Lesson 1Landmarks for early pregnancy: gestational sac, yolk sac, fetal pole, decidual reaction, and double decidual signOutlines main ultrasound markers in early pregnancy, like gestational sac, yolk sac, fetal pole, and decidual changes, plus the double decidual sign, normal progression, and timing by weeks.
Normal appearance of gestational sacYolk sac morphology and size limitsFetal pole visualisation 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, standard sagittal and transverse planes, and uterine position to support or replace transvaginal scans when needed.
Bladder filling and patient positioningMidline sagittal pelvic overviewTransverse pelvic sweep and adnexal surveyIdentifying uterine version and flexionOptimising depth, focus, and gain settingsLesson 3Assessment of free fluid in pelvis: location (Morison, pouch of Douglas), quantification, and clinical implicationsDetails checking free fluid in pelvis and upper abdomen, covering main areas, volume grading, and spotting clotted fluid, linking scans to urgency like possible ectopic breaks.
Scanning pouch of Douglas and paracolic guttersRight upper quadrant and Morison’s pouchCharacterising 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/recordCovers standard measures and records in early pregnancy, like MSD, CRL, and heart rate, with tips on caliper use, image saving, clips, and reports for dating and viability.
Mean sac diameter technique and pitfallsCrown-rump length and dating chartsFetal heart rate measurement methodsImage labelling and cine loop storageIntegrating measurements into reportsLesson 5Safety, informed consent and infection control for transvaginal scanningCovers safety rules, consent, and infection steps for transvaginal scans, including ALARA, chaperones, probe covers, disinfection, and sensitive 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 scanReviews reasons for first-trimester pelvic ultrasound and prep details, stressing bladder fill for transabdominal, limits, and adjusting to symptoms and stability.
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 a step-by-step transvaginal scan guide, focusing on probe handling, sagittal and coronal sweeps, and full check of uterus, cervix, and adnexa for early pregnancy and issues.
Patient positioning and probe insertion techniqueMidline uterine sagittal sweep fundus to cervixParamedian sagittal sweeps for uterine hornsCoronal plane acquisition and optimisationSystematic 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 standard report terms for viability, dating, and possible ectopic, plus follow-up times, alert signs, and urgent referral rules for 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-visualised IUP thresholds and beta-hCG correlationCovers scan signs hinting at ectopic pregnancy, like adnexal lumps, tubal ring, and free fluid, plus no IUP limits, hCG levels, and risk factors.
Typical tubal ring and adnexal mass patternsRing of fire and vascularity assessmentFree fluid patterns and haemoperitoneumDiscriminatory beta-hCG and absent IUPPregnancy of unknown location algorithmsLesson 10Criteria to confirm intrauterine pregnancy versus pseudogestational sacClarifies scan rules to verify true intrauterine pregnancy over fake sacs, noting traps, timing, and data links to prevent wrong calls and management.
Sonographic features of true gestational sacDouble decidual and intradecidual signsCentral fluid collections and pseudosacsRole of yolk sac and fetal pole visualisationCorrelation with symptoms and serial beta-hCGLesson 11Probe selection and machine presets: transabdominal curvilinear and transvaginal endovaginal transducerDiscusses picking probes and presets for first-trimester pelvic ultrasound, comparing transabdominal curvilinear and transvaginal types, and tuning frequency, depth, and settings.
Curvilinear versus endovaginal transducersChoosing frequency for body habitusPreset selection for early pregnancyAdjusting depth, focus, and dynamic rangeHarmonics and resolution versus penetration
