OP09.02: Comparing handheld point of care ultrasound to standard care with transvaginal ultrasound in early pregnancy

Point of Care Ultrasound (POCUS) is being increasingly used in all settings of healthcare. This study aims to evaluate the performance of handheld POCUS in comparison to standard care with transvaginal ultrasound (TVUS) within early pregnancy. 155 consecutive patients in early pregnancy at a London teaching hospital were recruited to this cross-sectional study. One sonologist conducted an assessment with a handheld POCUS. Following this a second sonologist conducted the standard care transvaginal ultrasound. The operators were blinded to each other's findings and measurements. There was almost perfect agreement between the POCUS and TVUS for identifying the presence or absence of a gestational sac, embryo, fetal heart motion, and diagnostic outcome (kappa coefficients, 0.882, 0.855, 0.912 and 0.870, respectively; P < 0.001). For the measured continuous variables, there was very high correlation for mean sac diameter, Crown–rump length (0.920 and 0.961; P < 0.001). Point of Care Ultrasound when used by a trained operator appears to give almost perfect concordance and very high correlation when comparing measurements which results in very similar diagnosis and management plans. However, they should be used to triage and not be used in place of standard care. Larger numbers are needed to see whether current guidelines of care in early pregnancy can be applied or need to be adjusted.