Introduction: The second trimester ultrasound remains an important screening tool for detecting fetal abnormalities. This pictorial guide for the second trimester ultrasound is designed to assist practitioners to produce a high quality diagnostic survey of the fetus by demonstrating and describing recommended images.
Methods: Each image is discussed in detail and has an associated drawn line diagram to aid in the identification of the important features of that image. There is a description of the salient landmarks and relevant measurements.
Result: The authors hope this article may act as a useful guide to all practitioners performing second trimester ultrasounds.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Objective
To ascertain Australian obstetric sonographers knowledge and current practice when assessing for vasa praevia in the mid‐trimester ultrasound with the view to improve prenatal diagnosis.
Methods
Between August and September 2018, a survey was emailed to 4868 Australian sonographers registered to participate in Australian Sonography Association Registry (ASAR) facilitated research projects. A total of 577 responses were received. The sonographers survey response was compared with published Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) recommendations.
Results
There appears to be an unfamiliarity with the RANZCOG recommendations, in particular that vasa praevia is defined as a fetal vessel lying within 20 mm of the cervical internal os (IOS). Transabdominally, if a vasa praevia risk factor is identified (including a fetal vessel observed in the lower uterine segment), less than 48% of surveyed sonographers proceed to a targeted transvaginal scan.
Conclusion
To enable effective diagnosis of vasa praevia, it is important to recognise associated risk factors that can raise suspicion for a potential vasa praevia; these are velamentous cord insertion, succenturiate lobe, and low‐lying placenta. A lower threshold of performing a transvaginal ultrasound when risk factors are identified (including a fetal vessel is identified in the lower uterine segment) may significantly improve vasa praevia diagnosis in the mid‐trimester ultrasound.
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