CENTRAL PHILIPPINE UNIVERSITY

College of Nursing
NCM 2313 – Clinical Enrichment I
OB Rotation

Name: Jy Lyt A. Pomado Date: 07/19/2022

Year & Section: BSN 2G Instructor: Prof. Ella Gipanago

ARTIFICIAL INTELLIGENCE: A NEW PARADIGM IN OBSTETRICS AND GYNECOLOGY

RESEARCH AND CLINICAL PRACTICE

Abstract:

Artificial intelligence (AI) is growing exponentially in various fields, including medicine.

This paper reviews the pertinent aspects of AI in obstetrics and gynecology (OB/GYN) and how
these can be applied to improve patient outcomes and reduce the healthcare costs and workload
for clinicians.

Herein, we will address current AI uses in OB/GYN, and the use of AI as a tool to interpret
fetal heart rate (FHR) and cardiotocography (CTG) to aid in the detection of preterm labor,
pregnancy complications, and review discrepancies in its interpretation between clinicians to reduce
maternal and infant morbidity and mortality. AI systems can be used as tools to create algorithms
identifying asymptomatic women with short cervical length who are at risk of preterm birth.
Additionally, the benefits of using the vast data capacity of AI storage can assist in determining the
risk factors for preterm labor using multiomics and extensive genomic data. In the field of
gynecological surgery, the use of augmented reality helps surgeons detect vital structures, thus
decreasing complications, reducing operative time, and helping surgeons in training to practice in a
realistic setting. Using three-dimensional (3D) printers can provide materials that mimic real tissues
and also helps trainees to practice on a realistic model. Furthermore, 3D imaging allows better depth
perception than its two-dimensional (2D) counterpart, allowing the surgeon to create preoperative
plans according to tissue depth and dimensions. Although AI has some limitations, this new
technology can improve the prognosis and management of patients, reduce healthcare costs, and
help OB/GYN practitioners to reduce their workload and increase their efficiency and accuracy by
incorporating AI systems into their daily practice.

AI has the potential to guide practitioners in decision-making, reaching a diagnosis, and

improving case management. It can reduce healthcare costs by decreasing medical errors and
providing more dependable predictions. AI systems can accurately provide information on the large
array of patients in clinical settings, although more robust data is required.
 Reaction:

Technology can be defined as the application of information for the creation and
development of devices and equipment that can be used in a variety of ways. Technology is now a
very crucial component of each and every one of our daily lives. The modernization that the world is
experiencing today is entirely due to technological advancements in various fields. The tasks are less
dangerous and more efficient now that new tools are available. Artificial intelligence is a combination
of the words artificial and intelligence, and it refers to artificial intelligence. As a result, Artificial
Intelligence is used when machines are equipped with man-made intelligence to perform intelligent
tasks similar to humans. It all comes down to creating intelligent robots that can mimic the human
brain and work and behave like humans. Artificial intelligence (AI) can provide picture quality
assurance and support clinical judgments. Although obstetrics and gynecology frequently use
ultrasonography, the use of AI is still in its infancy. However, AI has enormous potential in routine
ultrasound exams that involve the automatic positioning and identification of fetal features, prediction
of gestational age (GA), and real-time picture quality assurance. Ultrasound is used throughout the
entire pregnancy process. It is essential for observing fetal growth and development, as well as
diagnosing and treating disease. It can provide detailed fetal anatomy information with high-quality
images and improved diagnostic accuracy. At the moment, two-dimensional (2D) imaging and three-
dimensional (3D) ultrasound are widely used to assess organ functions, measure fetal structures, and
diagnose diseases. The availability of high-quality obstetric ultrasound imaging is critical for accurate
care and prognosis. One of the critical steps toward establishing the validity and clinical applicability
of AI algorithms is the promotion of interdisciplinary communication.  We will go over the application,
as well as the benefits and drawbacks of AI in obstetric ultrasound, in detail. Because the importance
of ultrasound examination varies depending on the stage of pregnancy, AI-assisted obstetric
ultrasound is classified as first, second, and third trimesters. Long-term prospects for obstetric
ultrasound include telemedicine or telediagnosis services, as well as virtual reality (VR) learning. AI
enables clinicians to make more confident decisions by assisting them in decision-making. It is
important to remember, however, that it is not a substitute for nursing expertise. Medical errors are
the third leading cause of death in the United States (US), and AI has the capability to improve and
mitigate them by enhancing analysis in accuracy and reducing workload, which can lead to details
being overlooked.
AI has a lot to offer when it comes to fetal heart monitoring and pregnancy surveillance in
relation to Cardiotocography. The protocol for the Interpretation of Fetal Heart Rate During Labor
(INFANT) study is a large trial that is currently analyzing the capacity of AI interpretation of CTG
during labor to assist practitioners in selecting the most suitable management on an individual basis.
The objective is to increase the accuracy of FHR reading, support the physician's interpretation and
decision-making, and lessen workload by increasing efficiency. Globally, perinatal asphyxia is a
serious issue, and by developing an effective method to track FHR, care might be enhanced and
negative effects could be reduced. As a result, an alarm monitor that alerts the practitioner to
probable fetal distress can direct them to act promptly and provide intrapartum interventions as
needed. In cases where fetal discomfort is not seen, it can also give comfort and help mothers avoid
treatment that is unneeded. The current gestational diabetes mellitus (GDM) screening process is
expensive and burdensome for expectant mothers. AI can help in the search for alternatives to the
current norm. They concluded there wasn't enough data to screen before 24-week gestation. To
avoid issues including neonatal hypoglycemia, large for gestational age babies, and a rise in cesarean
deliveries, among others, it is crucial to screen for GDM. Due to an increase in cesarean deliveries
caused by GDM, outcomes are also more expensive; this cost may be reduced if a more practical
screening test were available. A study designed by Polak and Mendyk evaluated the use of an AI
calculator to test for GDM, which would be less expensive and cumbersome for patients than existing
recommendations. Also, in pre-term labor, parturition, in vitro fertilization, cancer screening, and
gynecological surgery.

To sum up, technologies like AI are one way that the sciences would offer in order for us
students to manipulate and make our workloads lesser. As student nurses conducting classes online,
it is a huge blessing for us to cater to our queries with these new technologies specifically Artificial
Intelligence to hone our creative minds to picture-out various cases in the OB ward. As much as we
want to experience advancements both in school and in the hospital setting, we are somehow
deprived of the exposure that we deserve yet these technologies save us from ignorance and
illiteracy. Keep in mind that technology also has drawbacks. Instead of relying on ourselves to have
quick access to data, we should learn as students how to manually gather data in order to
scrutinize the issue and provide patient-centered interventions. On a more positive note, I consider
myself fortunate to know that science is significantly expanding its reach so that far-flung areas can
also benefit from it.

Illustration of products of Artificial Intelligence in Obstetrics:

Source: https://www.frontiersin.org/articles/10.3389/fmed.2021.733468/full

Neural network models are being used to

Used for in vitro fertilization
deliver prognoses in patients with ovarian
cancer. 
References:

Iftikhar, P. et. Al., 2022, Artificial Intelligence: A New Paradigm in Obstetrics and
Gynecology Research and Clinical Practice. Pubmed Central. doi: 10.7759/cureus.7124
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105008/

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