title: OS022. Global use of ultrasound for maternal mortality reduction incountries with high maternal mortality ratios.
abstract: BACKGROUND
  Over a decade ago, the World Health Organization identified ultrasound as a low cost, portable technology and advocated for widespread teaching and application. Outcome data related to the use of ultrasound, however, is limited in low income countries.
  
  
  OBJECTIVE
  We evaluated the global use of obstetric ultrasound for management of hypertensive disorders in pregnancies in countries with high maternal mortality ratios (MMR).
  
  
  METHODS
  We performed a systematic review of the English language literature through PubMed, Global Health, CINAHL (Nursing and Allied Health) and Google Scholar, databases. We searched the terms "ultrasound", "obstetrics", "pregnancy", "maternal services", "extrauterine pregnancy", "embryo implantation", pregnancy toxemia", "eclampsia", and "pregnancy complications" to identify all published papers from 2000 to 2011. These terms were cross referenced with "Africa, Asia, Latin America, and the Caribbean". The maternal mortality report of 2005 from WHO, UNICEF, UNFPA and World Bank was used to identify all countries with MMR of ⩾100/100,000 live births. We systematically reviewed papers that described the use of obstetric ultrasound. We categorized usage into groups based on maternal mortality reduction, prenatal diagnosis/anomaly detection and ultrasound practice patterns.
  
  
  RESULTS
  We identified 85 articles meeting the search criteria. The most commonly described obstetric categories included nomogram development, policy issues/social impact of ultrasound, and anomaly detection (Table 1). Six papers in the literature described maternal/perinatal outcomes, however, none described ultrasound use in the management of hypertensive diseases in pregnancy.
  
  
  CONCLUSIONS
  Hypertensive diseases in pregnancy remain leading causes of maternal mortality worldwide. Few studies in the world's literature address the use of obstetric ultrasound for maternal and perinatal mortality reduction in high MMR regions. Further research and publications are needed in this area.
authors.affiliation: Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Duke University School of Medicine, Durham, United States.
authors.forename: M
authors.initials: M
authors.lastname: Small
authors.affiliation: Obstetrics and Gynecology, Maternal Fetal Medicine, Albert Einstein School of Medicine, New York, United States.
authors.forename: K
authors.initials: K
authors.lastname: Demasio