Enhancing First Trimester Obstetrical Care: The Addition of Point-of-Care Ultrasound

PLAIN-LANGUAGE ARTICLE SUMMARY

Innovations in Primary Care

Single-Visit First-Trimester Care with Point-of-Care Ultrasound Cuts Emergency Visits by 81% for Non-Miscarrying Patients 

The Bethesda Family Medicine Clinic in St. Paul, Minnesota, established a bi-monthly Early Pregnancy Dating & Risk Assessment Clinic in September 2022. The clinic introduced an integrated approach, combining point-of-care ultrasound with immediate, multidisciplinary first-trimester care—a shift from the previous practice where each element, including ultrasound, risk assessment, and patient education, was conducted separately. During a single visit, patients under 14 weeks receive ultrasound-based dating, immediate assessment of pregnancy viability, and risk evaluation, with on-site counseling based on real-time ultrasound results. This integration allowed the clinic to quickly identify high-risk cases and offer timely intervention for issues such as miscarriage or abnormal pregnancies, reducing emergency visits, urgent clinic appointments, and first-trimester phone inquiries by 81% for non-miscarrying patients. For miscarriage cases, the time from initial concern to diagnosis decreased from an average of 5.8 days to 1.7 days. Clinic implementation led to more timely diagnosis of abnormal pregnancies and improved education and support for all patients, including those who experience miscarriage.

Enhancing First Trimester Obstetrical Care: The Addition of Point-of-Care Ultrasound

Allison Newman, MD, et al 

Woodwinds Hospital Family Medicine Residency Program, Department of Family Medicine and Community Health, University of Minnesota Medical School, St. Paul, Minnesota