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JOGC

Guideline No. 421: Point of Care Ultrasound in Obstetrics and Gynaecology

      ABSTRACT

      Objective

      To provide an opinion regarding the usefulness of point of care ultrasound in obstetrics and gynaecology.

      Target Population

      Women with pregnancy-related complications or issues who could benefit from an urgent bedside sonographic evaluation.

      Options

      Point of care ultrasound is a readily accessible option, requiring few resources.

      Benefits, Harms, and Costs

      This low-cost imaging option can expedite appropriate patient management, enhance provider confidence, and allay the patient's anxiety in a timely fashion. However, there is potential for error in imaging or interpretation, resulting in incorrect and potentially harmful patient management.

      Evidence

      MEDLINE, PubMed, Embase, and the Cochrane Library weres earched from 2009 to 2019. Medical Subject Headings (MeSH) and keywords were related to pregnancy, PoCUS, point of care ultrasound, and bedside ultrasound. This document represents an abstraction of the evidence rather than a methodological review.

      Validation Methods

      The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations).

      Intended Audience

      Providers of urgent care for pregnant women (obstetricians and gynaecologists, family physicians, emergency room physicians, midwives, nurse practitioners, nurses).

      SUMMARY STATEMENT (GRADE ratings in parentheses)

      • 1
        Point of care ultrasound can provide timely and valuable information for management of several complications or issues that arise during pregnancy, labour and delivery, and the postpartum period (low).

      RECOMMENDATIONS (GRADE ratings in parentheses)

      • 1
        All units providing urgent care to pregnant women (including labour and delivery services) should strive to provide 24-hour access to point of care ultrasound (conditional, low).
      • 2
        Training, accreditation, and quality assurance for point of care ultrasound should be guided by standards established by regional or local health authorities or local regulatory or credentialing bodies (conditional, low).

      Keywords

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