The first practical medical ultrasound machine was pioneered in the antenatal practice. Next, the rapid progress in the antenatal care and research demanded/propelled major advances in ultrasound technology and vice versa. Today, ultrasonography has become a part of pregnancy journey, emotional experience and bonding. Affordable pocket-sized ultrasound scanners and remote image transmission technology hold a new promise in rural areas. Point-of-care ultrasound by midwives for fetal growth and wellbeing is a growing domain. This article discusses current challenges and potential developments pertaining to the role of ultrasound in the first, second and third trimesters of pregnancy in different resource settings.