AFJOG

REVIEW African Journal of Obstetrics and Gynaecology | Volume 3 | Issue 2 | 2025 | The Role of Point-of-Care Ultrasound (POCUS) in improving maternal outcomes: An overview when themother is in a supine position but increases when she is in the left lateral decubitus position. This demonstrates that, although POCUS protocols can be used during pregnancy, a thorough understanding of physiological changes is essential for accurately interpreting images and clinical findings. (9-12) It is also important to acknowledge the limitations the gravid uterus places on obtaining subxiphoid views; thus, knowing how to get the relevant images from other views is crucial. 3.AbdominalPOCUSinObstetrics Using the principles of the E-FASTprotocol, the obstetric practitioner can apply this method to evaluate the abdomen for signs of occult postpartum hemorrhage and suspected uterine rupture in trauma cases. Right upper quadrant pain is notoriously difficult to assess, and pregnancy and abdominal POCUS can help quickly diagnose cholelithiasis. In cases of HELLP syndrome, prompt detection of a hepatic subcapsular hematoma is possible by performing a right upper quadrant view according to the E-FAST protocol. Basic renal ultrasound can also aid in identifying hydronephrosis and hydroureter, as well as detecting bladder abnormalities. (13) 4.UndifferentiatedShockandMaternalCardiacArrest The RUSH protocol enables quick identification of shock causes, helping clinicians distinguish between hypovolemic shock, cardiogenic shock, obstructive causes (such as pulmonary embolism and tamponade), and septic shock. This guides the clinician in deciding whether to administer fluids, vasopressors, or inotropes based on ultrasound findings. POCUS has also become a valuable tool during cardiopulmonary resuscitation to determine if there is true asystole, fine ventricular fibrillation, or return of spontaneous circulation. It assists in evaluating the effectiveness of cardiac compressions by checking femoral artery pulsations with Doppler ultrasound. Additionally, it helps identify reversible causes of arrest (part of theH’s andT’s algorithminAdvancedCardiac LifeSupport). (7) 5.DeepVenousThrombosis inPregnancy POCUS is a helpful tool for diagnosing deep vein thrombosis (DVT) in pregnant patients, particularly for proximal lower extremity DVT. While standard compression ultrasound may not visualize isolated pelvic DVT, POCUS can identify indirect signs of thrombosis such as increased venous diameter, resistance to compression, and reduced phasicity. In pregnant patients, DVT frequently occurs in the left iliofemoral vein, and POCUS aids in diagnosing it. (13,14) 6.ObstetricEmergencies As previously mentioned, POCUS is invaluable for diagnosing and managing obstetric emergencies such as postpartum hemorrhage, related hemodynamic assessments, pre-eclampsia complications, and acute abdominal conditions during pregnancy. Diagnosing amniotic fluid embolism (AFE) is particularly challenging for clinicians, and cardiac POCUS can assist in the initial evaluation. However, it may be difficult to distinguish between the ultrasound findings of an acute PE and those of AFE, as they often appear quite similar in cardiac ultrasound. (12) TRAININGANDIMPLEMENTATION Maternal POCUS improves clinical exams, reduces diagnostic delays, and enhances obstetricians’ existing ultrasound skills for a morecomprehensive systemicassessment.Wideadoptionof POCUS requires structured training and credentialing programs specifically designed for obstetricians and obstetric-related conditions and findings. As maternal medicine becomes more multidisciplinary, proficiency in POCUS should be a key component of ongoing professional development. CONCLUSION Integrating POCUS into routine antenatal and emergency care is bothpractical and impactful. POCUS is a valuable addition to clinical skills that enhances the diagnosis and treatment of many maternal conditions. Its portability, quick deployment, and accuracymake it a vital tool for improvingmaternal outcomes, especially in high-risk or resource-limited settings. Support from institutions for training and routine use will be essential to unlock its full potential. 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