Harris Robert D, Marks William M
Department of Radiology, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH 03756, USA.
J Ultrasound Med. 2009 Aug;28(8):1067-76. doi: 10.7863/jum.2009.28.8.1067.
Ultrasound imaging, a front-line diagnostic tool for perinatal care, is rarely available in the developing world, where maternal and newborn mortality rates are starkly higher than elsewhere. The development of portable and inexpensive medical ultrasound machines (compact ultrasound) offers the possibility of broader use of ultrasound. Our objective was to assess the potential benefits and challenges of deploying compact ultrasound in developing countries for improving obstetric health.
Existing literature on perinatal care, compact ultrasound, and issues in the deployments of medical technology in low-resource settings was reviewed. Anecdotal evidence was assessed, and the authors' field experiences in Nicaragua and Mali were evaluated as a template for wider deployments.
Few published studies directly concerned with compact ultrasound in low-resource settings were found. These, however, in combination with available anecdotal data, support the view that compact ultrasound in less-developed regions is feasible and would result in a relatively low-cost improvement in perinatal care.
The development of lightweight, portable, and relatively inexpensive ultrasound systems offers a great opportunity for reducing maternal and neonatal mortality in low-resource settings. Evidence-based analysis of compact ultrasound deployments as a public-health response to obstetric needs in less-developed countries has been hampered by limited data in 3 key areas: maternal and perinatal mortality and morbidity in these settings, evaluations of compact ultrasound systems as reliable alternatives to full-sized systems, and the lack of outcomes data based on actual deployments of compact ultrasound for this purpose. Field trials of compact ultrasound on a scale commensurate with public health interventions should be undertaken.
超声成像作为围产期护理的一线诊断工具，在发展中国家却很少见，而这些国家的孕产妇和新生儿死亡率明显高于其他地区。便携式且价格低廉的医用超声机器（紧凑型超声）的开发为更广泛地使用超声提供了可能性。我们的目的是评估在发展中国家部署紧凑型超声以改善产科健康的潜在益处和挑战。
回顾了关于围产期护理、紧凑型超声以及在资源匮乏地区部署医疗技术相关问题的现有文献。评估了轶事证据，并将作者在尼加拉瓜和马里的实地经验作为更广泛部署的模板进行了评估。
几乎没有发现直接涉及资源匮乏地区紧凑型超声的已发表研究。然而，这些研究与现有的轶事数据相结合，支持了这样一种观点，即欠发达地区的紧凑型超声是可行的，并且会以相对低成本改善围产期护理。
轻便、便携且相对廉价的超声系统的开发为降低资源匮乏地区的孕产妇和新生儿死亡率提供了巨大机遇。由于在三个关键领域数据有限，阻碍了对紧凑型超声部署作为欠发达国家产科需求的公共卫生应对措施进行基于证据的分析：这些地区的孕产妇和围产期死亡率及发病率、将紧凑型超声系统评估为全尺寸系统的可靠替代品，以及缺乏基于紧凑型超声实际部署用于此目的的结果数据。应开展与公共卫生干预规模相当的紧凑型超声现场试验。
