Obstetric ultrasonography, or ultrasound during pregnancy, is a frequent consult in radiology, whether it be early in pregnancy to evaluate intrauterine gestation, at mid-term to evaluate fetal anatomy, or at near-term when issues of fetal growth are at hand.
For many reasons, it is important to have a basic understanding of the obstetric ultrasound examination.
Including its indications, safety, and implications of imaging findings.
So, in this video I will discuss about those aspects in detail.
In the first trimester, identifying an intra-uterine gestational sac is a top priority.
In this image, the white arrow denotes the yolk sac within the gestational sac, which confirms the intrauterine pregnancy.
In addition to that, other indications for ultrasound scanning during the first trimester include the following.
To assess cardiac activity of the fetus, and to estimate gestational age.
Vaginal bleeding, pelvic pain, or any concern for an ectopic pregnancy.
To evaluate pelvic or uterine masses.
To assess for certain fetal anomalies in high-risk patients, including anencephaly.
When there is a concern for molar pregnancy.
And an adjunct to chorionic villus sampling, embryo transfer, or localization and removal of an intrauterine device.

Major indications for ultrasound scanning during the second and third trimesters include the following.
To assess the number of fetuses, presentation, and cardiac activity.
Amniotic fluid assessment.
To assess placental location and relationship to internal cervical os.
To measure the cervical length.
Gestational age measurement with comparison to clinical dating.
Fetal weight estimation.
And to assess the uterus of the mother.

Now let’s discuss a bit about the safety of an ultrasound scan.
Ultrasonography uses mechanical radiation in the form of sound waves to produce images.
This differs from the ionizing radiation involved in CT scanning and plain film radiography.
However, any radiation poses potential risks.
Despite the theoretical potential for harm, no data have shown any significant detrimental effect to the fetus from a routine obstetric ultrasound examination.
Therefore, it is considered as a safe procedure during pregnancy.
However, it is important to know that the quality and reliability of the results depend on the person who perform the test.

Preparation before the procedure is not required in ultrasonography.
Transvaginal route, where the ultrasound probe is inserted through the vagina, or transabdominal route, where the transducer is placed in the abdomen can be used to visualize the fetus.
Mother who undergoes the procedure should remove the clothes around her body where the probe is applied.
A coupling gel is used between the transducer and the skin to reduce acoustic impedance from environmental air.
The procedure usually takes a few minutes, and no anesthesia is required.

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