Incorporating personal-device-based point-of-care ultrasound into obstetric care: a validation study

Published:November 10, 2021DOI:


      Personal-device-based point-of-care-ultrasound (P-POCUS) probes plug directly into a cell phone or tablet to function as its display, creating the potential to increase access to obstetric ultrasonography in complex healthcare settings (COVID units, low resource settings); however, new technology must be proven to be reliable in the obstetric setting before integrating into practice.


      To evaluate the intraclass correlation (reliability) of personal-device-based-point-of-care-ultrasound devices as compared with standard ultrasound machines in obstetrics.

      Study Design

      This was a prospective, observational study of patients between 19–39 weeks gestation in an urban, prenatal ultrasound diagnosis center. Each patient underwent assessment by an expert sonographer using standard ultrasound machines and personal-device-based-point-of-care-ultrasound devices to determine estimated fetal weight. The statistical reliability and agreement between the estimated fetal weights was assessed through intraclass correlation coefficients, Bland-Altman plots, and Pearson correlation coefficients.


      100 paired sets of scans were performed from October 2020 to December 2020. For the estimated fetal weights, there was near-perfect agreement, with an intraclass correlation coefficient of 0.99 (P<.0001). Bland-Altman analysis showed an average difference of 53 grams, with 95% limit of agreement between −178 grams and 283 grams. Pearson correlation showed near-perfect correlation between the measurements (r=0.99, P<.0001).


      personal-device-based point-of-care-ultrasound devices are reliable tools for performing basic obstetrical ultrasound and have the potential to increase access to obstetrical ultrasound worldwide.

      Key words

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        • Donald I.
        • Macvicar J.
        • Brown T.G.
        Investigation of abdominal masses by pulsed ultrasound.
        Lancet. 1958; 1: 1188-1195
        • Campbell S.
        A short history of sonography in obstetrics and gynaecology.
        Facts views Vis ObGyn. 2013; 5: 213-229
        • Moore C.L.
        • Copel J.A.
        Point-of-care ultrasonography.
        N Engl J Med. 2011; 364: 749-757
        • Rosen Z.
        • Chan D.
        • Kelly R.E.
        • Han D.
        • Hollifield L.
        • Doyle N.
        Unique exposure to ultrasound in pre-clinical undergraduate medical education [39A].
        Obstet Gynecol. 2020; 135: 18S
        • Sayasneh A.
        • Preisler J.
        • Smith A.
        • et al.
        Do pocket-sized ultrasound machines have the potential to be used as a tool to triage patients in obstetrics and gynecology?.
        Ultrasound Obstet Gynecol. 2012; 40: 145-150
        • Turrentine M.
        • Ramirez M.
        • Monga M.
        • et al.
        Rapid deployment of a drive-through prenatal care model in response to the coronavirus disease 2019 (COVID-19) pandemic.
        Obstet Gynecol. 2020; 136: 29-32
        • Kozuki N.
        • Mullany L.C.
        • Khatry S.K.
        • et al.
        Accuracy of home-based ultrasonographic diagnosis of obstetric risk factors by primary-level health care workers in rural Nepal.
        Obstet Gynecol. 2016; 128: 604-612
        • Galjaard S.
        • Baeck S.
        • Ameye L.
        • Bourne T.
        • Timmerman D.
        • Devlieger R.
        Use of a pocket-sized ultrasound machine (PUM) for routine examinations in the third trimester of pregnancy.
        Ultrasound Obstet Gynecol. 2014; 44: 64-68
        • Sarris I.
        • Ioannou C.
        • Chamberlain P.
        • et al.
        Intra- and interobserver variability in fetal ultrasound measurements.
        Ultrasound Obstet Gynecol. 2012; 39: 266-273
        • Lu M.J.
        • Zhong W.H.
        • Liu Y.X.
        • Miao H.Z.
        • Li Y.C.
        • Ji M.H.
        Sample size for assessing agreement between two methods of measurement by Bland-Altman method.
        Int J Biostat. 2016; 12
        • Hadlock F.P.
        • Harrist R.B.
        • Martinez-Poyer J.
        In utero analysis of fetal growth: a sonographic weight standard.
        Radiology. 1991; 181: 129-133
        • Koo T.K.
        • Li M.Y.
        A guideline of selecting and reporting intraclass correlation coefficients for reliability research.
        J Chiropr Med. 2016; 15: 155-163
        • Ranganathan P.
        • Pramesh C.S.
        • Aggarwal R.
        Common pitfalls in statistical analysis: measures of agreement.
        Perspect Clin Res. 2017; 8: 187-191