Module Descriptions and Objectives Module 1 Description: The legal aspects of providing limited ultrasound are discussed and the low risk for liability for providing limited ultrasound explained in detail. Discuss the legal implications of limited ultrasound in obstetrics B. Examine the medical implications for the limited ultrasound in obstetrics C. Implement the knowledge of limited ultrasound in obstetrics D. Discuss why only trained medical personnel should interpret limited ultrasounds in obstetrics. Anticipated completion time for module: The medical indications for limited obstetric ultrasound are discussed and training guidelines for performance of limited obstetric ultrasound are outlined.

Obstetric ultrasonography

Ultrasonography of the cervix[ edit ] Fetus at 14 weeks profile Obstetric sonography has become useful in the assessment of the cervix in women at risk for premature birth. A short cervix preterm is undesirable: This includes checking the status of the limbs and vital organs, as well as sometimes specific tests for abnormalities. Some abnormalities detected by ultrasound can be addressed by medical treatment in utero or by perinatal care, though indications of other abnormalities can lead to a decision regarding abortion.

UItrasound provides detailed, real time information without the use of radiation.

Contact details Overview The RCOG curriculum now requires that all trainees have practical training in basic obstetric ultrasound, comprising two modules on early pregnancy ultrasound weeks and ultrasound assessment of fetal size, liquor and the placenta. These two practical modules need to be underpinned with a sound theoretical basis, which this course is designed to offer.

It also will serve as the basis for those trainees developing their skills further with the intermediate ultrasound modules both in obstetrics and gynaecology. This is primarily a theoretical course however, this course will provide opportunity for basic hands on training in the basic technique of TV ultrasound and TA assessment of pregnancy. The focus will be on technique and practical training to enhance the scan image quality, providing participants with an opportunity to put the theory of the early morning lectures into practice.

Learning objectives After attending the meeting, you will: Unfortunately, if you are an Associate Member it is not currently possible to book online at the discounted member rate. We are working to remedy this, but in the meantime please contact us directly to book and receive your discount. For any queries regarding this event, please contact Nkechi Ike, Conference Administrator:

Perinatology and Obstetrical Calculators

High School Many physicians know they want to become a doctor during high school or even earlier. In many respects the training of a doctor begins as early as high school, where the future doctor must obtain grades high enough to be accepted to a 4-year college. Students must balance the need for high grade point average GPA with their social needs, such as sports, dating, and school events. College In college, students hoping for an acceptance into medical school must take a large number of required science courses, such as biology, chemistry, genetics, physics, and organic chemistry.

Some medical schools also require one or more writing or literature classes. Most “pre-med” students major in biology, chemistry, or physics.

If cervical length is a concern, the length should be more closely evaluated.

This scan will be your first glimpse at your developing baby and we can accurately give you your due date of your baby. Learn more This is an ultrasound scan that is performed early in the pregnancy. Scan measurements are taken such that the dates of the pregnancy can be confirmed or determined. Other information obtained includes whether the pregnancy is in the uterus or outside the uterus an ectopic pregnancy , how many embryos there are, and whether there are any complications surrounding the pregnancy at this early stage.

The ovaries are also examined. What to expect on the day? The scan takes 30 minutes to perform. When you arrive for your scan you will be asked to fill out a form about when your last menstrual cycle took place if known and some other details relevant to the scan. You will be called by the sonographer who will take you to the scanning room. You will be asked to lie on the table and to expose your tummy and a towel will be tucked into your pants to limit spread of the gel onto your clothes.

The gel that we use is water-soluble so it does not stain your clothes. It can just be a bit sticky! Clear gel is applied to your tummy and the sonographer moves the probe over your tummy recording images. Please come with a full bladder which will make it easier to obtain images of the uterus.

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Prior to the 18th century, caring for pregnant women in Europe was confined exclusively to women, and rigorously excluded men. The expectant mother would invite close female friends and family members to her home to keep her company. The presence of physicians and surgeons was very rare and only occurred once a serious complication had taken place and the midwife had exhausted all measures to manage the complication. Calling a surgeon was very much a last resort and having men deliver women in this era whatsoever was seen as offending female modesty.

However, the subject matter and interest in the female reproductive system and sexual practice can be traced back to Ancient Egypt [6] and Ancient Greece.

Mean sac diameter measurements are not recommended for estimating the due date.

Doppler Ultrasound The doppler shift principle has been used for a long time in fetal heart rate detectors. Further developments in doppler ultrasound technology in recent years have enabled a great expansion in its application in Obstetrics, particularly in the area of assessing and monitoring the well-being of the fetus, its progression in the face of intrauterine growth restriction, and the diagnosis of cardiac malformations.

Doppler ultrasound is presently most widely employed in the detection of fetal cardiac pulsations and pulsations in the various fetal blood vessels. The “Doptone” fetal pulse detector is a commonly used handheld device to detect fetal heartbeat using the same doppler principle. Blood flow characteristics in the fetal blood vessels can be assessed with Doppler ‘flow velocity waveforms’.

Diminished flow, particularly in the diastolic phase of a pulse cycle is associated with compromise in the fetus. Various ratios of the systolic to diastolic flow are used as a measure of this compromise. The blood vessels commonly interrogated include the umbilical artery , the aorta , the middle cerebral arteries , the uterine arcuate arteries , and the inferior vena cava.

The use of color flow mapping can clearly depict the flow of blood in fetal blood vessels in a realtime scan, the direction of the flow being represented by different colors. Color doppler is particularly indispensible in the diagnosis of fetal cardiac and blood vessel defects , and in the assessment of the hemodynamic responses to fetal hypoxia and anemia.

Obstetric Ultrasound

You may like to take a look at charts for crown-rump length , biparietal diameter , femur length , abdominal circumference , gestational sac diameter , yolk sac diameter and intrauterine fetal weight. If you have problems understanding and calculating your due date, check out and download a copy of the Ob calculator by York Winston.

Hutchon’s site and the Gestation Network also provide pregnancy calculators. A large number of mails I received are about fetal anomalies, I have therefore tried to put together a Catalogue of Web pages which describe in some detail specific congenital anomalies that are diagnosable by ultrasound.

Additional cardiac views may be obtained for a more complete fetal cardiac evaluation.

Generate a file for use with external citation management software. Create File Ultrasound Obstet Gynecol. New charts for ultrasound dating of pregnancy and assessment of fetal growth: Correct assessment of gestational age and fetal growth is essential for optimal obstetric management. The objectives of this study were, first, to develop charts for ultrasound dating of pregnancy based on crown-rump length and biparietal diameter and, second, to derive reference curves for normal fetal growth based on biparietal diameter, head circumference, transverse cerebellar diameter, abdominal circumference and femur length from 10 weeks of gestational age onwards.

A total of pregnant women were included for analysis in this population-based prospective cohort study.

Methods for Estimating the Due Date

May 16, CDC For most women today, it’s hard to imagine going through a pregnancy without having an ultrasound. But these iconic black-and-white images of a developing fetus, generated by the reflection of high frequency sound waves, have only been around since the mid s. A new book explores the history of ultrasounds, in both their technical and social dimensions.

In “Imaging and Imagining the Fetus: The Development of Obstetric Ultrasound” The Johns Hopkins University Press, , authors Malcolm Nicolson, a history of medicine professor at the University of Glasgow in Scotland, and engineer John Fleming look at how ultrasounds came into wide use, and why their images lie at the crossroads of several hotly debated issues today.

One of the women he operated on was named Anarcha, the woman he first treated for a fistula.

Obstetric Pregnancy Obstetric Pregnancy For all Obstetrics scans, no special preparation is needed, although it is best to wear loose clothing that can easily be lifted or removed in order to expose your abdomen. You will lie on your back on an examination couch and the transducer moved back and forth across your stomach in order to gain the best possible image of the fetus.

Ultrasound imaging in pregnancy is widely used to evaluate the baby. It can determine if a baby is present, the position of the fetus and if there is a multiple pregnancy. It can also help to diagnose abnormalities or problems, help determine the age of the pregnancy and subsequent due date as well as showing the position of the placenta in relation to the birth canal. There is also then a routine scan at 20 weeks.

Individual circumstances may dictate that more scans may be offered and a breakdown of what you could receive is detailed below. Early viability scan This usually takes place at 6 to 10 weeks of pregnancy. The scan can confirm the number of babies in the uterus, the embryo can be observed and measured by about five and a half weeks and a heartbeat usually detected by 6 weeks.

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International conference on transition and cord clamping at birth April It is increasingly recognised that the circulatory changes involved in transition at birth cannot occur within a few seconds of birth. While the healthy fetal circulation and the healthy neonatal circulation are moderately well understood, the underlying triggers, the precise sequence and speed of the changes in the circulation are not. How can we interefere in something we do not understand?

During an obstetrical ultrasound the examiner may evaluate blood flow in the umbilical cord or may, in some cases, assess blood flow in the fetus or placenta.

A maximum vertical pocket of centimeters is normal Doppler scan As indicated Not recommended without an indication e. Am J Obstet Gynecol ; 5: Nutrition A woman carrying twins has unique nutritional needs, especially for additional calories. Because the patient most often experiences early satiety and loss of appetite, we recommend a consult with a nutritionist to address this and other issues. She must increase her daily dietary intake by about calories per day, calories more than a woman carrying a singleton gestation.

High-protein shakes are recommended given the high nutritional value. Because women carrying twins are at an increased risk of developing anemia, the Society of Maternal-Fetal Medicine recommends 30 milligrams of iron during the first trimester and 60 milligrams of iron until delivery. The Society of Maternal-Fetal Medicine also recommends that they take 1 mg of folic acid to prevent neural tube defects most prenatal vitamins have 0.

For dizygotic twins, there is a higher probability that one or more of the fetuses will have a trisomy, resulting in a higher overall risk to the pregnancy.

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Nobody wants a “science geek” as a doctor!

Pettker, MD; James D. Goldberg, MD; and Yasser Y. This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Accurate dating of pregnancy is important to improve outcomes and is a research and public health imperative. As soon as data from the last menstrual period, the first accurate ultrasound examination, or both are obtained, the gestational age and the estimated due date EDD should be determined, discussed with the patient, and documented clearly in the medical record.

Subsequent changes to the EDD should be reserved for rare circumstances, discussed with the patient, and documented clearly in the medical record. When determined from the methods outlined in this document for estimating the due date, gestational age at delivery represents the best obstetric estimate for the purpose of clinical care and should be recorded on the birth certificate.

For the purposes of research and surveillance, the best obstetric estimate, rather than estimates based on the last menstrual period alone, should be used as the measure for gestational age. Recommendations The American College of Obstetricians and Gynecologists, the American Institute of Ultrasound in Medicine, and the Society for Maternal—Fetal Medicine make the following recommendations regarding the method for estimating gestational age and due date:

US Early Pregnancy Template

The timing of certain tests, the monitoring of the baby’s growth, and the correct diagnosis of premature labor, or being truly “overdue,” postdates , as well as many other situations that arise in the course of a typical pregnancy, all depend on a correct determination of the EDC for appropriate management. In the past, the EDC was calculated by using Naegele’s Rule, which determined the date by subtracting 3 months from the 1st day of the last period and then adding 7 days.

In fact, when a woman who has very regular, “textbook” 28 day cycles presents for prenatal care, this often turns out to be the correct EDC more often than not. Other information used to calculate the gestational age, or the number of weeks and days from the first day of the last menstrual period LMP , includes the size of the uterus on pelvic bimanual examination. However, it is extremely common to encounter patients who have irregular or infrequent menstrual cycles, or have fibroid tumors that cause their uterus to feel enlarged on pelvic exam, or who conceive shortly after a pregnancy ends without ever actually having had a period after the last pregnancy , or who got pregnant while taking birth control pills, and these situations often render the above methods useless and misleading when trying to figure out a reliable EDC.

There is a slight increase in the risk of miscarriage:

This scan will also show if you are expecting a multiple pregnancy. What to Tell us? If you have recently experienced painful cramping or PV bleeding How to Prepare? Please drink 1 litre of water and hold for one hour prior to your appointment. Do not empty your bladder until after the examination. What does the procedure involve? The sonographer will tuck a piece of tissue into your underwear to protect your clothes, then drop some gel onto your abdomen.

This helps the scanning head to glide smoothly over your skin to get a clear image. Most dating scans are done with a trans-abdominal transducer and require a full bladder. However, if the pregnancy is in very early stages, the gestational sac and foetus may not be big enough to visualise and you may be offered an internal, transvaginal TV scan which will result in clearer images. How long will it take? When my results be available?

Your image films will be provided to you at the completion of appointment.

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