FETAL ULTRASOUND MEASUREMENTS AND GUIDELINES

1ST TRIMESTER MEASUREMENTS 1ST TRIMESTER ANATOMY

QUALITY CRITERIA
HEAD ABDOMEN
¡ Present ¡ Stomach present in LUQ
CRL ¡ Cranial bones ¡ Abdominal wall
¡ The midline facial profile, fetal spine and rump should ALL be ¡ Midline falx ¡ Normal cord insertion
visible in one complete image ¡ Choroid filled ventricles ¡ Bladder
¡ There should be fluid visible between the chin and the chest   ¡ Kidneys
of the fetus AND the ‘profile line’ should form an acute angle NECK ¡ No umbilical defects
with the CRL line before the rump ¡ Normal appearance
¡ The fetus should be as horizontal with line connecting the ¡ Nuchal translucency EXTREMITIES
crown and rump at between 75-90º to the ultrasound beam CROWN-RUMP LENGTH KIDNEY HEART (if accepted after ¡ 4 limbs with 3 segments
¡ The crown and rump should be clearly visible at both ends informed consent ¡ Normal orientation of
¡ The intersection of the calipers should be on the outer and trained/certified hands and feet
borders of the skin over the crown and rump operator available)
PLACENTA
¡ The fetus should fill more than 2/3rd of the image clearly
FACE ¡ Size and texture
demonstrating the crown and rump
¡ Eyes with lens
¡ Nasal bone CORD
NT ¡ Normal profile/mandible ¡ Three vessel cord
¡ The fetus should be in neutral position ¡ Intact lips  
¡ Skin continuity should be clearly visible NT = Nuchal translucency;
¡ Strict sagittal section SPINE LUQ = left upper quadrant;
¡ Calipers should be placed correctly (on-on) to measure NT ¡ Vertebra longitudinal
¡ The amniotic membrane should be identified separately
NUCHAL TRANSLUCENCY SPINE BLADDER and axial
from the fetus ¡ Intact overlying skin
¡ Adequate zoom
CHEST
¡ Symmetrical lung fields,
BPD no effusions or masses
¡ Largest true symmetrical axial view of the fetal head
 
¡ Midline third ventricle and inter-hemispheric fissure and
choroid plexi should be visible
HEART Obstetrics
¡ Cardiac regular activity
¡ Correct axial orientation is confirmed by including both ¡ 4 symmetrical chambers
anterior horns and low occipital lobes of the cerebral ventricles  
in the image, whilst keeping the plane above the cerebellum
¡ Adequate zoom BIPARIETAL DIAMETER EXTREMITIES ABDOMEN
Poster based on the ISUOG practice guidelines:  performance of first-trimester fetal ultrasound scan. Salomon LJ, Alfirevic Z, Bilardo CM, Chalouhi GE, Ghi T, Kagan KO, Lau TK, Papageorghiou AT, Raine-Fenning NJ, Stirnemann J, Suresh S, Tabor A, Timor-Tritsch IE, Toi A, Yeo G.Ultrasound Obstet
Gynecol. 2013 Jan;41(1):102-13. doi: 10.1002/uog.12342. Images courtesy of JP Bault. Images are for educational purposes only. They do not correspond necessarily to standardized planes to be produced as part of routine US examination. NB: Note that Doppler use is not recommended as part
of routine examination in the first trimester.

IMAGE QUALITY PROCESS: FETAL VOLUSON* TOOLS:

1 Depth adaptation
2 Focal adaptation
3 Frequency adaptation
4 Gain adaptation
Sonobiometry SonoNT Scan Assist Multiplanar view STIC OmniView HDlive
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