Session #9

Step 12: Ultrasound

Step 12: UltrasoundIndication for testing: Positive Pregnancy Test (ONLY) Confirm the viability of pregnancy.

visualize your baby’s heartbeat within the uterus. 31% of all pregnancies are not viable. (it could be

miscarriage, ectopic pregnancy, or multiple other reasons why the pregnancy hormone would be in the urine).

Confirming how far along she is related to her last menstrual period (LMP).

Explain what you anticipate before the exam.

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Step 12: UltrasoundUltrasound Routine “Glamor Shot” Measurements:

Heart Rate Gestational age measurement (GS and/or CRL) Mid Line: TRV and LNG views

Adnexa (same for both right and left) RT ADN: TRV and LNG LT ADN: TRV and LNG Label and measure ovaries/corpus luteum if seen

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Step 12: UltrasoundImportance of pt being alone:

Allows her to “feel” and express a reaction to what she sees

Offers privacy if needing to do vaginal ultrasound

Information of ultrasound (dates, etc) may add to situation

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----+3-4 wks

More clarity++++12 wks

arms & legs moving, jaw lines, fingers

and toes

++++11 wks

face++++9-10 wks

arms, legs++++8-9 wks

--+++6-7 wks

--?++5-6 wks

---?+4-5 wks

Development(visualized)

MovementsFetal Heart Motion

Yolk Sac (YS)

Gestational Sac (GS)

Gestational Age

Step 12: Ultrasound

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Step 12: UltrasoundFirst Trimester Symptoms:

Frequent urinationSize of uterus v bladder capacity

Nausea and vomitingEstimated gestational age, typically subsides

around 12 weeks

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Step 12: UltrasoundScope of Information Provided:

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Ultrasound ExamResults

See What YouExpect to See

Didn’t See WhatYou Expect to See

Confirm ViabilityCan not Confirm

Viability(Before 6 Weeks)

Can not Confirm Viability

(After 6 Weeks)

Step 12: UltrasoundSee What You Expect To See:

See What You Expect to See

Confirm Viability Can’t Confirm Viability

So, You’re Pregnant Brochure

Reschedule for Repeat Ultrasound

Refer to physician for Prenatal Care

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Step 12: UltrasoundSaw What you Expect to See

See What You Expect to See

Confirm ViabilityCan’t Confirm

Viability

Give Miscarriage/Ectopic Pregnancy

Brochure

Reschedule for repeat ultrasound

one week

Refer her to physician

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Step 12: UltrasoundDidn’t See What You Expect to See

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Didn’t See What You Expect to See

Can’t Confirm Viability

Symptoms ED No Symptoms

Call Patient’s OBFor Plan

If no OB, ED

Step 12: UltrasoundWhat this exam does not include:

Sex of the baby

Diagnosis of pregnancy from an RN or Sonographer

Diagnosis/Opinion of what is wrong if you do not see what you expect to see (to the pt.)

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