Ch 2 Intro Flashcards
What questions should we ask our pt before scanning?
-LMP
-Pain, bleeding, previous pregnancies, surgical procedures or pregnancy complications (such as preterm labour + cervical cerclage)
-Is there a positive pregnancy test
How much water must the pt drink for a TA 2nd + 3rd trimester exam?
2nd: 32oz water 1 hr before
3rd: 24oz water 1 hr before
How much water must the pt drink for an EV?
None, empty bladder
List reasons for a 2nd trimester exam?
-confirm IUP
-detailed anatomical assessment
-determine cause of vag bleeding/pain
-estimate gest age (usually growth exams tho)
-evaluate for multiple gestation
-confirm viability
-unable to hear FHR/decreased fetal movements
What is “viability” referring to?
If the baby can make it to term + be born (not simply if the baby is dead or alive)
List reasons for a 3rd trimester exam?
-evaluate growth
-decreased/increased SFH
-polyhydramnios
-follow up on previous abnormalities seen
-evaluate fetal position
-evaluate cervix length
-unable to hear FHR (very concerning in this tri)
-decreased fetal movements (very common reason for u/s)
Which TA probes are used?
-High frequency curvilinear probe is best
-Lower frequency 2.5 MHz sector probe on larger pt’s can be used
What structure are EV exams good at evaluating?
Cervix
Downside to higher frequency EV probes?
6-12MHz or more may not see fundus on larger uteruses
Why would a transperineal exam be done?
When EV can’t be done to evaluate the cervix due to infection, pt refusal, etc.
What 2 structures are transperineal exams good at visualizing?
-Lower uterine segment
-Cervix
Where should the focal zone be placed?
At or slightly below region of interest on image
What does a nuchal fold measure?
Thickness of skin behind the head (whereas nuchal translucency measures fluid)
How many measurements must we take for a BPD, HC, etc?
Min 2, do a 3rd if first two measurements are greater than 2-3cm within each other
Can we tell the pt the gender of the baby?
Nope!
Is 2nd or 3rd trimester best for imaging the heart?
2nd
Does 2nd or 3rd trimester have more routine images?
2nd!
Do we always image the cervix in the 3rd trimester?
No, only if less than 32 weeks
(doctor’s won’t intervene after 32 wks b/c there is nothing they can do that will change the outcome of the pregnancy)
Can pt’s come for an u/s just to find out the fetal sex?
No, exam time should not be extended + pt should not be rebooked if it is not seen. However, we should attempt to determine the gender throughout the exam.
