A step towards measuring the fetal head circumference with the use of obstetric ultrasound in a low resource setting

Worldwide, 99% of all maternal deaths occur in low-resource countries. Ultrasound imaging can be used to detect maternal risk factors, but requires a well-trained sonographer to obtain the biometric parameters of the fetus. One of the most important biometric parameters is the fetal Head Circumference (HC). The HC can be used to estimate the Gestational Age (GA) and assess the growth of the fetus. In this paper we propose a method to estimate the fetal HC with the use of the Obstetric Sweep Protocol (OSP). With the OSP the abdomen of pregnant women is imaged with the use of sweeps. These sweeps can be taught to somebody without any prior knowledge of ultrasound within a day. Both the OSP and the standard two-dimensional ultrasound image for HC assessment were acquired by an experienced gynecologist from fifty pregnant women in St. Luke's Hospital in Wolisso, Ethiopia. The reference HC from the standard two-dimensional ultrasound image was compared to both the manually measured HC and the automatically measured HC from the OSP data. The median difference between the estimated GA from the manual measured HC using the OSP and the reference standard was-1.1 days (Median Absolute Deviation (MAD) 7.7 days). The median difference between the estimated GA from the automatically measured HC using the OSP and the reference standard was-6.2 days (MAD 8.6 days). Therefore, it can be concluded that it is possible to estimate the fetal GA with simple obstetric sweeps with a deviation of only one week.