AI reading of blind-sweep ultrasound to date pregnancies where sonographers are scarce

Ultrasound is the best way to date a pregnancy, but it needs trained sonographers and costly machines. Researchers trained a computer program to estimate how many weeks pregnant a woman is from simple sweeps of a low-cost probe over the abdomen. In a study in Zambia and North Carolina, untrained users got dating about as accurate as trained sonographers. It is still a research tool and not routine care.

  • Idea
  • In this atlas

Overview

Technical summary

Hypothesis with a prospective test: AI estimation of gestational age from blind sweeps by novice users on a low-cost device is as accurate as standard biometry by credentialed sonographers. Results: development study (NEJM Evidence 2022; 4695 volunteers; mean absolute error 3.9 against 4.7 days) and prospective diagnostic accuracy study (JAMA 2024; 400 participants; 3.2 against 3.0 days, difference 0.2 days, 95% CI -0.1 to 0.5, within a prespecified 2-day margin). The first paper reports funding from the Bill and Melinda Gates Foundation. Dating accuracy only; effects on care and outcomes are not tested.

Hypothesis

Hypothesis, not a result. Nothing here has been demonstrated.

AI estimation of gestational age from blind ultrasound sweeps collected by novice users on a low-cost, battery-powered device is as accurate as fetal biometry done by credentialed sonographers on high-specification machines.

Maturity
Tested
Rationale
Ultrasound is indispensable to gestational age estimation, yet high equipment cost and the need for trained sonographers limit its use in low-resource settings (NEJM Evidence abstract).
Proposed test
A prospective diagnostic accuracy study in Lusaka, Zambia, and Chapel Hill, North Carolina, with an equivalence margin of 2 days (JAMA 2024), after a model-development study (NEJM Evidence 2022).

Objections

  • The prospective study covered the 14 to 27 week window at two sites and measured dating accuracy only, not effects on care or outcomes.
  • Several sub-comparisons in the development study have intervals that include no difference.

Claims and evidence

Context Pregnant individuals scanned by novice users with an AI-enabled ultrasound device, 14 0/7 to 27 6/7 weeks (Zambia and North Carolina)

Recipient
Fetal
Population
Individuals with viable, single, nonanomalous, first-trimester pregnancies (400 enrolled), whose gestational age was set by transvaginal crown-rump length. The person scanned is the pregnant woman; the quantity estimated is the gestational age of the pregnancy.
Care setting
Low-cost battery-powered device used by novice users with no prior training in sonography, at follow-up visits
Geography
Lusaka, Zambia, and Chapel Hill, North Carolina (United States)
Life stage
Pregnancy; primary evaluation window 14 0/7 to 27 6/7 weeks of gestation
Gestational age
14 weeks 0 days (98 days) to 27 weeks 6 days (195 days), measured at the time of measurement
Postnatal age
Not reported
Follow-up
Random follow-up visits throughout gestation
Eligibility: 1 inclusion criterion; 1 exclusion criterion
Included
  • Viable, single, nonanomalous, first-trimester pregnancy
Excluded
  • Not stated in the parts of the source that were read.
  • Description Observational Certainty not assessed

    A prospective diagnostic accuracy study enrolled 400 individuals with viable, single, nonanomalous, first-trimester pregnancies in Lusaka, Zambia, and Chapel Hill, North Carolina. At random follow-up visits, novice users with no prior training in sonography collected blind sweeps of the maternal abdomen with an AI-enabled low-cost, battery-powered ultrasound device, while credentialed sonographers did fetal biometry with a high-specification machine. In the primary window (14 0/7 to 27 6/7 weeks) the device met the prespecified equivalence margin of 2 days: mean absolute error 3.2 days against 3.0 days for biometry (difference 0.2 days, 95% CI -0.1 to 0.5). The share of assessments within 7 days of the reference gestational age was 90.7% for the device and 92.5% for biometry.

    Applies to Fetal
    • Individuals with viable, single, nonanomalous, first-trimester pregnancies (400 enrolled), whose gestational age was set by transvaginal crown-rump length. The person scanned is the pregnant woman; the quantity estimated is the gestational age of the pregnancy.
    • Low-cost battery-powered device used by novice users with no prior training in sonography, at follow-up visits
    • Lusaka, Zambia, and Chapel Hill, North Carolina (United States)
    • Pregnancy; primary evaluation window 14 0/7 to 27 6/7 weeks of gestation
    • Gestational age 14 weeks 0 days to 27 weeks 6 days, measured at the time of measurement
    • Postnatal age Not reported
    Follow-up Random follow-up visits throughout gestation
    Certainty method
    Not assessed
    Limitations
    Tested at two sites and in one gestational window (14 to 27 weeks), with first-trimester crown-rump length as the reference. It measures dating accuracy, not any effect on care or outcomes. It is a research tool; the sources do not show routine use. Only the abstract was read; the registry number printed there (NCT05433519) was not fetched.
    Last checked
    2026-10-14
    Next evidence check due
    Not scheduled
    Sources and citations (13)
    1. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    2. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    3. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

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      Abstract, DESIGN, SETTING, AND PARTICIPANTS, sentence 3, fragment 1 of 3
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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    4. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

      Locator
      Abstract, DESIGN, SETTING, AND PARTICIPANTS, sentence 3, fragment 2 of 3
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      PubMed abstract.
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      983cc77f9baeba4430473c25ed0df98926e093f8a2207d36ac68c5cc45c2ce94
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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    5. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

      Locator
      Abstract, DESIGN, SETTING, AND PARTICIPANTS, sentence 3, fragment 3 of 3
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      PubMed abstract.
      Retrieved
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      983cc77f9baeba4430473c25ed0df98926e093f8a2207d36ac68c5cc45c2ce94
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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    6. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

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    7. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    8. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    9. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    10. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    11. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

      Locator
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      PubMed abstract.
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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    12. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    13. Supports Diagnostic Accuracy of an Integrated AI Tool to Estimate Gestational Age From Blind Ultrasound Sweeps

      Publication · JAMA · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2024-08-27 · DOI: 10.1001/jama.2024.10770 · PMID: 39088200

      Locator
      Abstract, CONCLUSIONS AND RELEVANCE, sentence 1, fragment 2 of 2
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      PubMed abstract.
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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

Context Pregnant volunteers in North Carolina and Zambia, development and test sets of an AI gestational age model

Recipient
Fetal
Population
4695 pregnant volunteers recruited from September 2018 through June 2021 who had blind ultrasound sweeps of the abdomen alongside standard fetal biometry. The model was tested in three test data sets, including women who conceived by in vitro fertilisation and sweeps collected by untrained users with low-cost devices in Zambia.
Care setting
Research ultrasound; some sweeps collected by untrained providers with low-cost battery-powered devices
Geography
North Carolina (United States) and Zambia
Life stage
Pregnancy
Gestational age
Not reported
Postnatal age
Not reported
Follow-up
Not stated in the parts of the source that were read.
Eligibility: inclusion criteria not stated; 1 exclusion criterion
Included
None stated
Excluded
  • Not stated in the parts of the source that were read.
  • Description Observational Certainty not assessed

    In a model-development study, 4695 pregnant volunteers in North Carolina and Zambia were recruited from September 2018 through June 2021 and had blind ultrasound sweeps (cineloop videos) of the abdomen alongside standard fetal biometry. A neural network trained to estimate gestational age from the sweeps had a mean absolute error of 3.9 days against 4.7 days for biometry in the main test set (difference -0.8 days, 95% CI -1.1 to -0.5; P<0.001). In the set of sweeps collected by untrained users with low-cost, battery-powered devices, the error was 4.9 days for the model against 5.4 days for biometry (difference -0.6, 95% CI -1.3 to 0.1).

    Applies to Fetal
    • 4695 pregnant volunteers recruited from September 2018 through June 2021 who had blind ultrasound sweeps of the abdomen alongside standard fetal biometry. The model was tested in three test data sets, including women who conceived by in vitro fertilisation and sweeps collected by untrained users with low-cost devices in Zambia.
    • Research ultrasound; some sweeps collected by untrained providers with low-cost battery-powered devices
    • North Carolina (United States) and Zambia
    • Pregnancy
    • Gestational age Not reported
    • Postnatal age Not reported
    Follow-up Not stated in the parts of the source that were read.
    Certainty method
    Not assessed
    Limitations
    A development study with test sets drawn from the same project, before the prospective study above. The in vitro fertilisation and untrained-user comparisons have intervals that include no difference. Dating accuracy only. Only the abstract was read. The abstract states that the Bill and Melinda Gates Foundation funded the work.
    Last checked
    2026-10-14
    Next evidence check due
    Not scheduled
    Sources and citations (9)
    1. Supports AI Estimation of Gestational Age from Blind Ultrasound Sweeps in Low-Resource Settings

      Publication · NEJM evidence · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2022-03-28 · DOI: 10.1056/evidoa2100058 · PMID: 36875289

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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    2. Supports AI Estimation of Gestational Age from Blind Ultrasound Sweeps in Low-Resource Settings

      Publication · NEJM evidence · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2022-03-28 · DOI: 10.1056/evidoa2100058 · PMID: 36875289

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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    3. Supports AI Estimation of Gestational Age from Blind Ultrasound Sweeps in Low-Resource Settings

      Publication · NEJM evidence · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2022-03-28 · DOI: 10.1056/evidoa2100058 · PMID: 36875289

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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    4. Supports AI Estimation of Gestational Age from Blind Ultrasound Sweeps in Low-Resource Settings

      Publication · NEJM evidence · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2022-03-28 · DOI: 10.1056/evidoa2100058 · PMID: 36875289

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      PubMed abstract.
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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    5. Supports AI Estimation of Gestational Age from Blind Ultrasound Sweeps in Low-Resource Settings

      Publication · NEJM evidence · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2022-03-28 · DOI: 10.1056/evidoa2100058 · PMID: 36875289

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      PubMed abstract.
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      d1398ce4cfb7ce5ac00348751fd01da51e0ef49c72f4df2c8b63ee2c778f24a6
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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    6. Supports AI Estimation of Gestational Age from Blind Ultrasound Sweeps in Low-Resource Settings

      Publication · NEJM evidence · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2022-03-28 · DOI: 10.1056/evidoa2100058 · PMID: 36875289

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      Abstract, RESULTS, sentence 1, fragment 2 of 2
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      PubMed abstract.
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      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
    7. Supports AI Estimation of Gestational Age from Blind Ultrasound Sweeps in Low-Resource Settings

      Publication · NEJM evidence · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2022-03-28 · DOI: 10.1056/evidoa2100058 · PMID: 36875289

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    8. Supports AI Estimation of Gestational Age from Blind Ultrasound Sweeps in Low-Resource Settings

      Publication · NEJM evidence · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2022-03-28 · DOI: 10.1056/evidoa2100058 · PMID: 36875289

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    9. Background AI Estimation of Gestational Age from Blind Ultrasound Sweeps in Low-Resource Settings

      Publication · NEJM evidence · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read. · Published 2022-03-28 · DOI: 10.1056/evidoa2100058 · PMID: 36875289

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Record details

Record id
maternal:idea-ai-blind-sweep-ultrasound
Content hash
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