Obstetrics & Gynecology (OB\GYN) Outline |
Anatomy and Physiology 25% |
Normal Anatomy and Physiology |
GYN |
Assess both adnexa (i.e., ovaries, fallopian tubes) |
Assess the endometrium |
Assess the uterus (i.e., position, orientation, contour) |
Assess the cervix |
Assess the cul-de-sacs |
Assess patients of reproductive age |
Assess postmenopausal patients |
Assess premenarcheal patients |
OB |
Identify structures in the first trimester obstetrical exam at less than 10 weeks (i.e., decidual reaction, gestational sac, yolk sac, embryo) |
Identify fetal anatomy in the first trimester obstetrical exam at 10-14 weeks (i.e., calvarium, stomach, cord insertion, extremities) |
Identify multiple gestations (i.e., fetal number, chorionicity/amnionicity) |
Assess the placenta (i.e., size, location) |
Assess the umbilical cord (i.e., insertion into placenta, vessel number) |
Assess amnionic fluid volume |
Assess fetal lie and presentation |
Assess the fetal heart (i.e., axis, chambers, outflow tracts) |
Assess the neck |
Assess intracranial structures |
Assess the facial anatomy (i.e., nose, lips, nasal bones, orbits, profile) |
Assess the diaphragm |
Assess the thorax (i.e., thymus, lungs) |
Assess the abdomen (i.e., gallbladder, stomach, liver) |
Assess the skeletal system (e.g., cranial contour, long bones evaluation, ribs, vertebrae, skull, spine) |
Assess the ankles and feet |
Assess the hands/fingers |
Assess the genitalia |
Pathology 41% |
Abnormal Physiology and Perfusion |
GYN |
Identify adnexal pathology other than ovarian |
Identify ovarian pathology |
Identify endometrial pathology (i.e., polyps, hyperplasia) |
Identify uterine masses (e.g., leiomyomas, sarcomas) |
Identify Müllerian duct developmental anomalies (e.g., septated, subseptate, bicornuate, unicornis uterus) |
Identify adenomyosis |
Identify cervical pathology (e.g., polyps) |
Identify free fluid in the pelvis |
Identify vaginal pathology (e.g., imperforated hymen) |
OB |
Identify maternal pelvic pathology |
Congenital Anomalies |
Assess multiple gestations (e.g., conjoined twins, acardiac twin, twin to twin transfusion syndrome, discordance) |
Identify abnormal multiple gestations |
Identify molar degeneration |
Identify ectopic pregnancy |
Identify embryonic/fetal demise |
Identify anembryonic pregnancy |
Identify abnormal trisomy (e.g., 13, 18, 21) |
Identify abnormal congenital anomalies |
Identify abnormal amniotic fluid volume |
Identify abnormal fetal growth |
Identify abnormal yolk sac |
Identify abnormal central nervous system anomaly (e.g., anencephaly, acrania, hydranencephaly, Dandy-Walker malformation, encephalocele) |
Identify abnormal intracranial structures (e.g., choroid plexus cyst) |
Identify a thickened nuchal translucency |
Identify abnormal face (i.e., nose/ lips, orbits, profile) |
Identify abnormal neck (e.g., goiter, cystic hygroma) |
Identify abnormal fetal heart (e.g., axis, chambers, outflow tracts) |
Identify abnormal diaphragm |
Identify abnormal thorax |
Identify abnormal abdomen (e.g., gallbladder, stomach, liver) |
Identify abnormal abdominal wall defect (e.g., omphalocele, gastroschisis) |
Identify abnormal umbilical cord (e.g., insertion, vessels) |
Identify abnormal gastrointestinal system (e.g., echogenic bowel, duodenal atresia, bowel obstruction, esophageal atresia, cysts) |
Identify abnormal genitourinary system (e.g., hydronephrosis, cystic renal dysplasia, hydroureter, renal agenesis, bladder outlet obstruction, ureterocele, abnormal genitalia, ovarian cyst) |
Identify abnormal genitalia |
Identify abnormal skeletal system (e.g., skull, spine) |
Identify abnormal ankles and feet (e.g., club feet, polydactyly) |
Identify abnormal hands/fingers |
Placental Abnormalities |
Identify previa |
Identify vasa previa |
Identify subchorionic hemorrhage |
Identify abruption |
Identify accreta, increta, percreta |
Identify infarction |
Identify abnormal membrane/insertion shape (i.e., circumvallate) |
Identify accessory lobe |
Identify masses (e.g., chorioangioma) |
Protocols 25% |
Clinical Standards and Guidelines |
Obtain pertinent clinical history as a part of the exam |
Correlate previous exams |
Review lab results as a part of the exam (e.g., hCG levels, CA 125) |
Perform quality assurance checks on the equipment |
Perform transabdominal technique |
Perform transvaginal technique |
Perform translabial technique |
Measurement Techniques |
GYN |
Measure endometrium thickness |
Measure ovarian dimensions |
Measure uterine dimensions |
Measure cervical length |
OB |
Perform biophysical profiles |
Measure amniotic fluid (i.e., amniotic fluid index, deepest pocket) |
Measure crown rump length |
Measure mean sac diameter |
Measure the yolk sac |
Measure biparietal diameter |
Measure biparietal diameter corrected |
Measure head circumference |
Measure cisterna magnum |
Measure cerebellum |
Measure transverse cerebellar diameter |
Measure cerebral lateral ventricle |
Measure cephalic index |
Measure nuchal translucency in first trimester |
Measure nuchal fold between 15 and 20 weeks' gestation |
Measure orbital, intraorbital and outer orbital diameters |
Measure nasal bone |
Measure abdomen circumference |
Measure humerus length |
Measure femur length |
Measure other long bones (e.g., radius, ulna, tibia) |
Physics and Instrumentation 8% |
Hemodynamics |
GYN |
Assess ovarian vasculature with Doppler |
Assess the uterine arteries with Doppler |
Assess arteriovenous malformations using Doppler |
OB |
Assess embryonic and/or fetal heart rate and rhythm with M-mode |
Assess the middle cerebral artery with Doppler |
Assess the ductus venosus |
Assess fetal heart rate using Doppler |
Assess the umbilical cord vessels with Doppler |
Imaging Instruments |
Apply M-mode |
Apply color flow imaging |
Apply power (angio, amplitude) Doppler |
Apply pulsed spectral Doppler |
Apply harmonics |
Perform 3-D imaging |
Apply knowledge of artifacts |
Treatment 1% |
Sonographer Role in Procedures |
Provide guidance for sonohysterography |
Provide guidance for amniocentesis after 15 weeks |
Provide guidance for chorionic villus sampling |