Point-of-care ultrasound in obstetrics and gynecology: latest advancements and evolution

Point-of-care ultrasound (POCUS) in obstetrics and gynecology has evolved from a pragmatic bedside adjunct into a rapidly expanding clinical, educational and technological field. Since the publication of earlier narrative reviews, the discipline has been reshaped by handheld ultrasound systems, wireless probes, cloud-based image management, tele-ultrasound, artificial intelligence (AI) for image acquisition and interpretation, and the first specific practice guidance for POCUS in obstetrics and gynecology. This narrative review summarizes recent advances and proposes a clinically useful framework for the European ultrasound community. POCUS should be understood as a focused, problem-oriented and immediately actionable ultrasound examination performed and interpreted by the treating clinician. It is not a replacement for guideline-based screening, detailed fetal anatomy assessment, comprehensive transvaginal gynecologic imaging, Doppler surveillance or expert ultrasound. The strongest evidence supports POCUS for early pregnancy triage, confirmation of fetal viability and presentation, basic assessment of placental location and amniotic fluid, intrapartum evaluation of fetal head position and selected postpartum or gynecologic emergencies. In gynecology, POCUS can accelerate triage of acute pelvic pain, suspected ectopic pregnancy, intrauterine device position and adnexal pathology, but definitive risk stratification of complex masses remains a task for standardized specialist sonography. Technological progress has been substantial: handheld devices now provide diagnostically useful images for several focused tasks, AI-enabled blind-sweep protocols can estimate gestational age and fetal malpresentation in low-resource settings, and tele-ultrasound can extend expert support beyond tertiary centers. The next phase of OB/GYN POCUS will depend less on device availability than on implementation: indication-specific protocols, formal training, competency assessment, documentation, image archiving, infection control, data protection, quality assurance and clear escalation rules. POCUS in obstetrics and gynecology should therefore be framed as a governed clinical pathway rather than a device-driven shortcut.