II. Indications

  1. Determination of Gestational age
  2. Diagnosis
    1. Suspected Miscarriage or fetal demise
    2. Vaginal Bleeding
    3. Pelvic Pain
    4. Suspected Multiple Gestation
    5. Suspected hydatiform mole
    6. Suspected Ectopic Pregnancy
    7. Size-date discrepancy
    8. Uterine or pelvic mass or abnormality
    9. Congenital anomalies
    10. Fetal Presentation
  3. Antenatal Monitoring
    1. Biophysical Profile (BPP)
    2. Intrauterine Growth Retardation (IUGR)
    3. Fetal Macrosomia
  4. Adjunct to obstetrical procedures
    1. Chorionic Villus Sampling
    2. Amniocentesis
    3. Cephalic Version
  5. ACOG recommends Ultrasound at 18 weeks for all patients
    1. Confirm dates and Fetal Survey

III. Efficacy

  1. Radius Study evaluated screening Ultrasounds
    1. Evaluated low risk patients (n=15,151)
    2. Found no benefit
      1. No difference in perinatal mortality
      2. No difference in birthweight or preterm birth
    3. Did not evaluate high risk patients or other benefits
  2. Risks of screening Ultrasounds
    1. False positives
      1. Anxiety
      2. Unnecessary intervention
    2. False negatives
      1. False sense of reassurance
    3. Expensive: $200-$300
    4. Patients now want recreational U/S or for sexing
    5. Safety
      1. Thermal index (heat) should be 2 Celsius or less
        1. Increased risk with doppler Ultrasound
        2. Never use doppler Ultrasound in the first trimester of a viable pregnancy
      2. Mechanical index should be 4 or less
      3. Possible association with Speech Delay in children
        1. Does not appear to be significant risk
  3. Benefits of screening:
    1. Accurate Gestational age
    2. Earlier detection (first trimester) of fetal anomaly
    3. Enhanced prenatal bonding

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Ontology: Fetal Ultrasonography (C0162502)

Concepts Diagnostic Procedure (T060)
MSH D016216
English Ultrasonography, Fetal, FETAL ULTRASONOGR, ULTRASONOGR FETAL, ultrasonography fetal, fetal ultrasonography, ultrasound fetal, fetal ultrasounds, fetal ultrasound, Ultrasound fetal, Ultrasound foetal, Fetal Ultrasound, Fetal Ultrasonography
Italian Ecografia fetale, Ultrasonografia fetale
Dutch echo, foetaal, echo foetaal, Ultrasonografie, foetale
French Echographie foetale, Échographie du foetus, Échographie foetale, Ultrasonographie foetale, Ultrason foetal
German Ultraschalluntersuchung fetal, Fetale Ultrasonographie, Ultraschall fetal, Ultrasonographie, fetale
Portuguese Ecografia fetal, Ultrassonografia Fetal, Ultra-som fetal
Japanese 胎児超音波検査, タイジチョウオンパケンサ
Spanish Ultrasonografía Fetal, Ecografía fetal
Czech Fetální ultrazvuk
Hungarian Ultrahang foetalis, Ultrahang magzati
Norwegian Føtal ultrasonografi, Føtal ultralydsundersøkelse, Føtal ultralyd, Ultralydsundersøkelse av foster, Ultrasonografi av foster