Lesson 1Landmarks for early pregnancy: gestational sac, yolk sac, fetal pole, decidual reaction, and double decidual signThis lesson describes main sonographic markers of early pregnancy, including gestational sac, yolk sac, fetal pole, and decidual reaction, and explains the double decidual sign, normal progression, and expected times by gestational age.
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 orientationThis lesson covers transabdominal pelvic scanning in early pregnancy, including bladder prep, probe setup, standard sagittal and transverse planes, and checking uterine position to support transvaginal imaging or when it's not suitable.
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 implicationsThis lesson explains thorough checks for free fluid in the pelvis and upper abdomen, including key areas, grading amounts, and spotting echogenic clots, linking findings to urgency and 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/recordThis lesson details standard measurements and recording in early pregnancy, including MSD, CRL, and fetal heart rate, with tips on caliper use, image saving, cine loops, and reporting for accurate 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 scanningThis lesson addresses safety rules, informed consent, and infection control for transvaginal scanning, including ALARA, chaperone use, probe covers, high-level cleaning, and 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 lesson reviews reasons for first-trimester pelvic ultrasound and patient prep details, emphasising bladder filling for transabdominal scans, contraindications, and adjusting to symptoms and blood pressure 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 lesson outlines step-by-step transvaginal scans, stressing probe handling, systematic sagittal and coronal sweeps, and full checks of uterus, cervix, and adnexa to best view early pregnancy and pelvic 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 neededThis lesson defines standard reporting words for viability, dating, and suspected ectopic pregnancy, and outlines follow-up times, warning signs, and criteria for urgent gynae or emergency referrals 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 correlationThis lesson details ultrasound signs raising ectopic pregnancy concerns, including adnexal masses, tubal ring, and free fluid, and explains nonvisualised IUP limits, beta-hCG levels, and links to clinical risks.
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 sacThis lesson explains sonographic criteria confirming true intrauterine pregnancy, differentiating from pseudogestational sacs, and highlights pitfalls, timing, and clinical data links to avoid wrong diagnoses and poor 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 transducerThis lesson covers picking right probes and presets for first-trimester pelvic ultrasound, comparing transabdominal curvilinear and transvaginal transducers, and tweaking frequency, depth, and exam settings.
Curvilinear versus endovaginal transducersChoosing frequency for body habitusPreset selection for early pregnancyAdjusting depth, focus, and dynamic rangeHarmonics and resolution versus penetration
