The document outlines a basic obstetric ultrasound training program aimed at educating healthcare professionals in rural areas to enhance patient care and reduce maternal mortality rates. It covers ultrasound principles, terminology, pregnancy assessments, and practical scanning techniques for effective decision-making in obstetric care. Key topics include early pregnancy scanning, including gestational sac and fetal measurements, as well as conditions like oligohydramnios and polyhydramnios.

1. {
WELCOME TO
SMART
SONOGRAPHY
knowledge with skill

2. BASIC OBSTETRIC
ULTRASOUND TRAINING
FOR HEALTHCARE
PROFESSIONALS

3. PURPOSE OF TRAINING:
To educate midwives, nurses and other health workers in
rural areas on the effective use of ultrasound in enhancing
patient care and reducing maternal mortality rate by making
prompt decisions that relates to the health of their patients.
PROGRAMME OUTLINE
 Ultrasound defined with brief history
 Basic ultrasound principle
 Ultrasound terminology
 Intro to Basic Obstetric ultrasound
 1st , 2nd, and 3rd trimester pregnancy
 Basic measurements used in 1st, 2nd ,and 3rd trimester
pregnancy
 Writing the obstetric ultrasound Report
 Hands-on practicals

4. WHAT IS ULTRASOUND?
1. High frequency sound[pressure]waves
2. >20,000HZ[2kHz] upper limit of
human hearing.
3. 2MHZ-10MHZ medical diagnostic
frequency range.
4. Ultrasound waves are created by a
vibrating crystal within a ceramic probe.
5. “Piezoelectric” principle- electric
current causes crystals to vibrate,
returning waves create electric current.

5. HISTORY OF ULTRASOUND
- First introduced to medical world
in 1950s.
- However, has its beginnings in the
1880s when Pierre Curie introduced
simple echo sounding methods.
- This led to the discovery of
SONAR- [Sound navigating and
ranging]

6. IN ULTRASOUND THE FOLLOWING EVENTS
HAPPEN:
-The ultrasound machine transmits high frequency [1-12
mhz] sound pulses into the body using the probe.
- The sound waves travel into the body and hit a
boundary between tissues [e.g between fluid and soft
tissue or between soft tissue and bone].
- Some of the sound waves reflect back to the probe
while some travel on further until they reach another
boundary and reflect back to the probe.
- The reflected waves are detected by the probe and
relayed to the machine.

7. {
ULTRASOUND TERMINOLOGY
HOMOGENEOUS: Refers to an even echo pattern or
reflections that are relative and uniform in composition.
HETEROGENEOUS: Refers to an uneven echo pattern
HYPERECHOIC:: A relative term that refers to the echoes
returned from a structure. Hyperechoic refers to a lesion or
tumour which produces a stronger echo than surrounding
structures or tissues.
HYPOECHOIC: Refers to structures that contain fewer or weaker
echoes than surrounding tissues.
ACOUSTIC ENHANCEMENT: It is also called posterior
enhancement. Refers to the increased echoes deep to structures
that transmit sound exceptionally well, like fluid filled
structures.
ACOUSTIC SHADOWING: Characterized by a signal void
behind structures that strongly absorb or reflect ultrasound
waves.

8. {
ULT. TERMINOLOGY CONT’D
ECHOGENICITY: Capacity of a structure in the path of an
ultrasound beam to reflect back sound waves.
HYPERCHOGENIC: Refers to materials that produces
echoes that are stronger than normal or surrounding tissues
ANECHOIC: Free from echoes or reverberations
COMPLEX: Lesions composed of anechoic[cystic] and
echogenic[ solid] components.
ECHOES: The reflection of an ultrasound wave back to the
transducer from a structure.

9. {
HOMOGENEOUS HETEROGENEOUS
HYPERECHOIC HYPOECHOIC
ULT. TERMINOLOGY PHOTOS

10. {
ANECHOIC
ULT. TERMINOLOGY PHOTOS
ACOUSTIC ENHANCEMENT ACLOUSTIC SHADOWING
HYPERECHOIC

11. {
TYPES OF ULTRASOUND
MACHINES AND PROBES

12. {
TYPES OF ULTRASOUND
MACHINES AND PROBES

13. {
THE EARLY PREGNANCY SCAN
The aims of early pregnancy scanning
are:
 Determine viability
 Gestational age
 Fetal number
 In addition, the adnexa should
be visualized to exclude
significant pathology

14. {
METHODS
 TRANSVAGINAL If 5-8
weeks
 TRANSABDOMINAL If 10-13
weeks

15. {

16. {
WHAT WILL I EXPERIENCE
DURING THE PROCEDURE?
--Most ultrasound examinations are painless, fast
and easy, usually no discomfort from pressure.
--If scanning is performed over an area of
tenderness, you may feel pressure or minor pain
from the transducer.
--With transvaginal ultrasound, there may be
minimal discomfort as the transducer is moved in
the vagina.
--Once the procedure is complete, the gel will be
wiped off your skin

17. {
GESTATIONAL SAC
+ Earliest sign of
pregnancy
+Seen at 4-4.5 weeks
+ It is intradecidual
+ Surrounded by decidual
reaction
+ Can be used for dating
+ A normal gestational sac
grows by 1mm per day

18. {
YOLK SAC
--Seen at 5 weeks
gestation.
--Differenciates true
pseudo gestational sac.
--Seen at 20mm sac
diametert abdominally
and 8mm sac diameter
vaginally.

19. ORDER OF FETAL STRUCTURES
Gestational sac- 4- 5 weeks
Yolk Sac – 5 to 6 weeks
Fetal pole – 6 to 7 weeks
Cardiac Activity- 6 to 7 weeks

20. EARLY PREGNANCY FAILURE
 Failed early pregnancy refers to the
death of the embryo and therefore ,
miscarriage.
 The most common cause of
embryonic death is a chromosomal
abnormality.

21. NON- VIABLE PREGNANCY
A Pregnancy is considered non-viable on transvaginal
scan if:
--No fetal heart beat where
-CRL is greater or equal
to 7mm.
--No fetal pole where:
-MSD is greater than 25mm with no embryo.
- Both fetus and gestational sac are expected to grow
1mm/day. Hence, absence or inadequate growth on
serial scans at least 7-10days apart is suggestive of
non-viability.

22. Other poor prognostic indicators
include;
--No yolk sac where:
MSD is greater than 8mm.
Embryo seen
-- Irregular gestational sac
--Low position of the gestational sac

23. ECTOPIC PREGNANCY

24. HOW TO MEASURE THE GS

25. HOW TO MEASURE USING CRL
CRL MEASUREMENT

26. {
NUCHAL TRANSLUCENCY
+ Nuchal translucency {NT} measurement
assesses the lymphatic fluid that
accumulates under the skin at the back of
the fetal neck.
+ The measurement is taken between 10-
14weeks
+ There is a 10percent of major abnormality
when the measurement is more than 3mm,
increasing to 90percent at more than 6mm.

27. {
NUCHAL TRANSLUCENCY MEASUREMENT

28. {
2ND & 3RD TRIMESTER MEASUREMENTS- BPD

29. {
OBSTETRIC USG IN 2ND & 3RD TRIMESTER
--Record placental position
--Establish fetal age and growth by
fetal biometry including;
-Bi-parietal diameter
-Head circumference
-Femur length
-Abdominal circumference

30. {
2ND & 3RD TRIMESTER USG
MEASUREMENT CONT’D-
femur length

31. {
2ND & 3RD USG MEASUREMENT CONT’D
ABDOMINAL CIRCUMFERENCE

32. {
2ND & 3RD TRIMESTER USG
HEAD CIRCUMFERENCE

33. {
AMNIOTIC FLUID
ASSESSMENT

34. {
OLIGOHYDRAMNIOS
-Defn: Considerate deficiency of amniotic
fluid volume <200mls, 0.5-5.5percent of all
pregnancies
-Reasons: Fetal diseases,[ malformations,
hypotrophia, acardiacus]: maternal diseases[
Diabetes with microangiopathy, gestosis],
PROM, bad hydration, post-term pregnancy.
-Symptoms: Decreased fluid, fetal
movements, circumference of the abdomen,
easy to feel fetus parts and hard to move
presenting parts.

35. {
POLYHYDRAMNIOS
Defn: Excess amniotic
fluid [the largest
single pocket
measuring 11cm
approximately]

36. {
OLIGOHYDRAMNIOS & POLYHYDRAMNIOS

37. Writing the obstetric
ultrasound Report

38. THANK YOU
If your choice is
SMART SONOGRAPHY,
your ultrasound worries
don’t exist.

39. LET’S DO IT.
IT’S HANDS-ON TIME.
LET’S GO SCANNING.

40. Website: www.smartsonography-gh.com
facebook: @smartsonogh
Phones: 0243044363/0542417210