Aralin 1Placenta: lokasyon, morphology, at grading; assessment ng cord insertionIpinaliliwanag kung paano makilala ang placental site, grade, at morphology, makilala ang mga senyales ng previa at accreta spectrum, at suriin ang cord insertion, kabilang ang marginal, velamentous, at vasa previa patterns na nagbabago ng obstetric management.
Pagtukoy ng anterior, posterior, o fundal placentaLow-lying placenta at placenta previa criteriaPlacental lakes, thickness, at texture changesGrannum grading at clinical relevance limitsCord insertion: central, marginal, velamentousScreening para sa vasa previa at color Doppler useAralin 2Mga limitasyon ng ultrasound sa 21 linggo at kailan magrekomenda ng targeted tertiary referralPinag-aralan ang mga teknikal at biological na limitasyon ng 21-linggo na ultrasound, kabilang ang maternal habitus, fetal position, at equipment constraints, at tinukoy kung kailan ang hindi kumpletong views o hiniyanang anomalies ay nangangailangan ng targeted tertiary referral o repeat scans.
Impact ng maternal BMI, scars, at fibroidsFetal position, movement, at shadowing issuesEquipment resolution at operator dependenceKailan ang suboptimal views ay nagbibigay-katwiran sa repeat scanningCriteria para sa tertiary anomaly o cardiac referralPagpapahayag ng mga limitasyon nang malinaw sa mga clinicianAralin 3Pag-ulit ng clinical question at papel ng ultrasound sa mid-trimester painNakatuon sa paglilinaw ng clinical question sa mga babaeng may mid-trimester pain, pagtukoy ng papel ng ultrasound sa pagbubukod ng obstetric emergencies, pagsusuri ng cervix, placenta, membranes, at adnexa, at pagkilala kung kailan ang mga findings ay nangangailangan ng urgent escalation.
Paglilinaw ng pain onset, pattern, at associated signsPagsusuri ng fetal well-being sa panahon ng maternal painPagsusuri ng placenta, membranes, at retroplacental areaTransvaginal cervical length at funneling signsAdnexal, uterine, at urinary tract assessmentRed flags na nangangailangan ng urgent obstetric reviewAralin 4Pagpili ng probe, patient positioning at scanning planes para sa anatomy at biometryTinatalakay ang optimal na transducer types, frequency selection, patient positioning para sa comfort at image quality, at standard longitudinal, transverse, at oblique planes na kinakailangan upang makakuha ng reproducible anatomy at biometry measurements sa 21 linggo.
Pagpili at settings ng curved array probeMaternal positioning at tilt para sa kaligtasanTransverse at sagittal uterine survey planesStandard planes para sa head at brain biometryStandard planes para sa abdominal at femur biometryPag-optimize ng depth, focus, at gain controlsAralin 5Assessment ng Amniotic fluid: AFI at single deepest pocket technique at interpretationIpinaliliwanag ang mga metodo para sa pagsusuri ng amniotic fluid gamit ang AFI at single deepest pocket, kabilang ang measurement technique, normal ranges sa 21 linggo, at pagkilala ng oligohydramnios at polyhydramnios na may clinical implications.
Quadrant division at AFI measurement stepsSingle deepest pocket technique at limitsNormal fluid ranges para sa mid-trimester gestationOligohydramnios thresholds at implicationsPolyhydramnios thresholds at implicationsMga karaniwang technical errors at kung paano iwasan ang mga itoAralin 6Reporting structure para sa mid-trimester anatomy scan at key phrases na isasamaInilalarawan ang structured na mid-trimester report, kabilang ang mandatory headings, standard phrases, at recommended terminology para sa normal at abnormal findings, na nagsisiguro ng clarity, medicolegal robustness, at madaling paghahambing sa follow-up scans.
Essential report sections at layout orderStandard wording para sa normal fetal anatomyPaglalarawan ng soft markers at minor variantsClear phrasing para sa suspected major anomaliesPagdokumenta ng measurements at reference chartsRecommendations, follow-up, at disclaimer textAralin 7Indications at relevant maternal/fetal history na kukuhaninInilalahad ang key maternal at fetal indications para sa 21-linggo na scan, kabilang ang routine screening at high-risk scenarios, at tinukoy ang relevant history, medications, at prior imaging na dapat kukuhanin bago ang scanning.
Routine screening versus high-risk indicationsMaternal medical, surgical, at obstetric historyCurrent pregnancy complications at medicationsAssisted reproduction at multiple gestationsPrior ultrasound, screening, at lab resultsFamily history ng anomalies o genetic diseaseAralin 8Fetal presentation at lie, basic fetal Doppler targets (umbilical artery) at kailan gagamitinIpinaliliwanag ang assessment ng fetal lie, presentation, at placental relationship, at ipinakilala ang basic umbilical artery Doppler indications, technique, indices, at interpretation, kabilang ang kailan magdadagdag ng value ang Doppler sa 21 linggo.
Pagtukoy ng lie, presentation, at situsRelationship ng presenting part sa placentaUmbilical artery Doppler indications sa 21 linggoSampling technique at angle optimizationSystolic/diastolic ratio, PI, at RI basicsAbnormal waveforms at follow-up strategyAralin 9Relevant guideline references para sa obstetric dating at anomaly screening (kung paano hanapin)Gumagabay sa mga mag-aaral sa key international at national guidelines sa dating at anomaly screening, na nagpapaliwanag kung paano hanapin, interpretasyon, at paglalapat ng recommendations, kabilang ang measurement standards, timing windows, at documentation requirements.
Major societies: ISUOG, ACOG, SMFM, RCOGPag-access sa online guideline libraries at appsKey dating recommendations at CRL to biometryStandard anomaly screening checklists at timingPaggamit ng guideline charts at z-score calculatorsPagdokumenta ng adherence sa guideline standardsAralin 10Detailed fetal anatomy survey: organs at structures na susuriin sa 18–22 linggoInilalahad ang sistematikong fetal anatomical survey sa 18–22 linggo, kabilang ang brain, face, spine, thorax, heart, abdomen, kidneys, limbs, at genitalia, na may key normal landmarks at common structural anomalies na kinikilala at idinodokumento.
Cranial vault, midline, at posterior fossa viewsFacial profile, orbits, lips, at palate checksCervical, thoracic, lumbar, at sacral spine viewsFour-chamber heart at outflow tract viewsAbdominal wall, stomach, bowel, at kidneysLimbs, hands, feet, at genitalia assessmentAralin 11ALARA principle sa obstetric scanning at safety considerationsBinibigyang-diin ang ultrasound safety sa pagbubuntis, na nagdedetalye ng ALARA principle, prudent use ng output power at dwell time, pag-unawa sa TI at MI indices, at pag-iwas sa unnecessary Doppler exposure, lalo na sa early gestation at fetal brain.
Biological effects ng diagnostic ultrasoundPag-unawa sa TI at MI sa screenPaglalapat ng ALARA sa routine obstetric scansPaglilimita ng Doppler use at exposure timeSafety sa first-trimester at fetal brain scansPagbibigay ng payo sa mga pasyente tungkol sa ultrasound safetyAralin 12Biometry at dating: head, abdominal circumference, femur length norms at reference chartsTinatalakay ang standard biometric parameters sa 21 linggo, kabilang ang BPD, HC, AC, at FL, na may correct planes, caliper placement, at paggamit ng reference charts o z-scores para sa dating, growth assessment, at detection ng size discordance.
BPD at HC planes at caliper positioningAbdominal circumference plane at pitfallsFemur length technique at artifactsPagpili ng appropriate reference chartsPaggamit ng centiles at z-scores para sa datingPag-interpret ng small o large for gestational age
