A systematic review and meta-analysis published in PLOS Medicine evaluated the accuracy, feasibility, and clinical impact of teleultrasound in antenatal care. The analysis, led by Jack Le Vance, of the Department of Applied Health Sciences, University of Birmingham, United Kingdom, and colleagues, included 71 studies from 27 countries, examining both real-time (synchronous) and store-and-forward (asynchronous) teleultrasound systems across hospital, community, and home settings.
Teleultrasound allows ultrasound images to be transmitted to a remote specialist for interpretation. It has been proposed as a strategy to improve access to obstetric imaging in rural or underserved areas.
In pooled analyses, teleultrasound demonstrated diagnostic performance comparable to conventional ultrasound for identifying fetal and placental structures. The pooled risk ratio for fetal structure identification was 1.02, indicating noninferiority.
Diagnostic accuracy analysis showed strong overall performance, with an area under the receiver operating characteristic curve of 0.93. The pooled sensitivity was 70%, and the pooled false-positive rate was 3%. Interobserver agreement ranged from moderate to excellent, although variability was reported in assessments of more complex fetal anatomy.
Several studies reported improved prenatal detection rates and faster access to specialist consultation when teleultrasound was used. Both patients and clinicians generally reported high acceptability, particularly in settings where the technology reduced travel time and increased access to expertise.
Emerging applications included patient-operated home ultrasound systems for basic assessments such as confirming fetal cardiac activity and amniotic fluid levels. However, these systems currently support limited diagnostic scope. Three-dimensional, four-dimensional, and robotic-assisted teleultrasound platforms did not consistently outperform conventional two-dimensional imaging.
Economic evaluations suggested that although setup costs may be high, potential savings may occur through reduced travel, fewer repeat scans, and improved efficiency.
The authors noted significant heterogeneity among studies and variable reporting of technical standards. Many included studies were observational and at risk of bias. They concluded that teleultrasound appears to provide diagnostic performance comparable to standard ultrasound in selected obstetric applications but emphasized the need for additional high-quality randomized trials before broad implementation.
Source: PLOS Medicine.
