Lesson 1Landmarks for early pregnancy: gestational sac, yolk sac, fetal pole, decidual reaction, and double decidual signOutlines main ultrasound markers of early pregnancy, like gestational sac, yolk sac, fetal pole, and lining response, plus the double lining sign, normal progress, and timing by weeks.
Normal appearance of gestational sacYolk sac morphology and size limitsFetal pole visualization and timingDecidual reaction and double decidual signChronology of expected early findingsLesson 2Transabdominal acquisition: standard sagittal and transverse pelvic planes and uterine orientationHandles transabdominal pelvic scans in early pregnancy, including bladder prep, probe setup, routine side and cross planes, and womb position check to aid or replace internal scans when needed.
Bladder filling and patient positioningMidline sagittal pelvic overviewTransverse pelvic sweep and adnexal surveyIdentifying uterine version and flexionOptimizing depth, focus, and gain settingsLesson 3Assessment of free fluid in pelvis: location (Morison, pouch of Douglas), quantification, and clinical implicationsDescribes ordered check of free fluid in pelvis and upper belly, covering main areas, volume grading, and spotting thick clots, linking ultrasound to urgency like possible ectopic breaks.
Scanning pouch of Douglas and paracolic guttersRight upper quadrant and Morison’s pouchCharacterizing anechoic versus complex fluidSemi-quantitative grading of free fluidImplications for suspected ectopic ruptureLesson 4Measurements and documentation: mean sac diameter (MSD), crown-rump length (CRL), fetal heart motion and how to measure/recordSpecifies uniform sizes and records in early pregnancy, like MSD, CRL, and heart rate, with tips on tool placement, photo saving, video clips, and reports for dating and life checks.
Mean sac diameter technique and pitfallsCrown-rump length and dating chartsFetal heart rate measurement methodsImage labeling and cine loop storageIntegrating measurements into reportsLesson 5Safety, informed consent and infection control for transvaginal scanningCovers safety rules, consent process, and germ prevention for internal scans, including low-dose principles, attendant use, probe shields, deep cleaning, and kind talk for private exams.
ALARA and first-trimester safety indicesObtaining and documenting informed consentChaperone policies and patient dignityProbe covers, gel use, and barrier methodsHigh-level disinfection and traceabilityLesson 6Clinical indications, patient preparation: bladder filling protocols for transabdominal scanExamines reasons for first-trimester pelvic ultrasound and prep details, stressing bladder fill plans for outer scans, limits, and adjusting to signs and stability in patients.
Common indications in early pregnancyContraindications and relative limitationsBladder filling volumes and timingExplaining procedure and managing anxietyAdapting protocol to unstable patientsLesson 7Transvaginal acquisition: systematic sagittal and coronal views, uterine fundus-to-cervix sweep, adnexal interrogationProvides step-by-step internal scan guide, focusing on probe grip, ordered side and front sweeps, and full womb, neck, and side checks to best view early pregnancy and issues.
Patient positioning and probe insertion techniqueMidline uterine sagittal sweep fundus to cervixParamedian sagittal sweeps for uterine hornsCoronal plane acquisition and optimizationSystematic adnexal and cul-de-sac interrogationLesson 8Reporting language for viability, dating, and suspected ectopic pregnancy; recommended follow-up intervals and when urgent referral is neededSets uniform report words for life checks, dating, and possible ectopic cases, plus follow-up times, alert signs, and urgent send-off rules for safe care in Eritrea.
Structured report elements for early pregnancyStandard terms for viability and uncertaintyDating statements and measurement reportingSuggested follow-up and repeat scan timingWhen to escalate for urgent specialist reviewLesson 9Findings suggesting ectopic pregnancy: adnexal mass characteristics, tubal ring, and non-visualized IUP thresholds and beta-hCG correlationCovers ultrasound clues for ectopic pregnancy, like side masses, tube rings, and free fluid, plus missing womb pregnancy limits, hCG levels, and links to risks.
Typical tubal ring and adnexal mass patternsRing of fire and vascularity assessmentFree fluid patterns and hemoperitoneumDiscriminatory beta-hCG and absent IUPPregnancy of unknown location algorithmsLesson 10Criteria to confirm intrauterine pregnancy versus pseudogestational sacExplains ultrasound rules to verify true womb pregnancy against fake sacs, noting traps, timing, and patient data ties to prevent wrong calls and poor handling.
Sonographic features of true gestational sacDouble decidual and intradecidual signsCentral fluid collections and pseudosacsRole of yolk sac and fetal pole visualizationCorrelation with symptoms and serial beta-hCGLesson 11Probe selection and machine presets: transabdominal curvilinear and transvaginal endovaginal transducerDiscusses picking right probes and settings for first-trimester pelvic ultrasound, comparing outer curvilinear and inner types, and tuning frequency, depth, and exam needs.
Curvilinear versus endovaginal transducersChoosing frequency for body habitusPreset selection for early pregnancyAdjusting depth, focus, and dynamic rangeHarmonics and resolution versus penetration
