Lesson 1Landmarks for early pregnancy: gestational sac, yolk sac, fetal pole, decidual reaction, and double decidual signThis describe key ultrasound marks of early pregnancy, like gestational sac, yolk sac, fetal pole, lining reaction, and explain double lining sign, normal growth, expected time by pregnancy 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 orientationThis cover belly scan for early pregnancy pelvis, including bladder fill, probe direction, standard side and cross planes, check womb position to help vaginal scan or when not possible.
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 implicationsThis explain steady check of free fluid in pelvis and upper belly, key spots, grading amount, spotting bright clot, link ultrasound to urgency and possible outside womb break.
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/recordThis detail standard measures and writing in early pregnancy, like MSD, CRL, baby heart rate, guide on caliper place, image save, clips, reporting for true dating and life check.
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 scanningThis handle safety rules, agreement, infection control for vaginal scanning, including low dose, helper use, probe covers, deep clean, respectful talk about 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 scanThis review reasons for first-trimester pelvic ultrasound and detail patient prep, stress bladder fill for belly scans, no-go cases, fit to symptoms and blood flow status.
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 interrogationThis outline step-by-step vaginal scan, stress probe hold, steady side and front sweeps, full check of womb, neck, sides to best see early pregnancy and pelvis problems.
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 neededThis define standard writing for life check, dating, suspected outside womb pregnancy, outline follow-up times, danger signs, criteria for quick gyn or emergency send to help safe care.
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 correlationThis detail ultrasound signs worrying for outside womb pregnancy, like side masses, tube ring, free fluid, explain no womb pregnancy limits, beta-hCG levels, mix with risk factors.
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 sacThis explain ultrasound rules to confirm true womb pregnancy, tell from fake sac, highlight traps, time, mix with patient info to avoid wrong call and bad treatment.
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 transducerThis cover picking right probes and settings for first-trimester pelvic ultrasound, compare belly curved and vaginal probes, explain fix frequency, depth, exam settings.
Curvilinear versus endovaginal transducersChoosing frequency for body habitusPreset selection for early pregnancyAdjusting depth, focus, and dynamic rangeHarmonics and resolution versus penetration
