Maternal point-of-care ultrasound training during Maternal Fetal Medicine fellowship: A national survey

Point-of-care ultrasound (POCUS) is widely used to facilitate management of critical patients. Literature about maternal POCUS (M-POCUS) is limited, but there is interest in its potential to optimize care for high-risk obstetric patients. Currently, there is no data on the frequency of M-POCUS use among Maternal Fetal Medicine (MFM) fellows in training. We aimed to determine what proportion of MFM fellows perform M-POCUS, and whether exposure to an obstetric intensive care unit (OBICU) impacts M-POCUS utilization.

This was a cross-sectional survey of fellows in the United States. An anonymous 20-item web-based survey was designed to ascertain fellow exposure and interest in M-POCUS training. We defined M-POCUS as maternal cardiac, lung, and/or abdominal ultrasound, and excluded feto-placental assessment. We directly contacted 382 fellows and 112 program coordinators and directors via email. Surveys were distributed by email twice weekly and by text message weekly in March, 2025. The analysis was descriptive, with proportions and medians used when appropriate. Comparisons of participant demographics and responses were performed with a chi-square or Fisher's exact test when appropriate, and p < 0.05 was considered significant. Univariate regression was used to perform odds ratios (ORs) with 95% confidence intervals (CIs).

The response rate was 56.3% (n = 215/382). MFM fellows with OBICU exposure did not report a significant difference in M-POCUS use (p = 0.18). Overall, 60.0% of respondents performed M-POCUS at least once during fellowship. The highest predictors of performing an M-POCUS exam were self-reported adequate M-POCUS training (OR, 19.29; 95% CI, 5.79-64.32) and observing an M-POCUS exam during MFM fellowship (OR, 9.44; 95% CI, 4.70-18.98). Almost all respondents (96.7%, n = 208/215) are interested in pursuing further M-POCUS training.

Although OBICU exposure during MFM fellowship did not alter M-POCUS use among respondents, they generally perceive value in this skill and have interest in further training opportunities.