Lesson 1Machine settings and optimisation in pregnancy: depth, frequency selection, focal zone, image persistenceAddresses pregnancy-specific ultrasound tweaks, including depth, frequency, focal zones, gain, and persistence, to image maternal appendix, adnexa, and uterus safely with clear, repeatable diagnostic views.
Adjusting depth for gravid uterus and RLQFrequency selection for maternal and fetal targetsFocal zone placement over suspected appendixOptimizing gain, TGC, and dynamic rangeManaging persistence and frame rate tradeoffsLesson 2Clinical priorities and pregnancy-specific differentials: appendicitis, round ligament pain, obstetric complicationsReviews main differentials for RLQ pain at 24 weeks, blending obstetric and non-obstetric causes like appendicitis, round ligament pain, torsion, urine infection, and abruption, prioritising dangers via clinical info plus POCUS.
Risk stratifying suspected appendicitisDistinguishing round ligament pain on POCUSConsidering adnexal torsion and ovarian pathologyScreening for urinary and renal causesRecognizing obstetric emergencies in RLQ painLesson 3Targeted views: graded compression RLQ, transabdominal pelvic survey, limited obstetric views for fetal heart activitySpecifies must-have views for pregnant RLQ POCUS, like graded compression right lower quadrant, transabdominal pelvic check, and basic obstetric views for fetal heartbeat and placenta site for pain and surgery planning.
Standard graded compression RLQ sweepTransabdominal pelvic and adnexal surveyLimited fetal heart activity confirmationAssessing placental location and previa riskDocumenting and archiving key cine loopsLesson 4Limitations and pitfalls in pregnant abdominal POCUS: obscured appendix by gravid uterus, operator dependency, when to obtain MRI or surgical reviewCovers frequent errors in pregnant abdominal POCUS, like limited views from gravid uterus, bowel gas, operator skill gaps, and when unclear scans need MRI, surgical check, or other imaging to prevent delayed appendicitis treatment.
Obscured appendix from gravid uterus and bowel gasFalse reassurance from incomplete visualizationOperator dependency and learning curve issuesRecognizing nondiagnostic or equivocal scansIndications to escalate to MRI or surgeryLesson 5Structured scan order and rationale to minimise fetal exposure and maximise diagnostic yieldDescribes logical scan flow minimising fetal exposure while boosting yield, starting maternal survey, focused RLQ, targeted pelvic/fetal checks, and safe stop or extend rules.
Pre‑scan planning and informed explanationInitial global maternal abdominal sweepFocused RLQ and pelvic targeted passesBrief confirmatory fetal assessmentTime limits and ALARA considerationsLesson 6POCUS diagnostic goals in pregnancy: graded compression for appendicitis, viability and placental assessmentClarifies POCUS aims here: graded compression for appendicitis, fetal viability check, placenta/adnexa screen, and when ultrasound suffices versus needing more scans.
Defining focused clinical questions before scanGraded compression endpoints for appendicitisConfirming fetal viability and basic well‑beingScreening placenta and adnexa for pathologyDetermining when POCUS is sufficient or limitedLesson 7Landmarks and scanning technique: psoas muscle, iliac vessels, appendix landmarks, fetal cardiac activityReviews anatomy markers and scan tips for RLQ POCUS in pregnancy, like psoas, iliac vessels, caecum, appendix spot, plus fetal heartbeat views keeping mum comfortable with good images.
Identifying cecum, psoas, and iliac vesselsTracking the terminal ileum to the appendixProbe pressure and graded compression methodAdjusting windows around the gravid uterusFetal heart view acquisition and confirmationLesson 8How POCUS findings change immediate management: surgical consult, obstetric activation, antibiotics, analgesia and imaging choicesShows how POCUS patterns direct quick calls, like surgical/obstetric consult timing, antibiotics start, pain relief picks, and CT/MRI/serial ultrasound choice in stable 24-week pregnancy.
POCUS triggers for urgent surgical consultWhen to activate obstetric or maternal‑fetal teamsAntibiotic decisions based on POCUS likelihoodAnalgesia planning with uncertain diagnosisChoosing CT, MRI, or repeat ultrasoundLesson 9POCUS findings consistent with appendicitis, adnexal torsion suspicion, obstetric emergencies (placental abruption indicators)Sums up POCUS signs hinting appendicitis, adnexal torsion, obstetric crises like abruption, key ultrasound clues, supporting finds, and urgent multi-team flags.
Noncompressible blind‑ending tubular appendixPeriappendiceal fluid and fat stranding signsAdnexal torsion whirlpool and edema featuresPlacental abruption hematoma indicatorsIntegrating POCUS with labs and vital signsLesson 10Probe selection and use of curvilinear and linear probes for abdominal and superficial pelvic scanningGuides probe pick for pregnant RLQ/pelvic scans, comparing curvilinear/linear, frequencies, views, ideal for appendix/adnexa/superficial bits, balancing depth, sharpness, comfort.
Curvilinear probe for deep maternal structuresLinear probe for superficial RLQ and wallSwitching probes during graded compressionOptimizing presets for obstetric versus abdomenErgonomics and patient positioning with probes
