Basic Obstetric Ultrasound: Background, Indications, Contraindications

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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.

Katherine Chen, MD, MPH, Professor and Vice Chair of Ob-Gyn at the Icahn School of Medicine at Mount Sinai says: “The ACOG EDD Calculator is an accurate app that received high marks for comprehensiveness, function and design, resulting in an APPLICATIONS© score of 13 out of

It includes your checkups and prenatal testing. Prenatal care can help keep you and your baby healthy. It lets your health care provider spot health problems early. Early treatment can cure many problems and prevent others. Your doctor or midwife will give you a schedule for your prenatal visits. If you are over 35 years old or your pregnancy is high risk because of health problems like diabetes or high blood pressure , your doctor or midwife will probably want to see you more often.

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Overview Overview The estimation of pregnancy dates is important for the mother, who wants to know when to expect the birth of her baby, and for her health care providers, so they may choose the times at which to perform various screening tests and assessments, [ 1 ] such as serum screening, assessment of maturity, and induction of labor for postdate pregnancies.

The 3 basic methods used to help estimate gestational age GA are menstrual history, clinical examination, and ultrasonography. The first 2 are subject to considerable error and should only be used when ultrasonography facilities are not available. The date of feeling the first fetal movements quickening is far too unreliable to be useful. The date of the first documented positive pregnancy test and the beta-human chorionic gonadotropin bHCG level may help ascertain the minimum gestational age.

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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. You can visit the page here.

Gestational age determination based on obstetric dating criteria, early pregnancy ultrasound scans, Dubowitz examinations, and ultrasound scans performed shortly before delivery were reviewed for 69 preterm infants requiring neonatal intensive care.

Monday, February 27, courtesy: ACOG has always strived to curb elective deliveries before 39 weeks of pregnancy and spread awareness among obstetricians about the negative effects of elective delivery before 39 weeks, which increases neonatal respiratory and nonrespiratory morbidities. As the woman advances into second and third trimester the reliability of USG for the purpose of dating decreases linearly. The guidelines for management are: The decision about timing the delivery in a suboptimally dated pregnancy should be based on the best clinical estimate of the gestational age.

There is no role for elective delivery in suboptimally dated pregnancies to avoid the neonatal morbidity because the pregnancy may be earlier in gestation than believed to be. Decision to administer antenatal corticosteroids should be based on the best clinical judgement if a woman with suboptimally dated pregnancy is identified to be at risk for preterm delivery.

A follow-up sonography after weeks of the initial one is always advisable in women with suboptimally dated pregnancies.

Clinical Guidelines

Definitions[ edit ] Surgery is a technology consisting of a physical intervention on tissues. As a general rule, a procedure is considered surgical when it involves cutting of a patient’s tissues or closure of a previously sustained wound. Other procedures that do not necessarily fall under this rubric, such as angioplasty or endoscopy , may be considered surgery if they involve “common” surgical procedure or settings, such as use of a sterile environment, anesthesia , antiseptic conditions, typical surgical instruments , and suturing or stapling.

Obstetric Ultrasound is the use of ultrasound scans in pregnancy. Since its introduction in the late ’s ultrasonography has become a very useful diagnostic tool in Obstetrics. Currently used equipments are known as real-time scanners, with which a continous picture .

Notes References This calculator gives you many options for estimating gestation and delivery dates. Input any or all parameters to compare the various date calculations. The Current Date is set to your local workstation date. Gestation by LMP is calculated from the first day of the last menstrual period. Gestation by CRL is calculated: This will be gestation at time of ultrasound. Gestation by BPD is calculated using the formula: Gestation by HC is calculated: A comparative analysis of second-trimester ultrasound dating formulae in pregnancies conceived with artificial reproductive techniques.

New charts for ultrasound dating of pregnancy. Legal Notices and Disclaimer All information contained in and produced by the MedCalc system is provided for educational purposes only.

Antenatal care for uncomplicated pregnancies

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.

• Relationships formed with OB-GYN’s and Perinatologists North and South • Alberta Society of Radiologists CME dedicated to Obstetrical Ultrasound quality • TOP CPG’s underway for: • Pregnancy Dating* New SOGC and TOP guidelines for Obstetrical Ultrasound.

Women who are pregnant, their families and carers Is this guideline up to date? Your responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Prior knowledge of obstetric gestational age and possible bias of Ballard score

Underestimation of gestational age by conventional crown-rump length growth curves. Reprinted with permission of American College of Obstetricians and Gynecologists Variations in the measurement of CRL can be attributed to differences in fetal growth patterns. Such differences are related to factors similar to those that influence birth weight curves, including maternal age and parity, prepregnancy maternal weight, geographic location, and population characteristics.

These include incorporation of the yolk sac or lower limbs in the CRL measurement, excessive curling or extension of the fetus, and tangential section of the trunk. The biparietal diameter BPD is one of the most commonly measured parameters in the fetus. Campbell was the first investigator to link fetal BPD to gestational age 20 ; however, since this original report, numerous publications on this subject have appeared in the literature.

The Mysterious World of OB Ultrasound Coding Lori-Lynne’s Bio: She is a Specialty based E&M, and Procedure Coding, Compliance, Data If the CPT ultrasound code criteria does not specify ‘units’ (such as in the code ) it should never be Congenital Defect A problem or condition existing at or dating from birth; acquired during.

Where possible, please refer to your local hospital or booking hospital for continuity of care. Please refer to the on-call gynaecology SHO for admission Negative pregnancy test. Please refer to the on-call gynaecology SHO Previous ectopic no symptoms. Please refer to the Ultrasound Department Southmead: Kathryn Lloyd For problems in the following instances: Carolyn Turville and Hazel Endean For problems in the following instances: Contact details for the Community Midwives can be obtained by contacting the Community Midwifery office on Women should be advised to book early in their pregnancy with the community midwife and definitely before 13 weeks gestation.

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Basic Obstetric Ultrasound — Introduction