Low-Cost Teleradiology for Rural Ultrasound

In under-resourced communities, there are several preventable pregnancy complications that can lead to significant maternal or perinatal morbidity and mortality when left untreated. The lack of access to prenatal imaging is one of many factors that contribute to the greater mortality rates in such populations. Analysis of the most common complications suggest that even limited access to obstetric ultrasound imaging could have a positive impact, particularly in a rural context in which imaging can prompt transport of the patient to a capable facility. The authors describe their work to establish and validate an obstetric care model in Uganda, and the design and for a clinical study to measure this model´s efficacy in terms of improving outcomes at delivery. The central objective of this care model is to reduce mortality in remote locations by providing expectant mothers and their primary care-givers with advance notice of complications so that women at risk can be referred to appropriate care centers in time. The components of this model are described, including portable ultrasound machine, scanning protocols for clinical data acquisition by local operators, custom clinical data compression and transmission capabilities, and internet-based infrastructure for remote reading and reporting. The objectives, hypotheses, and design of the associated clinical outcomes study and progress to date are also presented.