with 5 new stations. The complete experiment was repeated at least 2 weeks later using the same stations but in reverse order. The true values were compared with both the digital and SM assessments using mean differences with 95% limits of agreement. The repeatability of the two methods was assessed in the same way.ResultsOverall, the SM was more accurate than digital examination. The mean error (S.D.) ranged from 0.1 (1.2) to 2.6 (1.6) for the StationMaster and 0.3 (1.3) to 4.3 (1.1) for digital examination. Inaccuracies increased as the head descended through the pelvis. When assessed digitally, the true value fell outside one standard deviation for stations of more than +1 cm. In contrast, with the SM the true value remained inside one standard deviation for all stations up to +5.ConclusionsIn vitro the SM improves the accuracy of intrapartum station assessment.