The use of ultrasound has been standard for detailed prenatal exams for decades. Now, according to a review article in the Archives of Gynecology and Obstetrics, point-of-care ultrasound (POCUS) should be considered a routine extension of practice for most OB/GYN clinicians as it can give immediate answers to what could be life-threatening situations for the mother and/or baby.
Ultrasound is very useful, particularly in obstetrics for providing real-time information that helps with clinical decision making. It can be useful in alleviating patient concerns or guiding clinical decision making,” says Dr. Ulrike Dehaeck, an obstetrician/gynecologist who provides care at her busy clinic and two large hospitals in Vancouver, Canada It is relevant to anybody who is providing care for pregnant patients, including family physicians, emergency room physicians, midwives, nurse practitioners and nurses.”
During a recent webinar, Dr. Ulrike presented her point-of-care ultrasound techniques for scanning the uterus and fetus as an extension of the routine visit, providing a more complete assessment of pregnancy, and relieving any anxiety her patients may have during their visit. She focused on exams to monitor the health of mothers and their fetuses during the third trimester of pregnancy.
Watch the webinar, «Third Trimester Obstetric Scans: Essential Point-of-Care Ultrasound Exams for Instant Answers», or scroll down for video highlights including how to confirm fetal viability and perform M-mode to assess cardiac rhythm and rate and assess overall fetal wellbeing.
Look for Fetal Cardiac Activity and Measure Heart Rate
Essential for confirming viability, especially when challenged with high BMI patients and multiple pregnancies. It’s quick, easy, and reassuring to patients.
Confirm Fetal Lie, Presentation and Placental Evaluation
In the 3rd trimester, especially near term, it’s helpful to know the position and presentation so we can move forward with delivery planning. Both can be confirmed with a quick ultrasound exam, and patient management can be expedited if necessary.
Detection of a low-lying placenta or placenta previa could significantly alter patient management, and a quick bedside ultrasound can easily confirm placental position. Placental thickness, uniformity, and cord insertion site can also be assessed during the exam.
Assess Amniotic Fluid Volume
The deepest vertical pocket (DVP) measurement is very amenable to bedside ultrasound – it’s quicker than measuring fluid in four quadrants to obtain the AFI, or amniotic fluid index. A DVP measurement of > 8 cm indicates polyhydramnios, versus oligohydramnios, which is less than 2 cm. Dr. Dehaeck demonstrates how to take a vertical measurement fluid measurement in this one-minute video.
Take Fetal Biometry Measurements
Biometric measurements can be done as part of an office visit if the patient is measuring large or small for gestational age. Dr. Dehaeck typically performs the BPD and head circumference measurements. Watch this video and learn how to perform fetal biometric measurements
Make It Meaningful with Act One
During an ultrasound exam, expecting parents enjoy receiving pictures of their baby. Act One is a feature that automatically creates an animated video from the images and cine clips captured during the exam. Then the video is easily and securely sent to their email address as a free keepsake.
For more information from Dr. Dehaeck about using POCUS in the third trimester, watch the full webinar.
Clarius Wireless Ultrasound for OB/GYN
Dr. Dehaeck uses the Clarius C3 HD3 for her OB/GYN practice. Clarius also offers the EC7 HD3, which is the world’s first wireless endocavity ultrasound scanner. Highly portable with high-definition imaging, the Clarius EC7 HD3 is a wide-band microconvex array scanner purposed-designed for early obstetrics, gynecology, IVF, pelvic, and urology exams.
Both options are available with an Advanced OB Package on the Clarius app that includes a comprehensive measurement package with several options for biometrics and reporting.