II. Indications
- Determination of Gestational age
- Diagnosis
- Suspected Miscarriage or fetal demise
- Vaginal Bleeding
- Pelvic Pain
- Suspected Multiple Gestation
- Suspected hydatiform mole
- Suspected Ectopic Pregnancy
- Size-date discrepancy
- Uterine or pelvic mass or abnormality
- Congenital anomalies
- Fetal Presentation
- Antenatal Monitoring
- Adjunct to obstetrical procedures
- ACOG recommends Ultrasound at 18 weeks for all patients
- Confirm dates and Fetal Survey
III. Efficacy
- Radius Study evaluated screening Ultrasounds
- Evaluated low risk patients (n=15,151)
- Found no benefit
- No difference in perinatal mortality
- No difference in birthweight or preterm birth
- Did not evaluate high risk patients or other benefits
- Risks of screening Ultrasounds
- False Positives
- Anxiety
- Unnecessary intervention
- False Negatives
- False sense of reassurance
- Expensive: $200-$300
- Patients now want recreational U/S or for sexing
- Safety
- Thermal index (heat) should be 2 Celsius or less
- Increased risk with Doppler Ultrasound
- Never use Doppler Ultrasound in the first trimester of a viable pregnancy
- Mechanical index should be 4 or less
- Possible association with Speech Delay in children
- Does not appear to be significant risk
- Thermal index (heat) should be 2 Celsius or less
- False Positives
- Benefits of screening:
- Accurate Gestational age
- Earlier detection (first trimester) of fetal anomaly
- Enhanced prenatal bonding