Point-of-care ultrasound (POCUS) has rapidly evolved from a supplementary imaging tool into a cornerstone of modern clinical practice. With the advent of portable and handheld ultrasound devices, high-quality imaging is no longer confined to radiology departments or tertiary hospitals. In Bangladesh—where maternal and newborn health remains a critical public health priority—this transformation is especially meaningful.
What Is Point-of-Care Ultrasound?
Point-of-care ultrasound refers to focused ultrasound examinations conducted at the patient’s bedside by the treating clinician to answer immediate clinical questions. Unlike traditional imaging—typically scheduled and performed in dedicated imaging suites—POCUS is real-time, goal-oriented, and closely tied to clinical decision-making. Portable systems range from compact laptop-style devices to handheld probes that connect to smartphones or tablets.
Why Portable Ultrasound Matters in Pregnancy Care in Bangladesh
Despite significant progress, Bangladesh continues to face challenges in maternal and newborn health. The maternal mortality ratio has declined over the past decades but remains high; recent estimates place it around 136 maternal deaths per 100,000 live births, far above the Sustainable Development Goal (SDG) target of less than 70 by 2030. Meanwhile, antenatal care (ANC) uptake remains suboptimal—with only around 41% of pregnant women receiving the recommended four or more ANC visits during pregnancy.
These data point to a gap in timely and quality pregnancy care, contributing to preventable maternal and perinatal complications. Portable ultrasound has a unique role to play in closing this gap by bringing essential imaging directly to where women seek care.
Key Pregnancy Applications of Point-of-Care Ultrasound
Portable ultrasound enhances maternal and fetal care by enabling early detection, rapid decision-making, and improved access—even outside major hospitals or diagnostic centers.
1. Confirming Pregnancy and Viability
In early pregnancy, clinicians can confirm an intrauterine pregnancy and assess fetal cardiac activity, which provides reassurance and helps identify potential ectopic or non-viable pregnancies quickly.
2. Estimating Gestational Age
In settings where women may present late or recall of last menstrual date is uncertain, point-of-care measurements like crown-rump length allow clinicians to estimate gestational age reliably.
3. Monitoring Fetal Growth and Presentation
In later trimesters, POCUS helps assess fetal growth and position (e.g., breech or cephalic), which is critical for delivery planning—especially where specialized imaging services are unavailable.
4. Assessing Amniotic Fluid and Placental Location
Qualitative assessments of fluid volume and placenta position can prompt timely referrals for comprehensive evaluation and management when anomalies are detected.
Supporting Broader Antenatal Care Goals
Available data show that routine ANC visits often include ultrasound as part of the evaluation—historically, up to 80% of women who attend ANC reported having an ultrasound scan, although access is uneven across geographic areas and facility types.
However, access to ultrasound in community clinics is limited, and many women only receive imaging once they reach higher-level facilities. Integrating portable ultrasound into primary and outreach services can help ensure earlier and more equitable imaging access, reducing delays in diagnosis and referral.
Addressing Inequities and Improving Access
In rural and resource-limited areas, portable ultrasound can be a game changer. Mobile clinics, community health workers, and midwife-led services equipped with portable devices can:
Enable earlier identification of high-risk pregnancies
Support timely referral to higher-level care
Reduce unnecessary travel and out-of-pocket costs for patients
Strengthen trust and engagement between women and healthcare providers
Training and Responsible Implementation
While portable ultrasound is a powerful tool, appropriate training and quality assurance are critical. POCUS is not meant to replace comprehensive diagnostic scans but to complement clinical assessment and strengthen decision-making at the point of care.
Health systems must invest in training clinicians and midwives, establish clear protocols, and ensure quality control to optimize the benefits of point-of-care imaging.
Looking Ahead: Future Directions in Bangladesh
Bangladesh’s public health frameworks increasingly emphasize quality antenatal and maternal care. Integrating portable ultrasound into these frameworks—supported by training, supervision, and monitoring systems—can significantly enhance maternal and fetal health outcomes. As technologies evolve, including innovations like AI-assisted imaging and tele-ultrasound support, the potential for portable devices to improve access and quality of care will only grow.
Conclusion
Portable ultrasound has the potential to revolutionize pregnancy and fetal care in Bangladesh, especially when integrated into point-of-care settings across the health system. By bringing critical imaging services closer to women—particularly those in underserved areas—POCUS enhances clinical decision-making, supports earlier detection of complications, and strengthens the overall continuum of maternal and newborn care.
In a country striving toward its maternal and child health goals, point-of-care ultrasound is not just a convenience—it’s a vital tool for saving lives.