Background:Ultrasound education has been provided to students in medical schools within and beyond the United States. A formal experiment with use of personal handheld ultrasound equipment by all first-year medical students has not been reported. Employing insonation (an application of ultrasound) at the personal leisure by medical school freshmen enables self-directed learning throughout the academic year.Methods:We describe a peer-led ultrasound curriculum with handheld devices. The students’ perceptions were gathered through quarterly Likert-style questionnaires, and the differences in the categories were tested using Analysis of Variance.Results:The response rate was 58.5% for the first survey (n = 32), 56% (n = 30) for the second survey, and 62.3% (n = 33) for the final survey, respectively, with an average response rate of 58.9%. At the baseline survey, overall agreement was observed for enhancement on performance (62.5%) and interpretation (56.3) of ultrasounds, understanding (68.8%) and learning of anatomy (61.3%), ease (78.1%), comfort (59.4%) and benefit of incorporation of insonation in the medical school curricula (all p-values < 0.001). Neutral response (38.7%) or disagreement (38.7%) was observed when assessing the effect of the integration in medical curriculum on specialty choice (p < 0.01). These trends remained constant over follow-up with the exception that the perceived benefit for integration of insonation into the longitudinal curricula (p < 0.05) increased significantly over time. Majority of disagreement was observed regarding current access to the personal ultrasound devices (38.7%) (p < 0.001).Conclusions:The introduction of insonation through personal handheld ultrasound devices in the first-year medical school curriculum was received enthusiastically by students, with the majority of respondents finding the devices both easy to use and a valuable aid to improving their understanding of the three-dimensional anatomy.

The aim of this study was to investigate the effect of serial amnioinfusion therapy (SAT) for pulmonary hypoplasia in lower urinary tract obstruction (LUTO) or congenital renal anomalies (CRAs), introduce patient selection criteria, and present a case of SAT in bilateral renal agenesis. We conducted a search of the MEDLINE, EMBASE, Web of Science, and Scopus databases for articles published from database inception to November 10, 2017. Eight studies with 17 patients (7 LUTO, 8 CRA, and 2 LUTO þ CRA) were included in the study. The median age of the mothers was 31 years (N¼9; interquartile range [IQR], 29-33.5 years), the number of amnioinfusions was 7 (N¼17; IQR, 4.5-21), gestational age at first amnioinfusion was 23 weeks and 4 days (N¼17; IQR, 21-24.07), gestational age at delivery was 32 weeks and 2 days (N¼17; IQR, 30 weeks to 35 weeks and 6.5 days), birthweight of newborns was 3.7 kg (N¼ 9; IQR, 2.7-3.7 kg), Apgar score at 1 minute was 2.5 (N¼8; IQR, 1-6.5), and Apgar score at 5 minutes was 5.5 (N¼8; IQR, 0-7.75). In conclusion, SAT may provide fetal pulmonary palliation by reducing the risk of newborn pulmonary compromise secondary to oligohydramnios. Multidisciplinary research efforts are required to further inform treatment and counseling guidelines. We propose a multidisciplinary approach to prenatal classification of fetuses with LUTO to inform patient selection.

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