The rising popularity of point-of-care ultrasound (POCUS) for obstetrics and midwifery has the potential to improve fetal and maternal outcomes across the globe. It provides the ability to make quicker and more accurate assessments. And in the first trimester, ultrasound assessments by midwives can have a particularly significant impact on the health and well-being of both the mother and the developing fetus.
To address the growing need for ultrasound education, we recently invited midwifery expert and ultrasound educator Carolyn Gegor to present two webinars covering ultrasound essentials for midwives. The first one-hour webinar: Early Pregnancy Care: 1st Trimester Ultrasound Essentials for Midwives, is available now to watch on demand.
Scroll down for some key clinical takeaways and two demonstration videos.
POCUS in Early Pregnancy: Benefits and Cautions
Advantages:
- Accessibility: POCUS devices are portable and easy to use, enabling bedside assessments.
- Timely Information: Get immediate answers to clinical questions, expediting patient management.
- Enhanced Confidence: Real-time imaging boosts provider confidence and reduces patient anxiety.
Cautions:
- Adequate Training: Hands-on training and understanding ultrasound principles are crucial.
- Clear Guidelines: Adhere to established guidelines for POCUS in midwifery practice.
- Equipment Maintenance: Ensure proper equipment maintenance for optimal image quality.
- Timely Referrals: Recognize limitations and refer patients for specialized care when needed.
1st Trimester Ultrasound: Clinical Applications
Confirming Pregnancy Location:
- Intrauterine Pregnancy (IUP): Visualize the gestational sac within the uterus, minimizing the risk of ectopic pregnancy.
- Ectopic Pregnancy: Suspect ectopic if no IUP is seen with a positive pregnancy test; requires immediate referral.
Assessing Fetal Well-being:
- Cardiac Activity: Document fetal heartbeat using M-Mode for accurate assessment.
- Gestational Age:
– Early Pregnancy: Use mean sac diameter (MSD) if no embryo is visible.
– Later 1st Trimester: Crown-rump length (CRL) provides the most accurate dating.
– After 12 Weeks: Biparietal diameter (BPD), abdominal circumference (AC), and femur length (FL) are used.
Identifying Complications:
- Early Pregnancy Loss: Empty sac, absent cardiac activity, or lack of embryo development indicate loss.
- Subchorionic Hemorrhage: Bleeding between the chorion and placenta; often resolves on its own.
- Multiple Gestations: Twins require referral for a comprehensive ultrasound to assess for potential complications.
VIDEO: 1ST Trimester Ultrasound Scan
Watch Shelley Guenther, CRGS, CRCS perform a 1st trimester pregnancy ultrasound using the Clarius C3 HD3 wireless handheld ultrasound scanner in under 3 minutes.
Documentation: A Critical Aspect
- Thorough Reporting: Include indication, patient history, exam findings, and follow-up recommendations.
- Image Storage: Save images to correlate with the report.
- Billing: Proper documentation is essential for billing purposes.
Recording patient data and notes is simple using the Clarius App. You can also record a full-length scan using the new Clarius Procedure Recording Mode. Watch this 1-minute video to learn more.
A 1st-trimester ultrasound scan is a powerful tool for midwives, enabling early detection of complications and accurate pregnancy dating. Integrating POCUS into your practice responsibly can enhance the quality of care you provide to both mother and baby. With some training, adherence to guidelines, and timely referrals, you’ll maximize the benefits of POCUS in early pregnancy care.
Get An Instant Window into the Health of Mothers and Their Fetuses with Clarius Ultrasound
Ideal for first visits, quick check-ups, and when you need to investigate pelvic pain, pre-term labor symptoms, and fetal viability, the Clarius C3 HD3 convex and EC7 HD3 endocavity scanners help deliver the image quality you need for a confident assessment.
Learn more about which scanner is right for you on our OB/GYN specialty page. Or contact us today to book a one-on-one virtual demo with one of our ultrasound experts.
