The calculation of a baby’s gestational age is a crucial step in providing quality prenatal care. While the World Health Organization advises that all pregnancies should have an ultrasound scan conducted before reaching 24 weeks, the reality in low-resource environments like Zambia or rural parts of the U.S. is often different. Due to high costs and the requirement for specialized personnel, many women in these areas don't get the scans they need. This can lead to increased risks, including birthing outside hospitals, or premature births. Now, a groundbreaking study has shown that a new AI-powered ultrasound algorithm for assessing gestational age could be a game-changer, especially in resource-strapped areas.

Researchers at the University of North Carolina (UNC) School of Medicine (Chapel Hill, NC, USA) have developed an AI tool that, when combined with the Butterfly IQ+ handheld ultrasound probe from Butterfly Network, Inc. (Guilford, CT, USA), can determine gestational age as accurately as an expensive, full-sized ultrasound system operated by an expert. The study used machine learning algorithms and proved that even healthcare providers without prior training in ultrasound technology can effectively gauge a baby’s gestational age using this handheld, AI-driven device. This development offers hope for making ultrasound technology accessible for pregnant women globally, no matter the state of healthcare infrastructure.

For the study, an interdisciplinary team of researchers studied 400 pregnant women in both the U.S. and Zambia. The participants were initially screened to determine their gestational age and then given follow-up appointments at random times for further scans. These scans were done using the AI-equipped Butterfly IQ+ device, by individuals without any specialized ultrasound training, as well as by expert sonographers using high-end ultrasound machines. Importantly, neither group of sonographers knew the previously established gestational ages. Between the 14th and 27th weeks of gestation, the untrained users operating the AI tool showed a performance similar to that of the experts, with a very minimal error margin.

In the later evaluation period between the 28th and 36th weeks, the AI tool even outperformed the experts by about a day. This range is particularly crucial as it's the time when the majority of women in low-resource settings are likely to first seek prenatal care. The findings suggest that the handheld Butterfly IQ+ device, enhanced with the AI tool, is just as reliable for estimating gestational age as a conventional, expert-operated machine. The widespread availability of such AI-driven tools could not only speed up the assessment of gestational age but also allow immediate, on-site clinical decision-making, alleviating some of the pressure on already strained healthcare systems.

“Ultrasound is like a stethoscope to the obstetrician. We use it all day, every day,” explained Jeffrey Stringer, MD, Professor of Obstetrics and Gynecology at the UNC School of Medicine, who led the study. “This new tool allows anyone to perform an ultrasound. Just sweep the probe across the woman’s belly a few times and the AI does the rest.”

“By automating both the image capture and interpretation processes with this tool, providers will get immediate, accurate clinical information at the patient’s bedside that can inform high stakes decisions,” said Butterfly’s Senior Director of Global Health, Sachita Shah, MD. “Butterfly is proud to collaborate on this application that has the potential to change maternal health delivery worldwide.” 

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