Monitoring fetal growth in settings with limited ultrasound access

Abnormal fetal growth significantly increases neonatal mortality and the risk of stillbirth. This creates the need for accurately monitoring fetal growth in all pregnancies regardless of the risk status. Several methods used in clinical practice include abdominal palpation, symphysio-fundal height measurements, and obstetric ultrasound. Of these, obstetric ultrasound remains the most reliable and objective way to monitor fetal growth. However, in most low-resource areas, access to obstetric ultrasound remains poor and this leaves the two as the only options available. This not only has effect on fetal growth monitoring but more importantly on the accuracy of pregnancy dating. To improve the current situation, we propose strategies for training of health workers, educating the public on importance of obstetric ultrasound, and improving access to basic equipment. However, interim solutions have to be implemented hand in hand with other strategies to ensure universal access to ultrasound technology for fetal growth monitoring.